Anesthesiology Information
•Download as PPT, PDF•
10 likes•1,503 views
The document discusses awareness during anesthesia, including its incidence, causes, detection methods, and prevention. Some key points: - The incidence of awareness has decreased from around 1% historically to 0.1-0.2% currently with improved monitoring and techniques. - Awareness can cause significant psychological trauma for patients including PTSD in some cases. - Light anesthesia, equipment issues, individual variability, and premature discontinuation of anesthetics can all cause awareness. - Monitoring like BIS and auditory evoked potentials can help detect awareness intraoperatively, though signs like heart rate are unreliable. - Prevention focuses on adequate dosing, vigilance, limiting paralysis, and using volatile anesthetics to supplement other agents
Report
Share
Report
Share
![References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
Recommended
Anesthesia awareness
Anesthesia awareness occurs when a patient becomes conscious during a surgical procedure performed under general anesthesia and has recall of events. The incidence is 0.1-0.2% but higher for certain procedures like cardiac surgery. Patients at risk include women, those under 60, long surgeries, and prior awareness. Causes include light anesthesia, increased anesthetic requirements, and equipment errors. Patients commonly recall sounds and paralysis. Aftereffects may include PTSD. Prevention strategies include preoperative evaluation, proper equipment use, and intraoperative monitoring like BIS monitoring to maintain anesthesia levels.
Intraoperative awareness
This document provides information about general anesthesia and intraoperative awareness. It discusses what general anesthesia is, how its depth is determined, and the different stages of awareness and memory formation. It also covers risk factors for awareness, its incidence and impact on patients. Monitoring techniques like BIS, entropy and EEG patterns are described. Finally, it discusses approaches to preventing and managing cases of intraoperative awareness.
accidental Awareness under general Anaesthesia
crisp and clear, practically oriented ppt on awareness under anaesthesia, intended for anaesthesia practitioners.
Awareness during anesthesia
Awareness under anesthesia occurs when a patient becomes conscious during a surgical procedure performed under general anesthesia and later recalls events from surgery. It has an incidence rate of 0.1-0.2% for most surgeries, but is higher for some like cardiac surgery at 1.1-1.5%. Risk factors include light anesthesia, certain types of surgeries or patients, equipment issues, and prior experiences with awareness. Patients who experience awareness may suffer from sleep disturbances, nightmares, anxiety, depression or post-traumatic stress disorder. Prevention strategies include evaluating risk factors preoperatively, checking anesthesia equipment, maintaining adequate anesthetic levels intraoperatively, and postoperative interviews to screen for recall.
Unintended Awareness
Unintended awareness during anesthesia is a disturbing event that can permanently change a patient's life. Several factors contribute to the risk of awareness, including the use of muscle relaxants which prevent patients from signaling distress. Depth of anesthesia monitors like BIS and Entropy indexes can help reduce risk but may not prevent all cases of awareness. Maintaining an adequate level of anesthesia through close clinical monitoring and an end-tidal gas concentration of at least 0.7 MAC is important to prevent patient recall. All reports of potential intraoperative awareness should be taken seriously and followed up with counseling to minimize psychological harm.
Monitoring depth of anaesthesia
This document provides an overview of monitoring depth of anesthesia. It discusses the aims of monitoring to ensure patient safety and prevent awareness during surgery. It reviews the historical background of defining anesthesia stages. Modern concepts view anesthesia as a complex interaction between stimuli, patient responses, and drug-induced effects. Factors like patient characteristics, drug combinations, and surgery duration impact correct drug dosing. Memory is gradually impaired with deeper anesthesia levels before autonomic responses. The document outlines stages of awareness and discusses specific drugs' relationships to anesthesia depth.
Monitoring depth of anaesthesia
1) Monitoring depth of anesthesia is important to ensure adequate anesthesia without oversedation and increased risk of awareness.
2) Various methods have been used historically to monitor depth from early definitions of stages of anesthesia to objective monitoring tools.
3) Current methods include monitoring autonomic responses, isolated forearm technique, electromyography, heart rate variability, and electroencephalography indices like bispectral index which provide objective and noninvasive measures of anesthetic depth.
NON OPERATING ROOM ANAESTHESIA
This document discusses anesthesia considerations for procedures performed outside the operating room. It notes that the number and complexity of such procedures has increased, bringing additional responsibilities for anesthesiologists. Special challenges include limited space, equipment, and support staff unfamiliar with patient management. Proper equipment, monitoring, and planning are important when providing anesthesia or sedation in remote locations. The document discusses various locations like radiology suites, specific procedures like ECT, and choices of anesthetic agents and techniques. Patient safety is the top priority for remote location anesthesia.
Recommended
Anesthesia awareness
Anesthesia awareness occurs when a patient becomes conscious during a surgical procedure performed under general anesthesia and has recall of events. The incidence is 0.1-0.2% but higher for certain procedures like cardiac surgery. Patients at risk include women, those under 60, long surgeries, and prior awareness. Causes include light anesthesia, increased anesthetic requirements, and equipment errors. Patients commonly recall sounds and paralysis. Aftereffects may include PTSD. Prevention strategies include preoperative evaluation, proper equipment use, and intraoperative monitoring like BIS monitoring to maintain anesthesia levels.
Intraoperative awareness
This document provides information about general anesthesia and intraoperative awareness. It discusses what general anesthesia is, how its depth is determined, and the different stages of awareness and memory formation. It also covers risk factors for awareness, its incidence and impact on patients. Monitoring techniques like BIS, entropy and EEG patterns are described. Finally, it discusses approaches to preventing and managing cases of intraoperative awareness.
accidental Awareness under general Anaesthesia
crisp and clear, practically oriented ppt on awareness under anaesthesia, intended for anaesthesia practitioners.
Awareness during anesthesia
Awareness under anesthesia occurs when a patient becomes conscious during a surgical procedure performed under general anesthesia and later recalls events from surgery. It has an incidence rate of 0.1-0.2% for most surgeries, but is higher for some like cardiac surgery at 1.1-1.5%. Risk factors include light anesthesia, certain types of surgeries or patients, equipment issues, and prior experiences with awareness. Patients who experience awareness may suffer from sleep disturbances, nightmares, anxiety, depression or post-traumatic stress disorder. Prevention strategies include evaluating risk factors preoperatively, checking anesthesia equipment, maintaining adequate anesthetic levels intraoperatively, and postoperative interviews to screen for recall.
Unintended Awareness
Unintended awareness during anesthesia is a disturbing event that can permanently change a patient's life. Several factors contribute to the risk of awareness, including the use of muscle relaxants which prevent patients from signaling distress. Depth of anesthesia monitors like BIS and Entropy indexes can help reduce risk but may not prevent all cases of awareness. Maintaining an adequate level of anesthesia through close clinical monitoring and an end-tidal gas concentration of at least 0.7 MAC is important to prevent patient recall. All reports of potential intraoperative awareness should be taken seriously and followed up with counseling to minimize psychological harm.
Monitoring depth of anaesthesia
This document provides an overview of monitoring depth of anesthesia. It discusses the aims of monitoring to ensure patient safety and prevent awareness during surgery. It reviews the historical background of defining anesthesia stages. Modern concepts view anesthesia as a complex interaction between stimuli, patient responses, and drug-induced effects. Factors like patient characteristics, drug combinations, and surgery duration impact correct drug dosing. Memory is gradually impaired with deeper anesthesia levels before autonomic responses. The document outlines stages of awareness and discusses specific drugs' relationships to anesthesia depth.
