Current opinion in anaesthesiology
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Anesthesiologists work in a complex environment that is intolerant of errors. Cognitive errors, or errors in thought processes, are mistakes that a clinician makes despite 'knowing better'. Several new studies provide a better understanding of how to manage risk while making better decisions. ⋯ Effective decision-making and risk management reduce the risk of adverse events in the operating room. This article proposes several new decision-making and risk assessment tools for use in the operating room.
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Curr Opin Anaesthesiol · Dec 2012
ReviewDifficult airway management in an ambulatory surgical center?
This review will focus on two key aspects of difficult airway management in an ambulatory surgical center (ASC). First, the selection process of patients with known difficult airways suitable for this environment, and second, the requirements of a difficult airway cart to manage unexpected airway problems. ⋯ The management of ambulatory surgical practices must provide suitable difficult airway management equipment as well as technical and nontechnical training. Patients may present to an ASC with expected and unexpected difficult airways. Appropriate management of these patients requires advance planning to avoid poor outcomes.
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To summarize the currently available data on malpractice claims related to ambulatory anesthesia and provide an insight into the emerging patterns of anesthesia liability in this practice setting. ⋯ With steady increase in outpatient surgery, anesthesiologists are confronted with new areas of liability. More data are needed to identify these risks and reduce exposure to malpractice claims.
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Curr Opin Anaesthesiol · Dec 2012
ReviewNausea and vomiting after surgery: it is not just postoperative.
The purpose of this review is to highlight postoperative nausea and vomiting (PONV), to discuss why it occurs, how it might be prevented and then how it can be treated. ⋯ It is easy to turn the vapourizer dial, but that is a part of the problem. Not everyone reacts the same to drugs. Although PDNV is not as well characterized as PONV, at the very least, avoid an anaesthetic that may make PONV/PDNV worse and be aggressive in treating the problem.