scholarly journals Effect of Procedure Simulation Workshops on Resident Procedural Confidence and Competence

2012 ◽  
Vol 4 (4) ◽  
pp. 479-485 ◽  
Author(s):  
Erin M. Augustine ◽  
Madelyn Kahana
Keyword(s):  
Airway Management ◽  
Lumbar Puncture ◽  
Vascular Access ◽  
Clinical Setting ◽  
Chest Tube ◽  
Tube Placement ◽  
Senior Year ◽  
Chest Tube Placement ◽  
Before And After ◽  
The Relationship

Abstract Background Pediatrics residents perform a limited number of some procedures in the clinical setting and may benefit from procedure simulation workshops. Objective To examine (1) the number and types of procedures performed by pediatrics residents in the clinical setting, (2) the relationship between the number of procedures performed and self-reported procedural confidence and competence, and (3) the effect of a procedure simulation workshop on self-reported procedural confidence and competence. Methods Pediatrics residents at Lucile Packard Children's Hospital at Stanford attended a half-day procedure workshop, rotating between 6 procedure simulation stations: vascular access, airway management, bladder catheterization, chest tube placement, lumbar puncture, and umbilical lines. Residents completed a survey immediately before and after the workshop to self-assess procedural confidence and competence. Results Seventy-two residents participated in a procedure workshop. The average number of procedures performed increased significantly from intern to junior to senior year. A positive correlation was found between number of procedures performed and preworkshop confidence (P < .001, R2  =  0.86) and competence (P < .001, R2  =  0.88). For each procedure assessed, completion of the procedure simulation workshop resulted in a statistically significant (P < .001) increase in self-perceived confidence (14%–131%; average, 48%) and competence (12%–119%; average, 50%). Statistically significant (P < .05) increases remained when results for interns, juniors, and seniors were examined separately. Conclusion Procedure simulation workshops improve resident self-reported procedural confidence and competence, particularly for procedures that are least performed.

Cardiopulmonary Diseases: Nonvascular Diseases

2018 ◽  
pp. 351-359
Author(s):  
John Smirniotopoulos ◽  
William F. Browne ◽  
Resmi A. Charalel
Keyword(s):  
Thoracic Duct ◽  
Clinical Setting ◽  
Chest Tube ◽  
Tube Thoracostomy ◽  
Tube Placement ◽  
Pleural Effusions ◽  
Interventional Radiologist ◽  
Chest Tube Placement ◽  
Image Guided ◽  
System P

Pleural effusions are frequently encountered in the clinical setting, affect thousands of patients annually, and have numerous etiologies. The interventional radiologist has an important set of tools available for the treatment of pleural effusions, ranging from image-guided chest tube placement to thoracic duct (TD) embolization. Knowledge of these nonvascular percutaneous interventions is an essential part of the basic and advanced toolset for every practicing interventional radiologist. An understanding of the pathophysiology of various pleural pathologies, the appropriate indications for small-caliber tube thoracostomy placement, and the management of chest tubes in the periprocedural setting is vital for appropriate patient care. In this chapter, the etiologies, management protocols, and techniques for treatment of several types of pleural effusions are reviewed, with a special look at the lymphatic system.

scholarly journals Comparison of non-intubated and intubated video-assisted thoracoscopic surgeries of major pulmonary resections for lung cancer—a meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Wenfei Xue ◽  
Guochen Duan ◽  
Xiaopeng Zhang ◽  
Hua Zhang ◽  
Qingtao Zhao ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Thoracic Surgery ◽  
Postoperative Complication ◽  
Complication Rate ◽  
Chest Tube ◽  
Meta Analysis ◽  
Tube Placement ◽  
Postoperative Complication Rate ◽  
Chest Tube Placement ◽  
Video Assisted

Abstract Objective The aim of this study was to compare the safety feasibility and safety feasibility of non-intubated (NIVATS) and intubated video-assisted thoracoscopic surgeries (IVATS) during major pulmonary resections. Methods A meta-analysis of eight studies was conducted to compare the real effects of two lobectomy or segmentectomy approaches during major pulmonary resections. Results Results showed that the patients using NIVATS had a greatly shorter hospital stay and chest-tube placement time (weighted mean difference (WMD): − 1.04 days; 95% CI − 1.50 to − 0.58; P < 0.01) WMD − 0.71 days; 95% confidence interval (CI), − 1.08 to − 0.34; P < 0.01, respectively) while compared to those with IVATS. There were no significant differences in postoperative complication rate, surgical duration, and the number of dissected lymph nodes. However, through the analysis of highly selected patients with lung cancer in early stage, the rate of postoperative complication in the NIVATS group was lower than that in the IVATS group [odds ratio (OR) 0.44; 95% CI 0.21–0.92; P = 0.03, I2 = 0%]. Conclusions Although the comparable postoperative complication rate was observed for major thoracic surgery in two surgical procedures, the NIVATS method could significantly shorten the hospitalized stay and chest-tube placement time compared with IVATS. Therefore, for highly selected patients, NIVATS is regarded as a safe and technically feasible procedure for major thoracic surgery. The assessment of the safety and feasibility for patients undergoing NIVATS needs further multi-center prospective clinical trials.

scholarly journals An alternative chest tube placement after uniportal video-assisted thoracic surgery

2018 ◽  
Vol 10 (5) ◽  
pp. 3078-3080
Author(s):  
Alessandro Palleschi ◽  
Paolo Mendogni ◽  
Alessio Vincenzo Mariolo ◽  
Mario Nosotti ◽  
Lorenzo Rosso
Keyword(s):  
Thoracic Surgery ◽  
Chest Tube ◽  
Tube Placement ◽  
Chest Tube Placement ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted

