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American Society of Anesthesiologists' physical status system: a multicentre Francophone study to analyse reasons for classification disagreement.

https://arctichealth.org/en/permalink/ahliterature131371
Source
Eur J Anaesthesiol. 2011 Oct;28(10):742-7
Publication Type
Article
Date
Oct-2011
Author
Philippe Cuvillon
Emmanuel Nouvellon
Emmanuel Marret
Pierre Albaladejo
Louis-Philippe Fortier
Pascale Fabbro-Perray
Jean-Marc Malinovsky
Jacques Ripart
Author Affiliation
Division of Anesthésie Réanimation Douleur Urgences, Hôpital Universitaire Caremeau, Nîmes France. philippe.cuvillon@wanadoo.fr
Source
Eur J Anaesthesiol. 2011 Oct;28(10):742-7
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anesthesiology - methods - standards
Canada
Cross-Over Studies
Female
France
Health Care Surveys
Health status
Humans
Language
Male
Middle Aged
Single-Blind Method
Societies
Treatment Outcome
United States
Abstract
Variability of American Society of Anesthesiologists' (ASA) physical status scores attributed to the same patient by multiple physicians has been reported in several studies. In these studies, the population was limited and diseases that induced disagreement were not analysed.
To evaluate the reproducibility of ASA physical status assessment on a large population, as used in current practice before scheduled surgery.
Multicentre, randomised, blinded cross-over observational study.
During a 2-week period in nine institutions, ASA physical status and details of assessment performed routinely by anaesthesiologists for patients who underwent elective surgery were recorded. Records were blinded (including ASA physical status) by an independent statistical division and returned randomly to one of the nine centres for reassessment by accredited specialist anaesthesiologists.
The level of agreement between the two measurements of the ASA physical status was calculated by using the weighted Kappa coefficient.
During the study period, 1554 anaesthesia records were collected and 197 were excluded from analysis because of missing data. After the initial evaluation, the distribution of ASA physical status grades was as follows: ASA 1, 571; ASA 2, 591; ASA 3, 177; and ASA 4, 18. After the final evaluation, the distribution of ASA grades was as follows: ASA 1, 583; ASA 2, 520; ASA 3, 223; and ASA 4, 31. Two per cent of the patients had an underestimation of their physical status. The degree of agreement between the two measures evaluated by the weighted Kappa coefficient was 0.53 (0.49-0.56). No difference was observed between public and private institutions. Patients with co-existing diseases, obesity, allergy, sleep apnoea, obstructive lung disease, renal insufficiency and hypertension were least likely to have been graded correctly.
The degree of agreement between two measures of the ASA physical status grade is moderate and influenced by staff characteristics and the complexity of diseases.
PubMed ID
21912242 View in PubMed
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Danish Guidelines 2015 for percutaneous dilatational tracheostomy in the intensive care unit.

https://arctichealth.org/en/permalink/ahliterature268286
Source
Dan Med J. 2015 Mar;62(3)
Publication Type
Article
Date
Mar-2015
Author
Kristian Rørbæk Madsen
Henrik Guldager
Mikael Rewers
Sven-Olaf Weber
Kurt Købke-Jacobsen
Jonathan White
Source
Dan Med J. 2015 Mar;62(3)
Date
Mar-2015
Language
English
Publication Type
Article
Keywords
Anesthesiology - methods - standards
Bronchoscopy - methods - standards
Critical Care - methods - standards
Critical Illness
Denmark
Dilatation - contraindications - methods - standards
Humans
Patient Safety
Respiration, Artificial - methods - standards
Societies, Medical
Tracheostomy - contraindications - methods - standards
Abstract
Percutaneous dilatational tracheostomy is a common procedure in intensive care. This updated Danish national guideline describes indications, contraindications and complications, and gives recommendations for timing, anaesthesia, and technique, use of fibre bronchoscopy and ultrasound guidance, as well as decannulation strategy, training, and education.
PubMed ID
25748872 View in PubMed
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Danish national sedation strategy. Targeted therapy of discomfort associated with critical illness. Danish Society of Intensive Care Medicine (DSIT) and the Danish Society of Anesthesiology and Intensive Care Medicine (DASAIM).

