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Category: Regional Anaesthesia

Posted in: ATOTW > Regional Anaesthesia 2020 Language: portuguese

Descrição do Tutorial: Este tutorial fornece uma revisão do bloqueio infraclavicular do plexo braquial guiado por ultrassom, incluindo indicações e contraindicações clínicas, sonoanatomia e dicas úteis sobre a realização do bloqueio.

Posted in: ATOTW > Regional Anaesthesia 2020 Language: portuguese

Uma revisão da anatomia do nervo ciático e seus ramos, e as indicações, contraindicações e técnica para bloqueio poplíteo guiado por ultrassom.

Posted in: ATOTW > Intensive Care Medicine 2020 Language: portuguese

A anestesia de emergência pré-hospitalar se refere à indução de anestesia e estabelecimento da via aérea no ambiente pré-hospitalar. É de alto risco devido a fatores do paciente e ao ambiente pré-hospitalar. Muitos fatores devem ser abordados para se minimizar os riscos. Este tutorial explora alguns desses fatores e discute mudanças recentes na prática.

Posted in: ATOTW > Obstetric Anaesthesia 2020 Language: portuguese

A gestão de grávidas com histórico de vício ou abuso de substâncias pode ser desafiadora. Este tutorial foca nos efeitos patofisiológicos do vício em drogas, fornecendo cuidados perioperatório seguros e atingindo analgesia tanto durante o trabalho de parto quando após uma cesárea.

Posted in: ATOTW > Anaesthesia 2020 Language: english

Test your knowledge across the board of anaesthesia specialities with our ATOTW Quarterly quiz!

Posted in: ATOTW > Anaesthesia 2020 Language: portuguese

Este tutorial revê as considerações anestésicas para procedimentos urológicos robóticos, abrangendo os estágios pré-, intra- e pós-operatórios.

Posted in: ATOTW > Paediatric Anaesthesia 2020 Language: english

The tutorial will describe the anaesthetic management of paediatric patients undergoing laparoscopic surgery. The reader will be guided through the physiologic changes that occur during laparoscopy as well as appropriate perioperative management, from the pre-operative interview until discharge from the post-anaesthesia care unit.

Posted in: ATOTW > Anaesthesia 2020 Language: english

Between September 2017 and January 2019, WFSA conducted an online survey to evaluate the utility of ATOTW. We are delighted to present the survey report to demonstrate ATOTW’s impact and also highlight areas for improvement and expansion of this valuable resource.

Because the scope of anesthesia practice continues to expand, especially within the perioperative domain, our specialty must continually examine technological services that allow us to provide care in innovative ways. Telemedicine has facilitated the remote provision of medical services across many different specialties, but it remains somewhat unclear whether the use of telemedicine would fit within the practice of anesthesiology on a consistent basis.

The safety and efficacy of intrathecal drug delivery systems (IDDSs) for the treatment of cancer-related pain have been demonstrated in randomized controlled clinical trials (RCTs). Despite positive evidence for this therapy, IDDS remains underutilized to treat cancer pain. Real-world registry data augment existing safety and effectiveness data and are presented here to broaden awareness of this therapeutic option, needed for adequate cancer-related pain treatment, and as a viable tool addressing concerns with systemic opioid use.

Posted in: ATOTW > Intensive Care Medicine 2019 Language: portuguese

A encefalite infecciosa é uma inflamação infecciosa aguda, geralmente viral, do parênquima cerebral. Uma minoria dos pacientes desenvolverá uma manifestação grave e podem piorar e exigir suporte aos órgãos, geralmente antes de o diagnóstico ser confirmado. Um alto índice de suspeita clínica e tratamento antimicrobiano (geralmente empírico) imediato é crucial para a melhor chance de recuperação sem deficiência. O manejo no ambiente de terapia intensiva foca no tratamento da patologia primária enquanto previne uma lesão cerebral secundária.

Posted in: ATOTW > Anaesthesia 2019 Language: english

This tutorial summarizes the current data and controversies surrounding the use of the bispectral index (BIS™, Medtronic, Minneapolis, MN, USA)—one of the more commonly used processed EEG devices—and provides recommendations regarding appropriate use of this technology in general anesthesia to prevent awareness

The increasing focus on and importance of surgical care in achieving universal health coverage requires the development of safe and accessible anaesthesia services. Increasing access to care by supporting the necessary inputs to the anaesthesia system, including medications, equipment and personnel, must be accompanied by processes that support high-quality care, including support for education, and guidelines for standards, and training. As safe, high-quality care requires an integrated approach, each element must be supported together, i.e., in an integrated manner to ensure that anaesthesia care reaches those who need it, and in the safest possible manner. Several important efforts have been undertaken globally to address and foster these elements, and resources to guide these processes exist for low- and middle-income countries to improve them. This review highlights both the needs and resources for safe and high-quality care that patients deserve.

The increasing focus on and importance of surgical care in achieving universal health coverage requires the development of safe and accessible anaesthesia services. Increasing access to care by supporting the necessary inputs to the anaesthesia system, including medications, equipment and personnel, must be accompanied by processes that support high-quality care, including support for education, and guidelines for standards, and training. As safe, high-quality care requires an integrated approach, each element must be supported together, i.e., in an integrated manner to ensure that anaesthesia care reaches those who need it, and in the safest possible manner. Several important efforts have been undertaken globally to address and foster these elements, and resources to guide these processes exist for low- and middle-income countries to improve them. This review highlights both the needs and resources for safe and high-quality care that patients deserve.

