Anesthesia and analgesia
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Caring for the Jehovah's Witness parturient is a complex task that presents a number of ethical, medical, and legal concerns because many Jehovah's Witnesses refuse allogeneic blood transfusion. Childbirth and its surrounding events may be associated with significant blood loss. Given their significant role in the intraoperative administration of blood products, anesthesia providers should be familiar with factors that must be considered in the perioperative care of Jehovah's Witness parturients. ⋯ Therefore, the patient-physician relationship must ensure that the individual patient's desires are accurately communicated, respected, and documented in the patient's medical record. The Perioperative Surgical Home model is appropriate for use in caring for Jehovah's Witness patients because it allows for the early and continuing coordination of care and communication between the patient and a multidisciplinary team. In this article, we present a focused review of concepts important to the provision of anesthetic care of parturients who are Jehovah's Witnesses and introduce an algorithmic perioperative approach that may be applied to the care of the Jehovah's Witness parturient undergoing an operative procedure.
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Anesthesia and analgesia · Dec 2015
Randomized Controlled TrialA Randomized Trial of a Supplemental Alarm for Critically Low Systolic Blood Pressure.
Intraoperative hypotension is associated with complications that might be ameliorated by earlier intervention. We therefore tested the primary hypothesis that a supplemental decision support alert for critically low systolic blood pressure (SBP) decreases the duration of intraoperative hypotension. ⋯ An additional warning for severe hypotension did not reduce the duration of hypotension or hospitalization. Decision support alerts may be more useful for more complicated situations.
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The last decade has seen an explosion in the growth of digital data. Since 2005, the total amount of digital data created or replicated on all platforms and devices has been doubling every 2 years, from an estimated 132 exabytes (132 billion gigabytes) in 2005 to 4.4 zettabytes (4.4 trillion gigabytes) in 2013, and a projected 44 zettabytes (44 trillion gigabytes) in 2020. This growth has been driven in large part by the rise of social media along with more powerful and connected mobile devices, with an estimated 75% of information in the digital universe generated by individuals rather than entities. ⋯ The amount of accumulating data has become so large that it has given rise to the term Big Data. In many ways, Big Data is just a buzzword, a phrase that is often misunderstood and misused to describe any sort of data, no matter the size or complexity. However, there is truth to the assertion that some data sets truly require new management and analysis techniques.