Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Anesthesia-related activities contribute to operating room waste impacting climate change. The aim of this study was to ascertain 1) the current existence and scope of department and education programs concerned with anesthesia "green" practice; and 2) perceived barriers to environmental sustainability efforts among Canadian anesthesia department chiefs and residency program directors. ⋯ Our results highlight current attitudes, gaps, and barriers to environmentally sustainable anesthesiology practice among departmental and educational leadership. Furthermore, this study identifies potential opportunities to develop cross-Canada collaborative educational programs in this field.
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Review Comparative Study
High-flow nasal cannula for acute hypoxemic respiratory failure in patients with COVID-19: systematic reviews of effectiveness and its risks of aerosolization, dispersion, and infection transmission.
We conducted two World Health Organization-commissioned reviews to inform use of high-flow nasal cannula (HFNC) in patients with coronavirus disease (COVID-19). We synthesized the evidence regarding efficacy and safety (review 1), as well as risks of droplet dispersion, aerosol generation, and associated transmission (review 2) of viral products. ⋯ High-flow nasal cannula may reduce the need for invasive ventilation and escalation of therapy compared with COT in COVID-19 patients with acute hypoxemic respiratory failure. This benefit must be balanced against the unknown risk of airborne transmission.
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Comparative Study Clinical Trial
A comparative study on position and paramedian neuraxial access on healthy volunteers using three-dimensional models registered to lumbar spine ultrasound.
Optimizing patient position and needle puncture site are important factors for successful neuraxial anesthesia. Two paramedian approaches are commonly utilized and we sought to determine whether variations of the seated position would increase the chance of puncture success. ⋯ An added dorsal table tilt did not increase puncture success in the seated position. The landmarks for puncture site described by Barash resulted in significantly more successful punctures compared with those described by Miller in all positions.