Monitoring depth of anaesthesia
1) Monitoring depth of anesthesia is important to ensure adequate anesthesia without oversedation and increased risk of awareness.
2) Various methods have been used historically to monitor depth from early definitions of stages of anesthesia to objective monitoring tools.
3) Current methods include monitoring autonomic responses, isolated forearm technique, electromyography, heart rate variability, and electroencephalography indices like bispectral index which provide objective and noninvasive measures of anesthetic depth.
NON OPERATING ROOM ANAESTHESIA
This document discusses anesthesia considerations for procedures performed outside the operating room. It notes that the number and complexity of such procedures has increased, bringing additional responsibilities for anesthesiologists. Special challenges include limited space, equipment, and support staff unfamiliar with patient management. Proper equipment, monitoring, and planning are important when providing anesthesia or sedation in remote locations. The document discusses various locations like radiology suites, specific procedures like ECT, and choices of anesthetic agents and techniques. Patient safety is the top priority for remote location anesthesia.
Delayed recovery from anaesthesia.ppt
Delayed recovery from anesthesia can have multiple contributing factors and causes. It is important to consider potential drug interactions, metabolic abnormalities, and organic causes that may cause prolonged unconsciousness and have serious health implications. Signs and symptoms of metabolic issues may not present normally in an anesthetized patient. The Glasgow Coma Scale provides an objective measure of conscious state regardless of cause.
Occupational hazards of Anesthesia
The document discusses several occupational hazards faced by anesthetists, including:
1. Historically, fires and explosions from explosive anesthetic agents like ether, but modern non-explosive agents have eliminated this risk.
2. Risk of infection from bloodborne pathogens like HIV and hepatitis B/C through needlesticks or exposure to body fluids, as well as airborne pathogens like tuberculosis through procedures involving endotracheal intubation or suctioning.
3. Recommendations for vaccination, protective equipment, and protocols to minimize risks from infectious diseases, radiation, waste gases, and other occupational hazards faced by anesthetists.
Neuromuscular Monitoring
Neuromuscular monitoring, also known as train of four monitoring, is a technique used during recovery from the application of general anesthesia to objectively determine how well a patient's muscles are able to function. It involves the application of electrical stimulation to nerves and recording of muscle response using, for example, an acceleromyograph. Neuromuscular monitoring is typically used when neuromuscular-blocking drugs have been part of the general anesthesia and the doctor wishes to avoid postoperative residual curarization (PORC) in the patient, that is, the residual paralysis of muscles stemming from these drugs.
Awareness under anaesthesia
The document discusses awareness under anesthesia, including definitions of key terms like consciousness, memory, and awareness. It describes the causes of intraoperative awareness as unexpected variability in drug requirements, light anesthesia levels, masking of inadequate depth, and machine errors. Prevention strategies include premedication, checking equipment, and brain monitoring. Consequences can include psychological trauma, and management involves deepening anesthesia if awareness is suspected.
NON OPERATING ROOM ANAESTHESIA
This document discusses non-operating room anesthesia (NORA). It begins by defining NORA as anesthesia provided outside the operating room, such as in radiology, endoscopy suites, MRI, and dental clinics. It then outlines a three step approach to NORA involving thorough patient assessment, appropriate monitoring and anesthesia care, and post-procedure management. Several ASA guidelines for equipment and facilities in NORA locations are also reviewed. Complications associated with NORA and special considerations for procedures like X-rays, MRIs, and IV contrast administration are discussed. The document emphasizes choosing anesthesia techniques based on patient factors and needs for each specific non-operating room procedure.
Uses of Ultrasound in Anesthesiology
Apart from regional blocks, there are numerous avenues where ultrasound has been utilized by Anesthesiologists.
Monitored anaesthesia care
The document discusses monitored anesthesia care (MAC), which involves administering drugs to provide anxiolytic, hypnotic, amnestic, and analgesic effects without depressing consciousness below a certain level. It provides guidelines on drug selection and dosing for MAC, including opioids like fentanyl and remifentanil, benzodiazepines like midazolam, propofol, ketamine, and dexmedetomidine. It also discusses factors that can lead to patient agitation during MAC and principles of drug administration via continuous infusion or patient-controlled methods.
Anaesthesia for laparoscopic surgeries
This document provides an overview of anesthesia considerations for laparoscopic surgeries. It discusses the history of laparoscopy, physiological effects of pneumoperitoneum including on the cardiovascular, respiratory, central nervous and renal systems. It also outlines respiratory complications like subcutaneous emphysema, pneumothorax, gas embolism and their treatment. The effects of patient positioning and conduct of anesthesia are summarized.
Ambulatory Anesthesia
This document discusses patient selection criteria and preoperative assessment and preparation for ambulatory anesthesia. It covers suitable procedures, duration limits, patient characteristics, contraindications, preoperative evaluation, and both nonpharmacologic and pharmacologic preparation. For patient selection, it recommends considering factors like procedure type, duration, medical history, age and contraindications. It also discusses anxiolysis, sedation, preemptive analgesia and preventing nausea for premedication. The goal is to safely perform procedures as outpatients and facilitate early recovery.
Management of intraoperative bronchospasm
The document provides information on the management of intra-operative bronchospasm, including risk factors, triggers, diagnosis, prevention, and treatment approaches. Bronchospasm can be caused by airway irritation or anaphylaxis and presents with signs of wheezing, increased airway pressures, and falling oxygen saturation. Differential diagnoses must be ruled out. Management involves deepening anesthesia, administering bronchodilators, optimizing ventilation, and considering anaphylaxis or postponing surgery. A case example demonstrates treatment of bronchospasm potentially caused by succinylcholine-induced anaphylaxis.
Anesthetic considerations for spinal surgery
1) The document discusses anesthesia considerations for spinal surgery, including pre-operative assessment of airway, respiratory, cardiovascular, and neurological systems, as well as unique challenges like patient positioning and intra-operative monitoring.
2) Key surgical procedures mentioned are laminectomy, discectomy, and instrumentation/fusion, while common spinal conditions requiring surgery include disc lesions, stenosis, tumors, and deformities.
3) Anesthesia techniques aim to maintain a stable depth and avoid sudden changes in anesthetic depth or blood pressure. Intra-operative monitoring discussed includes wake-up tests, SSEP, MEP, and EMGs to evaluate spinal functional integrity.
Neuromonitoring in anesthesia
Neuromonitoring techniques can monitor the brain's function, cerebral blood flow and intracranial pressure, and brain oxygenation and metabolism. Electroencephalography (EEG) measures electrical brain activity and is useful for detecting ischemia. Evoked potentials like somatosensory evoked potentials (SSEPs) monitor sensory pathways from stimulus to cortex. Jugular venous oximetry and near infrared spectroscopy (NIRS) provide noninvasive monitoring of cerebral oxygenation. These techniques guide anesthesia management and detect intraoperative brain injury.
Medico legal aspects of anesthesia
This document discusses various aspects of informed consent in anesthesia practice and medical malpractice litigation. It notes that informed consent is required to respect patient autonomy and involves explaining the risks, benefits and alternatives of a procedure to allow for substantially autonomous decision making. The key elements of competence that a patient must demonstrate to provide valid consent are described. Maintaining thorough anesthesia records and communicating well with patients can help minimize the risk of malpractice lawsuits.