https://arctichealth.org/en/permalink/ahliterature269088
Source
Dan Med J. 2015 Apr;62(4):C5052
Publication Type
Article
Date
Apr-2015
Author
Lise Fonsmark
Lars Hein
Helle Nibroe
Helle Bundgaard
Inge de Haas
Susanne Iversen
Thomas Strøm
Source
Dan Med J. 2015 Apr;62(4):C5052
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Anesthesiology - methods - standards
Conscious Sedation - methods - standards
Critical Care - standards
Critical Illness
Denmark
Female
Humans
Hypnotics and Sedatives - administration & dosage - adverse effects
Intensive Care Units - standards
Male
Outcome Assessment (Health Care)
Pain - drug therapy - physiopathology
Practice Guidelines as Topic - standards
Respiration, Artificial - methods
Risk assessment
Societies, Medical - standards
Abstract
Sedation of critically ill patients undergoing mechanical ventilation should be minimized or completely avoided. Only in selected situations is sedation indicated as first line therapy (increased intracranial pressure or therapeutic hypothermia). The critical care physicians primary objective should be to focus on the reversible causes of agitation, such as: pain, anxiety, delirium, dyspnea, withdrawal symptoms, sleep or gastrointestinal symptoms. If sedation is used a validated sedation scale is recommended. On a daily basis sedation should be interrupted and only restarted after a thorough search for reversible causes of discomfort and stress.
PubMed ID
25872538 View in PubMed
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Drug shortages in Canadian anesthesia: a national survey.

https://arctichealth.org/en/permalink/ahliterature115083
Source
Can J Anaesth. 2013 Jun;60(6):539-51
Publication Type
Article
Date
Jun-2013
Author
Richard Hall
Gregory L Bryson
Gordon Flowerdew
David Neilipovitz
Agnieszka Grabowski-Comeau
Alexis F Turgeon
Author Affiliation
Division of Critical Care Medicine, Department of Anesthesiology, Dalhousie University and the Capital District Health Authority, Room 5452 Halifax Infirmary, 1796 Summer Street, Halifax, NS B3H 3A7, Canada. rihall@dal.ca
Source
Can J Anaesth. 2013 Jun;60(6):539-51
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Anesthesia - methods - standards
Anesthesia Recovery Period
Anesthesia, General - methods - standards
Anesthesiology - methods - standards
Anesthetics - administration & dosage - supply & distribution
Canada
Humans
Medication Errors - statistics & numerical data
Questionnaires
Treatment Outcome
Abstract
Canadian physicians are faced with an increasing frequency of drug shortages. We hypothesized that drug shortages have a clinical impact on anesthesia care in Canada.
We conducted a self-administered survey of anesthesiologists in Canada using the membership list of the Canadian Anesthesiologists' Society. For survey development, we identified key domains, including types of drug shortages, impact on the ability of anesthesia practitioners to provide general anesthesia care, and impact on patient outcomes. We undertook assessments of face validity, clinical sensibility, and content validity. Respondents were surveyed from January-April 2012.
Completed valid questionnaires were submitted by 1,187 respondents (61.4%), and 779 (65.7%) of respondents described a shortage of one or more anesthesia or critical care drugs. Changes in anesthesia practice resulting from drug shortages were common; 586 (49%) respondents thought they had given an inferior anesthetic, and 361 (30%) reported administering medications with which they were unfamiliar. Respondents also reported that drug shortages were, at times, responsible for changes in the conduct of patient care, with 28 (2.4%) noting cancellation or postponement of surgery and 92 (7.8%) witnessing a drug error. One hundred sixty-five (13.9%) respondents regarded drug shortages as having prolonged recovery from anesthesia, and 124 (10.5%) viewed drug shortages as resulting in an increased number of postoperative complications, such as postoperative nausea and vomiting.
Drug shortages are common in anesthetic practice in Canada. This state of affairs may have a negative effect on how anesthesiologists practice anesthesia and may be associated with adverse patient outcomes.
Notes
Comment In: Can J Anaesth. 2013 Nov;60(11):1159-6024312966
Comment In: Can J Anaesth. 2013 Nov;60(11):1158-5924114742
Comment In: Can J Anaesth. 2013 Jun;60(6):523-723512193
Comment In: Can J Anaesth. 2013 Jun;60(6):519-2223532582
Erratum In: Can J Anaesth. 2013 Nov;60(11):1170
PubMed ID
23546924 View in PubMed
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From the front lines: a qualitative study of anesthesiologists' work and professional values.