Posted in: ATOTW > Basic Sciences 2019 Language: english

This tutorial will initially look at the pharmacodynamics and pharmacokinetic properties of clonidine. The article will then cover the clinical use of clonidine in anaesthetic practice including its use in sedation, analgesia, adjunct to local anaesthetics in regional blocks and other relevant uses.

Posted in: ATOTW > Regional Anaesthesia 2019 Language: portuguese

O uso de cateter perineural pode fornecer alívio significativo e prolongado da dor após cirurgias. O seguinte tutorial abrange as indicações, técnicas e o manejo pós-operatório de pacientes com esses cateteres. Dá-se ênfase particular no aspecto da segurança enquanto os cateteres são colocados com precauções assépticas rígidas e instruções claras para prevenir quaisquer complicações.

Posted in: ATOTW > Intensive Care Medicine 2019 Language: portuguese

• A SDRA é uma síndrome de insuficiência respiratória hipoxêmica associada a edema pulmonar não-cardiogênico que ocorre em 10% dos pacientes de UTI. A SDRA geralmente está associada a falência múltipla dos órgãos e tem altas mortalidade, morbidade e custo financeiro. Pode ser uma manifestação de uma lista variada de condições pulmonares e extrapulmonares. Devido à sua prevalência na população de pacientes de terapia crítica, é importante que os médicos entendam alguns princípios de manejo que possam ajudar a reduzir a mortalidade e morbidade da síndrome.

Posted in: ATOTW > Anaesthesia 2019 Language: portuguese

O tutorial pretende conscientizar sobre os fluidos de irrigação que são geralmente encontrados em cirurgias. Abrange as propriedades farmacológicas do fluido de irrigação, complicações potenciais associadas ao seu uso intraoperatório, e medidas para limitar resultados negativos.

Birth asphyxia is a leading cause of early neonatal death. In 2013, 32% of neonatal deaths in Zambia were attributable to birth asphyxia and trauma. Basic, timely interventions are key to improving outcomes. However, data from the World Health Organization suggest that resuscitation is often not initiated, or is conducted suboptimally. Currently, there are little data on the quality of newborn resuscitation in the context of a tertiary center in a lower–middle income country. We aimed to measure the competencies of clinical practitioners responsible for newborn resuscitation.

Maternal mortality rate in developing countries is 20 times higher than in developed countries. Detailed reports surrounding maternal deaths have noted an association between substandard management during emergency events and death. In parallel with these findings, there is increasing evidence for cognitive aids as a means to prevent errors during perioperative crises. However, previously published findings are not directly applicable to cesarean delivery in low-income settings. Our hypothesis was that the use of obstetric anesthesia checklists in the management of high-fidelity simulated obstetrical emergency scenarios would improve adherence to best practice guidelines in low- and middle-income countries.

Inadequate access to anesthesia and surgical services is often considered to be a problem of low- and middle-income countries. However, affluent nations, including Canada, Australia, and the United States, also face shortages of anesthesia and surgical care in rural and remote communities. Inadequate services often disproportionately affect indigenous populations. A lack of anesthesia care providers has been identified as a major contributing factor to the shortfall of surgical and obstetrical care in rural and remote areas of these countries. This report summarizes the challenges facing the provision of anesthesia services in rural and remote regions.

Postoperative sore throat (POST), hoarseness, and cough after tracheal intubation are not uncommon. Although both lidocaine and dexamethasone have been used independently to reduce these events, there is no study assessing the combined effects of lidocaine and dexamethasone.

In Africa, most countries have fewer than 1 physician anesthesiologist (PA) per 100,000 population. Nonphysician anesthesia providers (NPAPs) play a large role in the workforce of many low- and middle-income countries (LMICs), but little information has been systematically collected to describe existing human resources for anesthesia care models. An understanding of existing PA and NPAP training pathways and roles is needed to inform anesthesia workforce planning, especially for critically underresourced countries.

It is unknown whether the implementation of an information video on spinal anesthesia for cesarean delivery, narrated in a patient’s first language, reduces anxiety, increases satisfaction, and improves doctor–patient communication if there is a language barrier. In South Africa, most doctors speak English, and patients speak Xhosa, with educational and cultural disparities existing in many doctor–patient interactions.

Only 20% of the surgical burden in eastern sub-Saharan Africa is currently met, leaving >17 million surgical cases annually in need of safe surgery and anesthesia. Similarly, there is an extreme shortage of anesthesia providers in East Africa, with just 0.44 anesthesiologists per 100,000 people in Kenya compared to 20.82 per 100,000 in the United States. Additionally, surgical access is not equally distributed within countries, with rural settings often having the greatest unmet need. We developed and tested a set of tools to assess if graduates of the Kenya registered nurse anesthetist (KRNA) training program, who were placed in rural hospitals in Kenya, would have any impact on surgical numbers, referral patterns, and economics of these hospitals.

About the Library

WFSA's virtual library is a resource hub made up of our own publications and other open source material that we recommend for anaesthesia providers around the world. It contains a variety of media and can be searched according to keyword, publication and specialist category ensuring that the user finds the most relevant resource for their needs.

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The WFSA Virtual Library is for use by qualified anaesthesia providers and those pursuing a qualification in anaesthesia. Its content is supplementary to more formal education and is offered for informational purposes only. Whilst the WFSA has taken every care to ensure that content is accurate we can not be held responsible for any loss, damage or inconvenience caused as a result of any error or inaccuracy within the library.

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