Monitoring depth of anesthesia
This document discusses various methods for monitoring the depth of anesthesia. It describes clinical techniques such as assessing autonomic responses and muscle movement. It also discusses pharmacological principles like minimum alveolar concentration for different anesthetic responses. Methods for monitoring brain electrical activity are outlined, including spontaneous EEG, compressed spectral analysis, bispectral index, and entropy monitors. Brain electrical activity monitors provide quantitative measures of anesthetic effect but can be influenced by other physiological factors. Overall, the document provides an overview of traditional and advanced techniques for assessing depth of anesthesia.
Anaesthesia outside operating room
This document discusses anesthesia and sedation procedures performed outside the operating room. It outlines common procedures that require anesthesia outside OR settings like radiology suites and ICUs. It also describes the challenges anesthesiologists face in these settings like unfamiliar environments, limited equipment and monitoring, and patient issues. Guidelines are provided for sedation versus general anesthesia based on the procedure and safety standards for monitoring, equipment, and discharge criteria when anesthesia is provided outside the traditional operating room.
Delayed recovery from anaesthesia by prof. minnu m. panditrao
The document discusses various reasons for delayed recovery from anesthesia, including pharmacological factors related to specific drugs, surgery-related issues, and patient-specific factors. It provides case examples of delayed recovery and recommends having a generalized protocol as well as understanding specific situations to properly manage patients and prevent complications. Vigilance and careful balancing of many variables by an experienced anesthesiologist are important to avoid morbidity and mortality from delayed recovery.
Rapid sequence spinal anesthesia (RSS).pptx
Rapid sequence spinal anesthesia (RSS) is a technique used for urgent cesarean sections that requires effective coordination between medical staff. Segmental spinal anesthesia involves puncturing the spinal cord at higher thoracic levels using lower doses of local anesthetic, allowing selective blockade of dermatomes needed for surgery. This technique provides hemodynamic stability, less motor blockade, and faster recovery compared to conventional spinal anesthesia. Careful performance of segmental spinal anesthesia can establish it as a routine procedure for day surgery.
Obstructive sleep apnoea
This document provides an overview of obstructive sleep apnea (OSA) and its implications for anesthesia. It defines OSA and discusses its causes, diagnosis, and physiological effects. It outlines risks of anesthesia for those with OSA, including difficult intubation and postoperative respiratory depression. It recommends preoperative screening and treatment with CPAP or weight loss. Intraoperatively, it advises securing the airway and avoiding sedatives that could cause collapse. Postoperatively, supplemental oxygen is important due to risk of apnea and respiratory depression upon waking.
anaesthetic management of Meningomyelocele and its Surgical excision
This document discusses the anaesthetic management of patients with meningomyelocele. Key points include:
- Meningomyelocele is a complex birth defect involving protrusion of the meninges and spinal cord through the vertebrae.
- Patients often have other associated anomalies and hydrocephalus.
- Anaesthetic challenges include airway management, physiological immaturity of organ systems, fluid management due to third spacing and blood loss.
- Careful pre-operative evaluation, positioning to protect the meningocele, and meticulous intraoperative fluid management are important to optimize outcomes.
Minimum Alveolar Concentration
The document provides a history of anesthetic agents, beginning with diethyl ether in 1846 and progressing to modern volatile agents like sevoflurane. It discusses the properties of each agent that made them viable or led to their discontinuation. It also defines the minimum alveolar concentration (MAC) concept for measuring anesthetic potency based on immobilization during incision. Factors that increase or decrease MAC values are outlined.
Multimodal pain management following surgical procedures
1. The document discusses concepts related to nociception, central sensitization, and multimodal analgesia for perioperative pain management.
2. It provides definitions of terms like nociception and describes the types of pain and sensory receptors involved in pain perception.
3. The key aspects of multimodal analgesia involve combining different analgesics that act through different mechanisms in the nervous system to provide improved analgesia and fewer side effects than individual analgesics alone.
Anesthesia and Asthma
Who is at Risk of Asthma Complications after Surgery?For most people with mild to moderate asthma, t...
More Related Content
What's hot
Delayed recovery from anaesthesia.ppt
Delayed recovery from anesthesia can have multiple contributing factors and causes. It is important to consider potential drug interactions, metabolic abnormalities, and organic causes that may cause prolonged unconsciousness and have serious health implications. Signs and symptoms of metabolic issues may not present normally in an anesthetized patient. The Glasgow Coma Scale provides an objective measure of conscious state regardless of cause.
Occupational hazards of Anesthesia
The document discusses several occupational hazards faced by anesthetists, including:
1. Historically, fires and explosions from explosive anesthetic agents like ether, but modern non-explosive agents have eliminated this risk.
2. Risk of infection from bloodborne pathogens like HIV and hepatitis B/C through needlesticks or exposure to body fluids, as well as airborne pathogens like tuberculosis through procedures involving endotracheal intubation or suctioning.
3. Recommendations for vaccination, protective equipment, and protocols to minimize risks from infectious diseases, radiation, waste gases, and other occupational hazards faced by anesthetists.
Neuromuscular Monitoring
Neuromuscular monitoring, also known as train of four monitoring, is a technique used during recovery from the application of general anesthesia to objectively determine how well a patient's muscles are able to function. It involves the application of electrical stimulation to nerves and recording of muscle response using, for example, an acceleromyograph. Neuromuscular monitoring is typically used when neuromuscular-blocking drugs have been part of the general anesthesia and the doctor wishes to avoid postoperative residual curarization (PORC) in the patient, that is, the residual paralysis of muscles stemming from these drugs.
Awareness under anaesthesia
The document discusses awareness under anesthesia, including definitions of key terms like consciousness, memory, and awareness. It describes the causes of intraoperative awareness as unexpected variability in drug requirements, light anesthesia levels, masking of inadequate depth, and machine errors. Prevention strategies include premedication, checking equipment, and brain monitoring. Consequences can include psychological trauma, and management involves deepening anesthesia if awareness is suspected.
NON OPERATING ROOM ANAESTHESIA
This document discusses non-operating room anesthesia (NORA). It begins by defining NORA as anesthesia provided outside the operating room, such as in radiology, endoscopy suites, MRI, and dental clinics. It then outlines a three step approach to NORA involving thorough patient assessment, appropriate monitoring and anesthesia care, and post-procedure management. Several ASA guidelines for equipment and facilities in NORA locations are also reviewed. Complications associated with NORA and special considerations for procedures like X-rays, MRIs, and IV contrast administration are discussed. The document emphasizes choosing anesthesia techniques based on patient factors and needs for each specific non-operating room procedure.
Uses of Ultrasound in Anesthesiology
Apart from regional blocks, there are numerous avenues where ultrasound has been utilized by Anesthesiologists.
Monitored anaesthesia care
The document discusses monitored anesthesia care (MAC), which involves administering drugs to provide anxiolytic, hypnotic, amnestic, and analgesic effects without depressing consciousness below a certain level. It provides guidelines on drug selection and dosing for MAC, including opioids like fentanyl and remifentanil, benzodiazepines like midazolam, propofol, ketamine, and dexmedetomidine. It also discusses factors that can lead to patient agitation during MAC and principles of drug administration via continuous infusion or patient-controlled methods.
Anaesthesia for laparoscopic surgeries
This document provides an overview of anesthesia considerations for laparoscopic surgeries. It discusses the history of laparoscopy, physiological effects of pneumoperitoneum including on the cardiovascular, respiratory, central nervous and renal systems. It also outlines respiratory complications like subcutaneous emphysema, pneumothorax, gas embolism and their treatment. The effects of patient positioning and conduct of anesthesia are summarized.