Uncommon complications during chest tube placement

2002 ◽  
Vol 28 (6) ◽  
pp. 812-813 ◽  
Author(s):  
Sophie M. Jaillard ◽  
Alain Tremblay ◽  
Massimo Conti ◽  
Alain J. Wurtz
Keyword(s):  
Chest Tube ◽  
Tube Placement ◽  
Chest Tube Placement

Effect of Intraparenchymal Blood Patch on Rates of Pneumothorax and Pneumothorax Requiring Chest Tube Placement After Percutaneous Lung Biopsy

2013 ◽  
Vol 200 (6) ◽  
pp. 1238-1243 ◽  
Author(s):  
LaDonna J. Malone ◽  
Robert M. Stanfill ◽  
Huaping Wang ◽  
Kevin M. Fahey ◽  
Raymond E. Bertino
Keyword(s):  
Chest Tube ◽  
Lung Biopsy ◽  
Tube Placement ◽  
Chest Tube Placement ◽  
Blood Patch ◽  
Percutaneous Lung Biopsy

scholarly journals Pre-Hospital and In-Hospital Thoracostomy: Indications and Complications

2008 ◽  
Vol 90 (1) ◽  
pp. 54-57 ◽  
Author(s):  
Christopher J Aylwin ◽  
Karim Brohi ◽  
Gareth D Davies ◽  
Michael S Walsh
Keyword(s):  
Emergency Department ◽  
Chest Tube ◽  
Tension Pneumothorax ◽  
Tube Placement ◽  
Thoracic Injury ◽  
Complication Rates ◽  
Pleural Drainage ◽  
Chest Tubes ◽  
Chest Tube Placement ◽  
Output State

INTRODUCTION Pleural drainage with chest tube insertion for thoracic trauma is a common and often life-saving technique. Although considered a simple procedure, complication rates have been reported to be 2–25%. We conducted a prospective cohort observational study of emergency pleural drainage procedures to validate the indications for pre-hospital thoracostomy and to identify complications from both pre- and in-hospital thoracostomies. PATIENTS AND METHODS Data were collected over a 7-month period on all patients receiving either pre-hospital thoracostomy or emergency department tube thoracostomy. Outcome measures were appropriate indications, errors in tube placement and subsequent complications. RESULTS Ninety-one chest tubes were placed into 52 patients. Sixty-five thoracostomies were performed in the field without chest tube placement. Twenty-six procedures were performed following emergency department identification of thoracic injury. Of the 65 pre-hospital thoracostomies, 40 (61%) were for appropriate indications of suspected tension pneumothorax or a low output state. The overall complication rate was 14% of which 9% were classified as major and three patients required surgical intervention. Twenty-eight (31%) chest tubes were poorly positioned and 15 (17%) of these required repositioning. CONCLUSIONS Pleural drainage techniques may be complicated and have the potential to cause life-threatening injury. Pre-hospital thoracostomies have the same potential risks as in-hospital procedures and attention must be paid to insertion techniques under difficult scene conditions. In-hospital chest tube placement complication rates remain uncomfortably high, and attention must be placed on training and assessment of staff in this basic procedure.

Efficiency and Safety of Patent Ductus Arteriosus Surgical Ligation in Extremely Low Birth Weight Infants Without Chest Tube Placement

2021 ◽  
Author(s):  
Georgios Kourelis ◽  
Meletios Kanakis ◽  
Constantinos Loukas ◽  
Felicia Kakava ◽  
Konstantinos Kyriakoulis ◽  
...  
Keyword(s):  
Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Chest Tube ◽  
Ductus Arteriosus ◽  
Extremely Low Birth Weight ◽  
Tube Placement ◽  
Chest Tube Placement ◽  
Surgical Ligation ◽  
Patent Ductus

AbstractPatent ductus arteriosus (PDA) has been associated with increased morbidity and mortality in preterm infants. Surgical ligation (SL) is generally performed in symptomatic infants when medical management is contraindicated or has failed. We retrospectively reviewed our institution's experience in surgical management of PDA for extremely low birth weight (ELBW) infants without chest tube placement assessing its efficiency and safety. We evaluated 17 consecutive ELBW infants undergoing SL for symptomatic PDA (January 2012–January 2018) with subsequent follow-up for 6 months postdischarge. Patients consisted of 9 (53%) females and 8 (47%) males. Mean gestational age (GA) at birth was 27.9 ± 2.1 weeks. Median values for surgical age (SA) from birth to operation was 10 days (interquartile range [IQR]: 8–12); PDA diameter 3.4 mm (IQR: 3.2–3.5); surgical weight (SW) 750 g (IQR: 680–850); and days of mechanical ventilation (DMV) as estimated by Kaplan–Meier curve 22 days (95% confidence interval: 14.2–29.8). We observed a statistically significant negative association between DMV and GA at birth (rho = − 0.587, p = 0.017), SA (rho = − 0.629, p = 0.009) and SW (rho = − 0.737, p = 0.001). One patient experienced left laryngeal nerve palsy confirmed by laryngoscopy. Otherwise, there were no adverse events to include surgical-related mortality, recurrence of PDA, or need for chest tube placement during follow-up. SL of PDA in ELBW infants without chest tube placement is both efficient and safe. Universal consensus recommendations for the management of PDA in ELBW neonates are needed. Further study is required regarding the use of the less invasive option of percutaneous PDA closure in ELBW infants.

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