Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Dec 2014
ReviewUpdate on the management of postoperative nausea and vomiting.
Postoperative nausea and vomiting (PONV) continues to be one of the most common postsurgical medical problems. An understanding of the pathophysiology of PONV and the pharmacological profiles of agents affecting receptors involved in emesis is necessary to effectively treat PONV. ⋯ Proper management of PONV includes an evaluation of risk factors, a strategy for prophylaxis, and rescue antiemetic treatment if necessary. In high-risk patients, combination therapy is recommended in preventing PONV. Knowledge of antiemetic efficacy and safety may facilitate an increase in patient satisfaction, decreased negative health consequences, and reduced medical costs.
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Many patients presenting for surgical or other procedures in an ambulatory setting are taking new antiplatelet or anticoagulant agents. This review assesses how the novel features of these new agents affect the management of antithrombotic therapy in the ambulatory setting. ⋯ As there are few clinical studies to guide management, clinicians must make rational decisions in relation to continuing or ceasing new antithrombotic agents. This requires knowledge of their pharmacokinetics, and a careful multidisciplinary assessment of the relative thrombotic and bleeding risks in individual patients.
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Curr Opin Anaesthesiol · Dec 2014
ReviewTransfusion errors: causes, incidence, and strategies for prevention.
Miss-transfusion of blood has become one of the leading causes of death related to blood transfusion. New technology is able to better prevent miss-transfusions than older methods. ⋯ Humans make errors. New technology can prevent those errors.
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Curr Opin Anaesthesiol · Dec 2014
ReviewProgress in simulation education: developing an anesthesia curriculum.
Simulation's role in anesthesia education is expanding to include more advanced skills and training for subspecialty practice. This review will provide an overview of many recent studies that expand the simulation curriculum for anesthesia education. ⋯ A curriculum is emerging that utilizes a variety of simulation modalities as part of a more comprehensive educational strategy for anesthesia specialty training.
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Curr Opin Anaesthesiol · Dec 2014
ReviewThe role of the anesthesiologist in perioperative patient safety.
Despite the benefits of rapidly advancing therapeutic and diagnostic possibilities, the perioperative setting still exposes patients to significant risks of adverse events and harm. Anesthesiologists are in midstream of perioperative care and can make significant contributions to patient safety and patient outcomes. This article reviews recent research results outlining the current trends of perioperative patient harm and summarizes the evidence in favor of patient safety practices. ⋯ Current research provides growing evidence for the effectiveness of several patient safety practices designed to prevent or diminish perioperative adverse events and patient harm. Future investigations will hopefully fill the numerous persisting knowledge gaps.