Ambulatory Anesthesia
This document discusses patient selection criteria and preoperative assessment and preparation for ambulatory anesthesia. It covers suitable procedures, duration limits, patient characteristics, contraindications, preoperative evaluation, and both nonpharmacologic and pharmacologic preparation. For patient selection, it recommends considering factors like procedure type, duration, medical history, age and contraindications. It also discusses anxiolysis, sedation, preemptive analgesia and preventing nausea for premedication. The goal is to safely perform procedures as outpatients and facilitate early recovery.
Management of intraoperative bronchospasm
The document provides information on the management of intra-operative bronchospasm, including risk factors, triggers, diagnosis, prevention, and treatment approaches. Bronchospasm can be caused by airway irritation or anaphylaxis and presents with signs of wheezing, increased airway pressures, and falling oxygen saturation. Differential diagnoses must be ruled out. Management involves deepening anesthesia, administering bronchodilators, optimizing ventilation, and considering anaphylaxis or postponing surgery. A case example demonstrates treatment of bronchospasm potentially caused by succinylcholine-induced anaphylaxis.
Anesthetic considerations for spinal surgery
1) The document discusses anesthesia considerations for spinal surgery, including pre-operative assessment of airway, respiratory, cardiovascular, and neurological systems, as well as unique challenges like patient positioning and intra-operative monitoring.
2) Key surgical procedures mentioned are laminectomy, discectomy, and instrumentation/fusion, while common spinal conditions requiring surgery include disc lesions, stenosis, tumors, and deformities.
3) Anesthesia techniques aim to maintain a stable depth and avoid sudden changes in anesthetic depth or blood pressure. Intra-operative monitoring discussed includes wake-up tests, SSEP, MEP, and EMGs to evaluate spinal functional integrity.
Neuromonitoring in anesthesia
Neuromonitoring techniques can monitor the brain's function, cerebral blood flow and intracranial pressure, and brain oxygenation and metabolism. Electroencephalography (EEG) measures electrical brain activity and is useful for detecting ischemia. Evoked potentials like somatosensory evoked potentials (SSEPs) monitor sensory pathways from stimulus to cortex. Jugular venous oximetry and near infrared spectroscopy (NIRS) provide noninvasive monitoring of cerebral oxygenation. These techniques guide anesthesia management and detect intraoperative brain injury.
Medico legal aspects of anesthesia
This document discusses various aspects of informed consent in anesthesia practice and medical malpractice litigation. It notes that informed consent is required to respect patient autonomy and involves explaining the risks, benefits and alternatives of a procedure to allow for substantially autonomous decision making. The key elements of competence that a patient must demonstrate to provide valid consent are described. Maintaining thorough anesthesia records and communicating well with patients can help minimize the risk of malpractice lawsuits.
Monitoring depth of anesthesia
This document discusses various methods for monitoring the depth of anesthesia. It describes clinical techniques such as assessing autonomic responses and muscle movement. It also discusses pharmacological principles like minimum alveolar concentration for different anesthetic responses. Methods for monitoring brain electrical activity are outlined, including spontaneous EEG, compressed spectral analysis, bispectral index, and entropy monitors. Brain electrical activity monitors provide quantitative measures of anesthetic effect but can be influenced by other physiological factors. Overall, the document provides an overview of traditional and advanced techniques for assessing depth of anesthesia.
Anaesthesia outside operating room
This document discusses anesthesia and sedation procedures performed outside the operating room. It outlines common procedures that require anesthesia outside OR settings like radiology suites and ICUs. It also describes the challenges anesthesiologists face in these settings like unfamiliar environments, limited equipment and monitoring, and patient issues. Guidelines are provided for sedation versus general anesthesia based on the procedure and safety standards for monitoring, equipment, and discharge criteria when anesthesia is provided outside the traditional operating room.
Delayed recovery from anaesthesia by prof. minnu m. panditrao
The document discusses various reasons for delayed recovery from anesthesia, including pharmacological factors related to specific drugs, surgery-related issues, and patient-specific factors. It provides case examples of delayed recovery and recommends having a generalized protocol as well as understanding specific situations to properly manage patients and prevent complications. Vigilance and careful balancing of many variables by an experienced anesthesiologist are important to avoid morbidity and mortality from delayed recovery.
Rapid sequence spinal anesthesia (RSS).pptx
Rapid sequence spinal anesthesia (RSS) is a technique used for urgent cesarean sections that requires effective coordination between medical staff. Segmental spinal anesthesia involves puncturing the spinal cord at higher thoracic levels using lower doses of local anesthetic, allowing selective blockade of dermatomes needed for surgery. This technique provides hemodynamic stability, less motor blockade, and faster recovery compared to conventional spinal anesthesia. Careful performance of segmental spinal anesthesia can establish it as a routine procedure for day surgery.
Obstructive sleep apnoea
This document provides an overview of obstructive sleep apnea (OSA) and its implications for anesthesia. It defines OSA and discusses its causes, diagnosis, and physiological effects. It outlines risks of anesthesia for those with OSA, including difficult intubation and postoperative respiratory depression. It recommends preoperative screening and treatment with CPAP or weight loss. Intraoperatively, it advises securing the airway and avoiding sedatives that could cause collapse. Postoperatively, supplemental oxygen is important due to risk of apnea and respiratory depression upon waking.
anaesthetic management of Meningomyelocele and its Surgical excision
This document discusses the anaesthetic management of patients with meningomyelocele. Key points include:
- Meningomyelocele is a complex birth defect involving protrusion of the meninges and spinal cord through the vertebrae.
- Patients often have other associated anomalies and hydrocephalus.
- Anaesthetic challenges include airway management, physiological immaturity of organ systems, fluid management due to third spacing and blood loss.
- Careful pre-operative evaluation, positioning to protect the meningocele, and meticulous intraoperative fluid management are important to optimize outcomes.
Minimum Alveolar Concentration
The document provides a history of anesthetic agents, beginning with diethyl ether in 1846 and progressing to modern volatile agents like sevoflurane. It discusses the properties of each agent that made them viable or led to their discontinuation. It also defines the minimum alveolar concentration (MAC) concept for measuring anesthetic potency based on immobilization during incision. Factors that increase or decrease MAC values are outlined.
What's hot (20)
Delayed recovery from anaesthesia by prof. minnu m. panditrao
Delayed recovery from anaesthesia by prof. minnu m. panditrao
anaesthetic management of Meningomyelocele and its Surgical excision
anaesthetic management of Meningomyelocele and its Surgical excision
Viewers also liked
Multimodal pain management following surgical procedures
1. The document discusses concepts related to nociception, central sensitization, and multimodal analgesia for perioperative pain management.
2. It provides definitions of terms like nociception and describes the types of pain and sensory receptors involved in pain perception.
3. The key aspects of multimodal analgesia involve combining different analgesics that act through different mechanisms in the nervous system to provide improved analgesia and fewer side effects than individual analgesics alone.
Anesthesia and Asthma
Who is at Risk of Asthma Complications after Surgery?For most people with mild to moderate asthma, t...
Preoperative preparations by Dr.Syed Alam Zeb
The document discusses the role of the surgeon in preoperative patient preparation. It outlines the steps involved which include taking a history, performing examinations and required investigations, providing preoperative treatments, ensuring proper communication, and obtaining informed consent. Various types of examinations, common investigations, preoperative treatments for different medical conditions, and elements of the informed consent process are described in detail.
