Masui. The Japanese journal of anesthesiology
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We report the refinement of the simulation-based sedation training course (SEDTC) hosted by the Japanese Association of Medical Simulation, and the drafting and development of an learning goal and instructor course. In basic airway management training, we highlighted the importance of the "call for help" and oxygen supply. In card-based simulation training sessions, we posted a picture detailing recommended amounts of oxygen and the duration of its use. ⋯ Twenty-seven SEDTCs were conducted between August 2011 and March 2013 at several locations in Japan. A total of 395 medical staffs affiliated with various medical departments participated in the courses. SEDTCs may serve as a vehicle to improve the safety of sedation and analgesia.
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Comparative Study
[Comparison of TaperGuard tube and the Portex Softseal for prevention of vomitus leakage in an in vitro simulation airway model].
Microaspiration of vomitus can cause a serious condition known as Mendelson's syndrome. The present study used simulated stomach contents and an airway model to compare a tracheal tube with a tapered cuff (Taper) to the conventional high volume low pressure cuff (HVLP) in their abilities to prevent microaspiration. ⋯ We conclude that the Taper may be more effective than the conventional HVLP in preventing vomitus microaspiration in an airway model simulation.
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Comparative Study
[Difference in nitrous oxide-mediated increases in intracuff pressure between two tracheal tubes in a simulated pediatric lung model].
The purpose of this study was to compare the nitrous oxide-mediated increases in cuff pressure between a tracheal tube with a tapered cuff (Taper) or conventional high volume low pressure cuff (HVLP) utilizing a simulated pediatric lung model. ⋯ These findings suggest that the Taper may be more effective than the HVLP in preventing hyperinflation of the tracheal tube cuff in response to nitrous oxide exposure in children.
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A 71-year-old male was scheduled for a laparoscopic cholecystectomy. The plan was to intubate him using direct laryngoscopy. After induction of anesthesia and analgesia direct laryngoscopy was performed but it was difficult to get a good view of epiglottis, and at 2nd attempt there was laryngeal edema, which made the procedure more difficult. ⋯ After the operation, the patient was extubated from the trachea with the Aura-i still in place. When sufficient respiration returned, the Aura-i was removed. There was no bleeding in the mouth after removal of the Aura-i.
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We report a case of an accidental loss of anesthesia records through network failure of an anesthesia information management system (AIMS). The backup data were not kept in the anesthesia workstations or the server during the failure. Accordingly, anesthesia records of five patients were lost for one hour. ⋯ Despite the redundant pathways, transient power failures of network switches caused interruptions in both pathways. Our case indicates that, to improve the robustness of the AIMS as electronic medical records, every network apparatus of AIMS, should be supplied with an uninterrupted power supply. Furthermore, each anesthesia workstation should function independently as an anesthesia record keeping client when network failure occurs.