https://arctichealth.org/en/permalink/ahliterature139956
Source
Can J Anaesth. 2011 Jan;58(1):108-17
Publication Type
Article
Date
Jan-2011
Author
Anne Wong
Author Affiliation
Department of Anesthesia, McMaster University, 1200 Main St. West, HSC-2U4, Hamilton, ON, L8N 3Z5, Canada. wongan@mcmaster.ca
Source
Can J Anaesth. 2011 Jan;58(1):108-17
Date
Jan-2011
Language
English
Publication Type
Article
Keywords
Anesthesia - methods - standards
Anesthesiology - methods - standards
Canada
Clinical Competence
Data Collection
Female
Humans
Male
Physician's Practice Patterns - standards
Physician-Patient Relations
Professional Role
Stress, Psychological - etiology
Abstract
Despite significant contributions to medicine, anesthesiology is poorly recognized and faces the threat of "deprofessionalization". Clear articulation of its work and professional values plays an integral role in maintaining the viability of a profession. The purpose of this qualitative study is to explore anesthesiologists' perspectives in order to define the distinct elements of their work and their professional values.
A qualitative research approach was used for this study. Sixteen Canadian faculty anesthesiologists were interviewed regarding their choice of anesthesiology as a career, the characteristics of a good anesthesiologist and good anesthetic care, and the sources of work-related stress. The interviews were taped and transcribed. The qualitative analysis of the interviews included primary coding, which separated the data into units of meaning. Next, similar codes were clustered into pattern codes to identify common themes and subthemes. The relationships between the themes and subthemes were analyzed and interpreted to identify core values.
The anesthesiologists were motivated to choose their career path by the academic, technical, and practice aspects of the profession, influential role models, and an interest in human consciousness. Five themes characterized a good anesthesiologist: clinical competence, personality traits, physician-patient relationship, approach to anesthetic care, and outcomes. The major sources of stress were: balancing clinical care and teaching, unexpected critical events, and administrative issues. Four core professional values were identified: goal-directed care, responsibility, control, and humility.
Anesthesiology is characterized by its distinct work and core professional values. Under the threat of deprofessionalization, the practice of anesthesiology should be guided by its professional values in defining and envisioning its future.
PubMed ID
20960082 View in PubMed
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Guidelines for Percutaneous Dilatational Tracheostomy (PDT) from the Danish Society of Intensive Care Medicine (DSIT) and the Danish Society of Anesthesiology and Intensive Care Medicine (DASAIM).

https://arctichealth.org/en/permalink/ahliterature129100
Source
Dan Med Bull. 2011 Dec;58(12):C4358
Publication Type
Article
Date
Dec-2011
Author
Kristian Rørbæk Madsen
Henrik Guldager
Mikael Rewers
Sven-Olaf Weber
Kurt Købke-Jacobsen
Reinhold Jensen
Author Affiliation
Department of Anesthesiology and Intensive Care, Odense University Hospital, Soendre Boulevard 29, 5000 Odense C, Denmark. kristian.roerbaek.madsen@ouh.regionsyddanmark.dk
Source
Dan Med Bull. 2011 Dec;58(12):C4358
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Anesthesiology - methods - standards
Critical Illness
Denmark
Humans
Intensive Care - methods - standards
Respiration, Artificial - methods - standards
Societies, Medical
Time Factors
Tracheostomy - methods - standards
Abstract
Percutaneous dilatational tracheostomy is a common procedure in intensive care. This guideline from the Danish Society of Intensive Care Medicine (DSIT) and the Danish Society of Anesthesiology and Intensive Care Medicine (DASAIM) describes indications and contraindications, timing, complications compared to surgical tracheostomy, anaesthesia and technique, decannulation strategy, as well as training and education.
PubMed ID
22142581 View in PubMed
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Guidelines to the Practice of Anesthesia: Revised edition 2011.

https://arctichealth.org/en/permalink/ahliterature138319
Source
Can J Anaesth. 2011 Jan;58(1):74-107
Publication Type
Article
Date
Jan-2011
Author
Richard Merchant
Craig Bosenberg
Karen Brown
Daniel Chartrand
Steven Dain
Joy Dobson
Matthias Kurrek
Kenneth LeDez
Pamela Morgan
Monica Penner
Romesh Shukla
Author Affiliation
Canadian Anesthesiologists' Society, 1 Eglinton Avenue East, Suite 208, Toronto, ON, M4P 3A1, Canada. richard.merchant@ubc.ca
Source
Can J Anaesth. 2011 Jan;58(1):74-107
Date
Jan-2011
Language
English
French
Publication Type
Article
Keywords
Anesthesia - methods - standards
Anesthesiology - methods - standards
Canada
Humans
Patient Care - methods - standards
Quality of Health Care
Abstract
The Guidelines to the Practice of Anesthesia Revised Edition 2011 (the guidelines) were prepared by the Canadian Anesthesiologists' Society (CAS), which reserves the right to determine their publication and distribution. Because the guidelines are subject to revision, updated versions are published annually. Whereas previous versions of the guidelines appeared as special supplements to the Canadian Journal of Anesthesia (the Journal), this edition of the guidelines is published within the Journal. This allows for improved archiving and online access to complement the printed version-a new offering for CAS members and Journal subscribers. The Guidelines to the Practice of Anesthesia Revised Edition 2011 supersedes all previously published versions of this document. Although the CAS encourages Canadian anesthesiologists to adhere to its practice guidelines to ensure high-quality patient care, the society cannot guarantee any specific patient outcome. Each anesthesiologist should exercise his or her own professional judgement in determining the proper course of action for any patient's circumstances. The CAS assumes no responsibility or liability for any error or omission arising from the use of any information contained in its Guidelines to the Practice of Anesthesia.
PubMed ID
21191680 View in PubMed
Less detail