Treatment of malignant hyperthermia in an outpatient surgery center
Mix dantrolene as quickly as possible and hand to
anesthesia for rapid IV push.
DANTROLENE NURSE
Continue mixing dantrolene vials as anesthesia calls
for them.
Have pre-filled syringes ready to hand off.
Monitor anesthesia for additional vials needed.
Remind anesthesia to call out vials used to ensure
adequate supply.
Be prepared to mix additional vials as needed.
Stay focused on mixing dantrolene as quickly as
possible.
COOLING NURSE
Obtain ice
Anaesthesia For Laparoscopic Assisted Surgery Dr. Shailendra
This document discusses anesthesia management for laparoscopic assisted surgery. Some key points include:
- Laparoscopy has advantages over open surgery like shorter hospital stays and faster recovery, but can pose respiratory and cardiovascular risks under anesthesia.
- Maintaining adequate ventilation and oxygenation can be challenging due to absorption of carbon dioxide and positioning effects.
- Gas embolism is a serious risk if gas is directly injected into blood vessels, which can cause hypotension, arrhythmias and death if massive.
- Patient positioning like head-down can increase risks like elevated intracranial pressure and decreased cardiac output that anesthesiologists must manage closely.
6. Special Techniques
1. Local anesthesia involves injecting chemical agents near sensory neurons to temporarily disrupt nerve impulses and induce loss of sensation. It has advantages over general anesthesia like low toxicity and excellent pain control.
2. Common local anesthetic agents include lidocaine, bupivacaine, mepivacaine, and procaine. They work by blocking sodium channels and preventing nerve impulse transmission.
3. Local anesthetics can be administered via infiltration, nerve blocks, epidurals, and other regional techniques to induce localized numbness for various surgical procedures. Proper administration and dosage are important to avoid adverse effects.
Asthma
1. The document discusses approaches for ventilating patients with asthma, focusing on the benefits of decelerating flow over constant flow.
2. Data from studies on pediatric and adult asthma patients show that pressure control ventilation with decelerating flow results in better oxygenation, lower carbon dioxide levels, and shorter time to clinical improvement compared to volume control ventilation with constant flow.
3. The preferred ventilation approach for asthma is to use pressure control modes with decelerating flow, limit lung injury by avoiding dynamic hyperinflation, minimize plateau pressures, and allow some hypercapnia to prevent barotrauma.
Hypertension and surgery
Hypertension is a major risk factor for complications during and after surgery. Patients with untreated severe hypertension are at highest risk, as they may experience exaggerated blood pressure changes during anesthesia induction and in response to pain. Those with mild or moderate controlled hypertension usually do not face increased operative risk unless related end-organ damage is present. Antihypertensive medications should generally be continued up to and after surgery, with intravenous alternatives available if needed. Postoperative hypertension requires treatment to prevent complications.
Orthopedic surgery
Orthopedic surgery involves various procedures to repair bones and joints, from open reduction of fractures to joint replacement and amputation. Preoperative management focuses on optimizing patient health through nutrition, hydration, and infection control. Postoperative care monitors for complications like bleeding and swelling while preventing issues from immobility through careful nursing interventions.
Anesthesia for robotic surgery
1) The document discusses robotic surgery and defines terms like robotic surgery, robotically assisted surgery, computer-assisted surgery, telesurgery, telemanipulation, and telepresence.
2) It describes the da Vinci robotic surgical system, which has three components: a console, vision tower, and surgical cart with four robotic arms.
3) The system allows 7 degrees of freedom of motion and filters out hand tremors, with the surgeon seated at a console to control the robotic arms from a remote location with an magnified 3D view of the surgical area.
Preoperative hypertension
This document discusses the management of hypertension in patients undergoing surgery. It notes that hypertension can cause blood pressure and heart rate to rise significantly during anesthesia induction, and these patients are also more likely to experience significant fluctuations in blood pressure intraoperatively and postoperatively. For elective surgery, blood pressure should be controlled below 170/110 mmHg, and surgery should not be delayed if blood pressure is below 110/90 mmHg as long as blood pressure is closely monitored. Most chronic antihypertensive medications should be continued up to and after surgery to prevent rebound effects, though diuretics can cause hypokalemia and beta blockers withdrawal may cause cardiac issues. Parenteral alternatives are recommended for patients unable to take oral
Splanchnic circulation
This is a presentation about splanchinc circulation.
Done by year 3 medical students at the University of Science and Technology, Sana'a, Republic of Yemen.
Spring semester of 2010.
Perioperative complications (respiratory)
This document discusses various respiratory complications that can occur during and after anesthesia and surgery. It covers complications related to intubation like damage to teeth or larynx. Other complications discussed include respiratory obstruction, hypoxemia, hypercapnia, hypoventilation, and aspiration pneumonia. Causes, signs, and treatments are provided for each complication. The most common causes of hypoventilation in the post-anesthesia care unit are residual effects of anesthetic drugs and lingering neuromuscular blockade.
Atelectasis/Lung Collapse Part-1 by Dr Bashir Ahmed Dar Associate Professor M...
Atelectasis/Lung Collapse Part-1 by Dr Bashir Ahmed Dar Associate Professor M...Prof Dr Bashir Ahmed Dar
The term atelectasis is derived from the Greek words ateles and ektasis, which mean incomplete expansion.The incomplete expansion of lung may involve part of lung or entire lung.Most symptoms and signs are determined by the rapidity with which the collapse of lung occurs,the size of the lung area affected, and the presence or absence of complicating infection.
Rapid bronchial occlusion with a large area of lung collapse causes pain on the affected side, sudden onset of dyspnea, and cyanosis. Hypotension, tachycardia, fever, and shock may also occur.
Slowly developing atelectasis may be asymptomatic or may cause only minor symptoms. Middle lobe syndrome often is asymptomatic, although irritation in the right middle and right lower lobe bronchi may cause a severe, hacking, nonproductive cough.TURP
TURP is a procedure to relieve urinary symptoms from an enlarged prostate. It carries risks due to the elderly patient population and long duration. A thorough pre-op assessment helps determine anesthesia technique, with subarachnoid block preferred. Potential complications include hypotension, hemorrhage, bladder perforation, hypothermia, and the rare but serious TURP syndrome caused by excessive fluid absorption. Close monitoring is needed to rapidly identify and treat any issues.
Perioperative management of hypertension
This document discusses the peri-operative management of hypertension. It notes that hypertension occurring before, during or after surgery increases the risk of cardiovascular events and postoperative morbidity and mortality. It provides guidelines on evaluating and controlling pre-operative hypertension, managing anesthesia for hypertensive patients, monitoring blood pressure during surgery, and treating postoperative hypertension. The effects of hypertension on organ systems like the heart, brain and kidneys are reviewed. Acute hypertensive crises are also discussed.
Patient safety in anesthesia
This document discusses strategies to improve patient safety during anesthesia. It identifies that anesthesia can induce physiological changes that increase morbidity and mortality risks, so factors threatening safety in the operating room must be addressed. These factors include equipment issues, patient health problems, and human errors by anesthetists and surgeons. The document recommends developing preoperative plans, maintaining situational awareness during procedures, emphasizing teamwork and communication, avoiding production pressures, and fostering a learning culture where errors are reported and used to implement safety improvements.
