Harefuah
-
There are major challenges in teaching and assessing skills expected from practicing anesthesiologists and residents in anesthesia training programs. It is important to measure two separate aspects of skilled performance in managing crises: implementing appropriate technical actions (technical performance), manifesting appropriate crisis solving, and management of anesthesia non-technical behaviors. Anesthesia nontechnical skills (ANTS) can be divided into two subgroups: (1) cognitive or mental skills (decision-making, planning, strategy, risk assessment, situation awareness); and (2) social or interpersonal affective skills (teamwork, communication, leadership). ⋯ Communication and collaboration among centers involved in simulation programs (including sharing of validated scenarios) is important to the future of this technology and approach. In summary, cognitive and non-cognitive simulation-based skills assessment that included the so-called ANTS can help to identify areas of strength and weakness that can be used to guide the residency curriculum, especially regarding deficiencies in tasks requiring higher order processing. Any such deficiencies need to be addressed in any training program.
-
Intrathecal morphine administration at the time of neuraxial anesthesia performance is the gold standard for post-cesarean delivery (CD) analgesia. When intrathecal morphine administration is inappropriate or contraindicated, the use of systemic analgesic options increase side effects and risks to both the parturient and the breastfeeding neonate. Moreover, systemic analgesia is often inadequate. ⋯ Some may prove to be superior to the TAP block. These techniques include: ilioinguinal/ilio-hypogastric nerve blocks (II-IH), the quadratus lumborum (QL) blocks and the erector spinae plane (ESP) block. In this review, we will discuss and assess these techniques regarding analgesia following CD.
-
Anesthesia and intensive care, perioperative medicine and pain management, emergency medicine and resuscitation, all together constitute the field of action of the anesthesiologist. The definition of "anesthesiologist" underestimates the profession, and the lack of anesthesiologists seems understandable when we examine the scope of their activities throughout the hospital. There is little awareness among the public of the extent of the anesthesiologist's activity. ⋯ The possibility that anesthesia may be associated with cognitive changes in infancy and in older age became a major concern and an active research field. Anesthetic complications can rapidly deteriorate and endanger the life of the patient, may leave him confused, and incapacitated. Larger and complicated modern surgeries are now possible thanks to the special skills and capabilities of the modern anesthesiologist to keep the patient alive and well, even in the presence of major surgery.
-
SARS-CoV-2 is dispersed from patients by talking, coughing and sneezing. The generated micro-droplets aerosols can travel up to 8 meters, stay suspended for long periods and preserve viral infectivity for a median of 2.7 hours. ⋯ N95 respirators and surgical masks block 95% and 50-60% respectively of inhalable particles and protect the wearer from infection. Surgical masks and N95 without exhalation valve, protect both the wearer and the environment from carriers and sick people.
-
Medical cannabis (MC) is becoming more and more popular among patients with chronic pain syndromes. In this study we evaluated the characteristics of MC use among patients with fibromyalgia. ⋯ MC is an effective treatment for fibromyalgia, with nearly zero % withdrawal from this treatment. The mean daily amount consumed was relatively low, less than 1 gram, and the main method of consumption was smoking with a huge variety in the frequency of smoking during the day and night among the participants. MC treatment enabled nearly half of the patients to discontinue any treatment for fibromyalgia and all participants recommended MC treatment for their loved ones in case they develop severe fibromyalgia. Most participants were against the reform of MC in Israel. Mild adverse effects were reported in nearly a quarter of the patients but did not result in discontinuing its consumption.