Guidelines to the Practice of Anesthesia Revised Edition 2012.

https://arctichealth.org/en/permalink/ahliterature128649
Source
Can J Anaesth. 2012 Jan;59(1):63-102
Publication Type
Article
Date
Jan-2012
Author
Richard Merchant
Daniel Chartrand
Steven Dain
Joy Dobson
Matthias Kurrek
Kenneth LeDez
Pamela Morgan
Romesh Shukla
Author Affiliation
Canadian Anesthesiologists' Society, 1 Eglinton Avenue East, Suite 208, Toronto, ON M4P 3A1, Canada. standards@cas.ca
Source
Can J Anaesth. 2012 Jan;59(1):63-102
Date
Jan-2012
Language
English
French
Publication Type
Article
Keywords
Anesthesia - methods - standards
Anesthesiology - methods - standards
Canada
Humans
Patient Care - methods - standards
Quality of Health Care
Societies, Medical
Abstract
The Guidelines to the Practice of Anesthesia Revised Edition 2012 (the guidelines) were prepared by the Canadian Anesthesiologists' Society (CAS), which reserves the right to determine their publication and distribution. Because the guidelines are subject to revision, updated versions are published annually. Whereas previous versions of the guidelines appeared as special supplements to the Canadian Journal of Anesthesia (the Journal), this edition of the guidelines is published within the Journal. This allows for improved archiving and online access to complement the printed version--a new offering for CAS members and Journal subscribers. The Guidelines to the Practice of Anesthesia Revised Edition 2012 supersedes all previously published versions of this document. Although the CAS encourages Canadian anesthesiologists to adhere to its practice guidelines to ensure high-quality patient care, the society cannot guarantee any specific patient outcome. Each anesthesiologist should exercise his or her own professional judgement in determining the proper course of action for any patient's circumstances. The CAS assumes no responsibility or liability for any error or omission arising from the use of any information contained in its Guidelines to the Practice of Anesthesia.
PubMed ID
22183296 View in PubMed
Less detail

Guidelines to the Practice of Anesthesia--Revised Edition 2014.

https://arctichealth.org/en/permalink/ahliterature105429
Source
Can J Anaesth. 2014 Jan;61(1):46-59
Publication Type
Article
Date
Jan-2014
Author
Richard Merchant
Daniel Chartrand
Steven Dain
Gregory Dobson
Matt M Kurrek
Annie Lagacé
Shean Stacey
Barton Thiessen
Author Affiliation
Canadian Anesthesiologists' Society, 1 Eglinton Avenue East, Suite 208, Toronto, ON, M4P 3A1, Canada, standards@cas.ca.
Source
Can J Anaesth. 2014 Jan;61(1):46-59
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Advance Care Planning - standards
Anesthesia - methods - standards
Anesthesiology - methods - standards
Canada
Child
Humans
Patient Care - methods - standards
Pediatrics
Abstract
The Guidelines to the Practice of Anesthesia Revised Edition 2014 (the guidelines) were prepared by the Canadian Anesthesiologists' Society (CAS), which reserves the right to determine their publication and distribution. Because the guidelines are subject to revision, updated versions are published annually. The Guidelines to the Practice of Anesthesia Revised Edition 2014 supersedes all previously published versions of this document. Although the CAS encourages Canadian anesthesiologists to adhere to its practice guidelines to ensure high-quality patient care, the society cannot guarantee any specific patient outcome. Each anesthesiologist should exercise his or her own professional judgement in determining the proper course of action for any patient's circumstances. The CAS assumes no responsibility or liability for any error or omission arising from the use of any information contained in its Guidelines to the Practice of Anesthesia.
PubMed ID
24385228 View in PubMed
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[Intensive care and anaesthesia for blood loss in obstetrics. Clinical guidelines were approved by the Presidium of the Federation of Anaesthesiologists and Reanimatologists of Russia on 15/09/13 in Krasnoyarsk. Sectional commission in "Anesthesiology and Reanimatology" of the Ministry of Health of the Russian Federation approved the guidelines for submission to the Ministry of Health of the Russian Federation on 11/15/13].

https://arctichealth.org/en/permalink/ahliterature104071
Source
Anesteziol Reanimatol. 2014 Mar-Apr;(2):76-8
Publication Type
Article

13 records – page 1 of 2.