Anesthesia for non Obstetric Surgery in Pregnancy
This document discusses anaesthesia considerations for non-obstetric surgery during pregnancy. It notes that while no anaesthetic agents have been proven to be teratogenic in humans, surgery can increase risks of preterm labour, abortion, or perturbations in uteroplacental blood flow that could impact the fetus. It emphasizes the importance of consulting an obstetrician prior to any invasive procedures or surgery during pregnancy due to their expertise in maternal-fetal physiology. Regional anaesthesia is generally preferred over general anaesthesia when possible.
Perioperative death/safe anesthesia practice
1. The document discusses perioperative mortality and safe anesthesia practices. It defines anesthetic death and classifies the causes of perioperative mortality.
2. Major causes of perioperative mortality include human error, communication failures, equipment failures, and underlying patient diseases. The document provides strategies to prevent complications through improved preoperative assessment, monitoring standards, anesthesia techniques, and postoperative care.
3. In the event of a complication or death, the document stresses the importance of general management practices like monitoring, diagnosis, and treatment, as well as thorough documentation, handling of deceased patients sensitively, and communicating with family members.
TURP step by step operative urology
TURP step by step operative urology series
for more resources:
www.uronotes2012.blogspot.com
enter your mail & press follow us by mail to receive our daily feeds
Viewers also liked (20)
Multimodal pain management following surgical procedures
Multimodal pain management following surgical procedures
Treatment of malignant hyperthermia in an outpatient surgery center
Treatment of malignant hyperthermia in an outpatient surgery center
Anaesthesia For Laparoscopic Assisted Surgery Dr. Shailendra
Anaesthesia For Laparoscopic Assisted Surgery Dr. Shailendra
Atelectasis/Lung Collapse Part-1 by Dr Bashir Ahmed Dar Associate Professor M...
Atelectasis/Lung Collapse Part-1 by Dr Bashir Ahmed Dar Associate Professor M...
Similar to Anesthesiology Information
Patient safety During Anesthesia
1) Anesthesia safety has greatly improved over time, with mortality decreasing from 1 in 5,000 anesthetics in the 1970s to 1 in 200,000-300,000 in 1999. Current trends show further decreases in complication rates.
2) Factors influencing anesthesia risk include patient status, procedure invasiveness, facility resources and equipment, and the skills of the anesthesiologist and surgeon. Monitoring equipment, safer drugs and equipment, airway management skills, and adherence to guidelines have all contributed to increased safety.
3) Anesthesiology is considered a high-risk specialty, but patients have a higher chance of dying from a car accident than from general anesthesia according to WHO statistics. Contin
Anesthesiology clerkship rotation_handbook - copy
This document provides an overview of topics relevant to an anesthesiology clerkship rotation, including:
1) A definition of general anesthesia and discussion of associated risks.
2) Guidelines for preoperative assessment and optimization of patient medical conditions such as cardiovascular, respiratory, endocrine, and renal diseases.
3) Descriptions of important hereditary conditions like malignant hyperthermia that require special anesthetic considerations.
Spectral entropy 2012
This document discusses spectral entropy monitoring during general anesthesia. It notes that spectral entropy monitoring uses algorithms to process EEG and EMG signals to provide information on a patient's level of consciousness during anesthesia via two parameters - State Entropy and Response Entropy. State Entropy assesses hypnotic effect based on EEG signals alone, while Response Entropy can also detect facial muscle movement via EMG signals. The document reviews how entropy values generally decrease with deepening anesthesia and can help identify inadequate analgesia or impending emergence from anesthesia if values increase suddenly.
Consciousness monitoring by Wael Nasri
BIS monitoring provides additional information for the anesthesia provider by directly measuring the effects of anesthesia on your patient
Awareness Anesthesia
Awareness Anesthesia occurs when a patient becomes conscious during a surgical procedure performed under general anesthesia and subsequently has recall of these events
Regional anesthesia
This document discusses complications that can occur with regional anesthesia techniques. It begins by outlining general principles for safe regional anesthesia including thorough patient assessment, skilled monitoring during the procedure, and having necessary equipment and assistance available. It then discusses specific complications that can occur with local anesthetics including allergic reactions, systemic toxicity, and cardiac issues. Potential complications of peripheral nerve blocks are reviewed such as direct needle trauma, pneumothorax, and vascular or spinal cord injury. The toxic effects of local anesthetics on nerves and surrounding tissues like myotoxicity and phrenic nerve paresis are also covered. Finally, complications associated with neuroaxial blocks like direct needle trauma, ischemic injuries, and management of neurologic injuries are summarized.
regional analgesia in ICU
Regional analgesia techniques can provide effective pain management for critically ill ICU patients. While regional analgesia reduces opioid use and related side effects, it also poses unique challenges in the ICU setting. Expertise is required to perform regional techniques safely in critically ill patients, where complications may be difficult to detect due to patient factors like sedation. A risk-benefit analysis must be conducted individually for each patient and reviewed daily for continuous techniques. Regional analgesia, when appropriately performed, can improve outcomes for critically ill ICU patients compared to systemic opioid treatment alone.
Role of anaesthesiologist in management of cancer pain
This document discusses the role of anesthesiologists in managing cancer pain. It covers types of cancer pain like somatic, visceral and neuropathic pain. It discusses pharmacologic approaches like opioids, non-opioids and adjuvants according to the WHO pain ladder. Non-pharmacologic options like acupuncture, yoga and TENS units are also covered. The role of anesthesia includes interventions like nerve blocks, epidurals and intrathecal pain pumps to manage cancer pain. Different types of nerve blocks and drugs used for sympathetic blocks are explained.
ICU psychosis.pptx
This document discusses ICU psychosis/delirium, which is an acute organic brain syndrome that commonly affects critically ill patients in intensive care units (ICUs). The incidence is reported to be 15-80% of ICU patients, with elderly patients being especially vulnerable. Factors that can predispose patients to ICU psychosis include sensory overload, sleep deprivation, immobilization, stress, unfamiliar environments, and medical conditions/treatments. Symptoms include impaired cognition, disorganized thinking, confusion, and changes in perception or sleep cycles. Diagnosis involves assessments like CAM-ICU or MMSE. Treatment prioritizes managing the underlying causes, while antipsychotics may help control symptoms. Non-drug strategies focus on improving sleep,
Awareness Under Anaesthesia- Dr. Sonalika .pdf
This document discusses awareness under anesthesia. It begins by defining awareness as the perception of sensory stimuli by a patient during intended general anesthesia with later explicit recall. The incidence of intraoperative awareness varies from 1 in 1000 to 1 in 14,500 general anesthetics. Depth of anesthesia is currently assessed using loss of consciousness, end-tidal gas concentrations, processed EEG monitors, and evoked potentials. Preventing and detecting awareness relies on careful anesthetic titration, monitoring, and post-operative questioning using tools like the Brice questionnaire. Consequences of unprevented awareness can include severe psychological issues like post-traumatic stress disorder.
ICU psychosis.pptx
This document discusses ICU psychosis/delirium, which is an acute organic brain syndrome that commonly affects 15-80% of critically ill patients in intensive care units. It is caused by factors like sensory overload, sleep deprivation, immobilization, and medications. Symptoms include impaired cognition, disorganized thinking, memory issues, and hallucinations. It is diagnosed using tools like the Confusion Assessment Method. Treatment aims to reduce stressors and includes modifying the environment, mobilization, relaxation techniques, and medications like antipsychotics or benzodiazepines. Prolonged ICU stays and older age can increase risk.
