AANA journal
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This column will give a brief history of the development of guidelines for isolation precautions in hospitals. The current Centers for Disease Control and Prevention (CDC) guidelines will be reviewed along with examples of the disease processes that apply to each category. An example of an anesthesia department's guide for the care of patients with transmissible diseases requiring anesthesia care will be presented. The guide can be used by readers as a template for the development of a guide applicable to their practice.
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We present a statistical method that uses data from surgical services information systems to determine the minimum number of anesthetists to be scheduled for weekend call in an operating room suite. The staffing coverage is predicted that provides for sufficient anesthetists to cover each hour of a 24-hour weekend period, while satisfying a specified risk for being understaffed. ⋯ By using this method to schedule weekend staff, an anesthesia group can assure as few anesthetists are on call as possible, and for as few hours as possible, while maintaining the level of risk of understaffing that the anesthesia group is willing to accept. An anesthesia group also can use the method to calculate its risk of being understaffed in the surgical suite based on its existing weekend staffing plan.
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Drug development involves the chemical identification and characterization of a compound to determine stability and define the drug's preliminary actions. Preclinical research follows in animals to develop a pharmacokinetic profile to determine dose range, biotransformation, elimination, and toxicology. The 4 phases of clinical research, phase 1 to phase 4, encompass a progressive investigation of healthy subjects, otherwise healthy patients, to patients with a target disease to obtain US Food and Drug Administration (FDA) approval. ⋯ The duration of action of Ro 48-6791 as measured by the OAA/S score and HTLW test did not differ between groups. Ro 48-6791 seemed to be a safe and effective agent to achieve conscious sedation in outpatients undergoing short invasive procedures. However, clinical drug development of Ro 48-6791 was stopped because it did not meet the efficacy criteria of an ultra-short-acting benzodiazepine.
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Randomized Controlled Trial Clinical Trial
To reuse your circuit: the HME debate.
Heat and moisture exchangers (HMEs) have been used for more than 30 years for heat and moisture retention during general anesthesia. Studies about bacteriostatic vs nonbacteriostatic HMEs (BHMEs/NHMEs) have been conducted to assess their role in preventing bacterial transmission to the anesthesia breathing circuit; none have been done on anesthetized patients in the operating room. The present study adds to existing knowledge about the HME's ability to prevent transmission of bacteria, with implications for cost reduction resulting from reuse of anesthesia breathing circuits among patients. ⋯ These results support not reusing breathing circuits. Of 53 participants in group 2, 28 had positive ETT cultures with 7 showing transmission to anesthesia breathing circuit. Of 46 participants in group 1, 28 had positive ETT cultures with 9 showing transmission to anesthesia breathing circuit.
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Pulmonary edema is a generalized descriptive term for the accumulation of fluid within the interstitium and/or the alveolar spaces of the lungs. This accumulation of fluid has a cause that may be termed cardiogenic or noncardiogenic. ⋯ Some occurrences of NCPE can be traced directly to the administration of anesthesia. For example, NCPE can result from upper airway obstruction or the administration of naloxone.