Frequent mistakes of young anesthetists-intensivists
This document discusses frequent medication errors made by young anesthetists-intensivists. It notes that while modern medicine has made these fields safer, complex conditions and multi-step processes still leave room for potentially life-threatening errors. Errors most commonly occur during administration of drugs and in the middle of procedures. Common drugs involved in errors include induction agents, muscle relaxants, sedatives, and drugs used in critical care like inotropes and anticoagulants. The document recommends strategies like simplifying processes, redundancy, standardization, and double checking to help minimize medication errors.
Sedation
The document discusses guidelines for sedation, analgesia, and neuromuscular blockade in the adult ICU. It describes the benefits of daily sedation interruption and titration programs to lighten sedation levels. It provides an overview of options for sedation and analgesia, including opioids, benzodiazepines, propofol, dexmedetomidine, and neuromuscular blockade. It also addresses risks of oversedation like delirium and discusses strategies for preventing and treating delirium.
pain ppt for undergraduates
Regional anesthesia & pain medicine is led by Dr. G. Uma at KIMS&RC. The document discusses various regional anesthesia techniques like spinal, epidural, plexus blocks, and peripheral nerve blocks. It covers indications, contraindications, advantages, and complications of techniques like neuraxial blockade and epidural analgesia. It emphasizes multimodal analgesia and the importance of adequate acute pain management for improved patient outcomes.
ug class pain 7-12-22 (1).pptx
This document discusses regional anesthesia and pain management. It provides an overview of regional anesthesia techniques including spinal, epidural, caudal and peripheral nerve blocks. It outlines considerations for choosing regional techniques like suitability for surgery and patient factors. The advantages of regional blocks are also highlighted such as improved patient satisfaction and reduced side effects compared to general anesthesia. Contraindications for neuraxial blockade are described. Epidural analgesia benefits for postoperative pain are discussed.
Icu psychosis
This document discusses ICU psychosis/ICU syndrome, which is an acute organic brain syndrome that occurs in critically ill patients treated in intensive care units. It has an incidence rate of 15-80% among ICU patients. Factors that can precipitate it include sensory overload, sleep deprivation, immobilization, and various medical conditions. Symptoms include impaired cognition, disorganized thinking, and altered perception. Diagnosis involves assessments for confusion. Treatment aims to minimize risk factors and control symptoms, with close monitoring, a calm environment, and occasionally antipsychotic medications. As more patients receive ICU care, ICU psychosis is a growing problem.
Preoperative nursing care
1. The document discusses perioperative nursing care, describing the three phases - preoperative, intraoperative, and postoperative.
2. In the preoperative phase, nurses conduct assessments, educate patients, and prepare them physically and psychologically for surgery.
3. The intraoperative phase involves monitoring the patient's physiological status and ensuring a sterile environment during the surgical procedure.
4. Different types of anesthesia are described, including general, local/regional, conscious sedation and spinal anesthesia, along with their risks and complications.
Pre op in neuro
This document provides details on pre-operative evaluation for neurosurgery patients. It outlines the importance of gathering a thorough history including neurological symptoms, prior surgeries/treatments, and general medical conditions. A focused physical exam is also described which evaluates neurological function, signs of increased intracranial pressure, and other system involvement. The goal is to assess risk factors and develop an appropriate anesthesia management plan.
Epilepsy2
Seizures and epilepsy are defined. Seizures are caused by sudden surges of electrical activity in the brain that affect how a person feels or acts for a short time. Epilepsy is a condition involving the central nervous system that requires a person to have had at least two seizures not caused by a known medical condition. Diagnosing seizures involves considering witness accounts, symptoms, and test results like EEGs and neuroimaging. Treatment involves identifying seizure types and potentially using anti-seizure medications or surgery to control seizures.
Similar to Anesthesiology Information (20)
Role of anaesthesiologist in management of cancer pain
Role of anaesthesiologist in management of cancer pain
Frequent mistakes of young anesthetists-intensivists
Frequent mistakes of young anesthetists-intensivists
More from MedicineAndHealth
Medical.Profession Kalabay.Laszlo
The document discusses the attributes and roles of medical professionals. It describes how physicians must be trained scientifically to understand the scientific method, gather and analyze data, and continuously improve care. Physicians are also called to be caregivers who earn patients' trust, show compassion, and commit to patients' long-term needs. As professionals, physicians must put patients' interests above their own and maintain high standards of excellence through lifelong learning.
HOW TO DO PATENT LANDSCAPING(USING FREE DATABASEs e.g. USPTO & ESP@CENET HO...
This document outlines the procedure for conducting patent landscaping using free databases like USPTO and ESPACENET. The process involves searching for patents related to a product by name and assignee on USPTO, then searching individual patent numbers on ESPACENET to find family information from other countries. Key details like priority date, filing date, and estimated expiration date are gathered. Independent claims are analyzed to understand the scope of protection.
Accounting I: Introduction to University Accounting Accounting I: Introduct...
This document provides an overview and introduction to university accounting concepts. It discusses key accounting terms like assets, liabilities, fund balance and income statements. It also covers accounting standards, the chart of accounts, identifying revenue and expense accounts, and the major financial reports used for reporting and oversight. The goal is for students to understand basic accounting principles and be able to classify university financial transactions.
Personalized Medicine: Current and Future Perspectives Personalized Medicin...
The document discusses personalized medicine, including its definitions, current state, and future perspectives. It provides examples of personalized medicine like warfarin dosing and breast cancer risk assessment. It outlines key issues for stakeholders like payers, providers, developers, government, and consumers regarding pharmacogenomics testing, costs, access, and emerging ethical and policy concerns around privacy, informed consent, and potential for discrimination.
Medicare Basics
This document provides an overview of Medicare, including:
- Parts A and B which cover hospital insurance and medical insurance. Part C includes Medicare Advantage Plans and Part D covers prescription drug coverage.
- Original Medicare and Medicare Advantage Plans (like HMOs and PPOs) are choices for coverage. Extra help is available for those with limited income.
- Eligibility, enrollment periods, premiums, deductibles, and cost sharing are explained for different parts and plan options. Programs like Medicaid and Medicare Savings Programs also help cover costs.
Victim Compensation Without Litigation - the Lexington Experience Victim Co...
The document discusses the victim compensation program implemented at the Lexington VA Medical Center since 1987. Under the program, when medical errors are identified that cause patient harm, the hospital fully discloses the facts to patients, accepts responsibility, and offers compensation through negotiated settlements. Over 13 years, the hospital settled over 170 cases through this approach, with an average settlement of $16,000, avoiding costly litigation. Studies found this approach improved patient satisfaction and reduced costs compared to traditional denial and litigation practices.
Long term Care in Developed Countries and Recommendations for Slovak Republic...
The document discusses long-term care systems in several developed countries, including Denmark, Germany, the Netherlands, and Sweden. It finds that these countries take different approaches, such as Denmark providing long-term care through municipalities and Germany establishing a universal social insurance program. Overall, the countries aim to provide community-based long-term care and integrate health and social services while controlling costs. The document recommends that Slovakia develop a public long-term care system.
BUSINESS ETHICS
The document discusses business ethics and provides a quick test to assess one's ethical beliefs in business situations. It includes questions about priorities, rules, honesty, and other ethical dilemmas that may arise. The test is scored out of 40 points, with a lower score indicating more questionable ethics. The document encourages reflecting on why certain answers were chosen and establishing an ethical framework to make complex business decisions.
Sorry Works
The document discusses the Sorry Works! Coalition, which promotes a program of full disclosure and apology when medical errors occur. The program aims to reduce litigation by handling issues compassionately and compensating harmed parties. Data suggests programs like those used in Canada and the US lower costs from fewer lawsuits and settlements. While some remain cautious of apologies due to liability concerns, the coalition argues real apologies do not increase legal risks when part of an organized program with thorough investigations and compensation when appropriate.
Compensation Larger Practices
This document summarizes different physician compensation models for allergy practices. It discusses straight salary, salary plus productivity, full productivity-based compensation, equal sharing, salary plus contribution margin, and compensation based on revenue, cost centers, full-time percentage and shares. The key advantages and disadvantages of each model are provided for both employees and employers. It also outlines steps to structure a compensation system, including defining goals, physician input, appointing a committee, and balancing group and individual objectives.
Defending Medical Malpractice
To protect yourself from medical malpractice, doctors should provide excellent patient care, develop good relationships with patients, stay up-to-date on their area of medicine, and know when to consult others or transfer a patient. When defending a malpractice case, lawyers will review medical records, identify experts, prepare the doctor for deposition, determine the standard of care, and try the case in court. Doctors experiencing a malpractice suit may feel stress over impacts to their career, insurance rates, and family; proper insurance and estate planning can help address these issues.
Personalized Medicine: Balancing the Promise and Peril of ... Personalized ...
This document discusses the promise and challenges of personalized medicine through pharmacogenomics. It explores opportunities like more effective drug development through tailoring therapies based on genetic differences. However, it also examines ethical issues such as deciding research priorities, demonstrating clinical utility with smaller trials, integrating testing into care, preventing discrimination and maintaining privacy and confidentiality. The document notes economic challenges around business decisions and costs, as well as social impacts on identity, health inequalities and creating feelings of fatalism or helplessness in some groups.
Seven Basics
The document discusses seven key considerations for physicians entering into contracts with private group practices: 1) there are three categories of contracts - internal group agreements, "group" agreements, and physician agreements; 2) physicians should conduct due diligence on the group and understand the advantages of equity ownership; 3) employment agreements should address essential terms like compensation, duties, and termination; 4) professional malpractice insurance is important to understand; 5) be aware of potentially problematic contract clauses; 6) consider other practice options like academic positions or solo/small group practices; 7) conduct thorough pre-contract due diligence and understand that the employment contract is legally binding.
Negotiating For The Ideal Job
1) The document provides tips for physicians on negotiating an employment contract or job offer, including planning ahead, knowing your worth and market salary ranges, prioritizing needs versus wants, and being realistic in your demands.
2) Key areas to negotiate include salary, bonuses, benefits, insurance, retirement plans, vacation time, promotion requirements, and terms of partnership or employment such as obligations, termination conditions, and restrictive covenants.
3) It's important to have the contract be as specific as possible in writing, use an experienced lawyer to review it, and be willing to walk away from a bad deal that does not meet your priorities and limits.
Medical malpractice
The document discusses several topics related to medical malpractice including:
- Medical error is estimated to occur at a rate equivalent to 3 jumbo jet crashes per day.
- Common reasons patients sue doctors include diagnostic errors, surgical errors, and improper medical treatment. The doctors most often sued are surgeons, anesthesiologists, and obstetricians.
- While a negligent doctor has a 3 in 100 chance of being sued, a non-negligent doctor has only a 13 in 10,000 chance - suggesting most malpractice claims are not frivolous.
- Medical malpractice is defined as when a doctor fails to act as a reasonable physician would under the circumstances. Proving malpractice
Medical errors, negligence, and litigation
The document discusses medical errors and their relationship to negligence and malpractice litigation. Some key points:
- Medical errors are estimated to cause between 44,000-98,000 deaths per year in the US, making it a leading cause of death. However, other studies estimate a lower number of around 5,000 deaths due to errors.
- Only a small percentage (around 1-2%) of medical errors result in negligent injuries. Of those negligent injuries, only 10-13% result in malpractice claims.
- Common reasons for malpractice litigation include needing money, believing there was a cover up, or wanting information or revenge. However, the system rarely identifies or holds providers accountable for substandard care
The Physician Market Part 2
The document discusses various compensation models used by managed care organizations (MCOs) to influence physician behavior and control costs, including capitation, withholds, bonuses, and risk sharing. It provides examples of how capitation, withholds, and bonuses are implemented. It also discusses the advantages of capitation for physicians in terms of financial autonomy and cash flow stability. Finally, it summarizes the rise and fall of large physician practice management companies in the 1990s that aimed to aggregate physician practices but often struggled with integration and cost prediction issues.
What to Run Before Your Business Plan Course What to Run Before Your Busine...
The document discusses running an "Opportunity Assessment Course" before a business plan course to help students critically evaluate market opportunities. It would involve students conducting feasibility studies on opportunities they choose to assess market and industry attractiveness. This would help avoid biases and embarrassment compared to traditional business plan competitions. The course would cover the seven key domains to evaluate - macro factors like market attractiveness and micro factors like a company's competitive advantages and management team. Warren Buffett's quote is cited that a brilliant management team cannot overcome fundamentally poor market opportunities.
The physician market Part 1
The document summarizes key aspects of the physician market in the United States, including market structure, conduct, and performance. It notes that the US has a higher proportion of specialists compared to other countries, which may contribute to higher healthcare costs. Physician practices are increasingly moving to group models, which tend to be more productive and benefit from economies of scale. Managed care places pressures on physicians to control costs and modify behavior.
More from MedicineAndHealth (20)
HOW TO DO PATENT LANDSCAPING(USING FREE DATABASEs e.g. USPTO & ESP@CENET HO...
HOW TO DO PATENT LANDSCAPING(USING FREE DATABASEs e.g. USPTO & ESP@CENET HO...
Accounting I: Introduction to University Accounting Accounting I: Introduct...
Accounting I: Introduction to University Accounting Accounting I: Introduct...
Personalized Medicine: Current and Future Perspectives Personalized Medicin...
Personalized Medicine: Current and Future Perspectives Personalized Medicin...
Victim Compensation Without Litigation - the Lexington Experience Victim Co...
Victim Compensation Without Litigation - the Lexington Experience Victim Co...
Long term Care in Developed Countries and Recommendations for Slovak Republic...
Long term Care in Developed Countries and Recommendations for Slovak Republic...
Personalized Medicine: Balancing the Promise and Peril of ... Personalized ...
Personalized Medicine: Balancing the Promise and Peril of ... Personalized ...
What to Run Before Your Business Plan Course What to Run Before Your Busine...
What to Run Before Your Business Plan Course What to Run Before Your Busine...
Recently uploaded
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Histopathology of Rheumatoid Arthritis: Visual treat
Histopathology of Rheumatoid Arthritis: Visual treat
Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS). Parc Taulí. Sabadell
Top Travel Vaccinations in Manchester
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Journal Article Review on Rasamanikya
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
All info about Diabetes and how to control it.
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
Identifying Major Symptoms of Slip Disc.
Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
Cell Therapy Expansion and Challenges in Autoimmune Disease
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
NARCOTICS- POLICY AND PROCEDURES FOR ITS USE
This document outlines policies and procedures for handling narcotic and controlled drugs in NABH accredited hospitals.
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
It includes regulation of combination products and medical devices. FDA and industry liaisons.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Recently uploaded (20)
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Histopathology of Rheumatoid Arthritis: Visual treat
Histopathology of Rheumatoid Arthritis: Visual treat
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Cell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune Disease
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
Anesthesiology Information
- 1. Awareness During Anesthesia Do You Remember…?
- 19. Prevention and Management of Awareness
- 23. Thanks for your attention!