Considerations for Epidural Blood Patch and Other Postdural Puncture Headache Treatments in Patients with COVID-19.
Link to Pub Med web Page
Spinal Cord Stimulation Therapy for Advanced Bilateral Kienbocks Disease – Case Report
Farah F, Kalaydjian A, Miller J, Scemama P Practical Pain Management July/Aug 2019 - 2018
A randomized controlled trial of clinician-led tactile stimulation to reduce pain during vaccinations in infants
Scemama P. [commentary]. In: The 2015 Year Book of Pediatrics ed. By Cabana MD. Elsevier; Philadelphia, PA. 2015.
Academic Anesthesia: Innovate to Avoid Extinction
Todd and Fleisher editorialize that the field of anesthesia has an upcoming problem of few anesthesia trainees choosing to pursue academic careers. 1 They admonish that this trend would result in a slowing of creativity and creation that would ultimately lead to “professional extinction.” When commenting on the recent study by Sakai et al., 2 they accurately suggest that two problems exist when thinking about this troubling situation for our specialty:(1) incentives and (2) the measured outputs of academic endeavors. However, both of these issues require additional comment.
Anesthesia Care for Low-Risk Patients Undergoing Gastrointestinal Endoscopies
Link to JAMA Web page
The study by Dr Liu and colleagues1 suggests that money could be saved if the use of anesthesiologists for low-risk patients undergoing colonoscopy were eliminated. There has been intense ongoing debate about both the value and safety of propofol and anesthesia care in gastrointestinal endoscopy.2 One challenge in this debate is the difficulty in disentangling the sedation drug regimen (benzodiazepine/opioid vs propofol) from protocols, personnel, monitoring, and depth of sedation. The authors are correct that the value of anesthesia care for routine endoscopy has yet to be demonstrated in the literature. However, its wide utilization appears to be driven by gastroenterologists and patients' perception of its value and is an area of active investigation.
Developing Leaders in Anesthesiology A Practical Framework
Link to Research Gate Web Page
The specialty is confronting what has been coined an “adaptive” challenge, ie, a challenge for which there is no preexisting solution. 3 Furthermore, there is evidence both inside and outside of medicine that organizations that focus exclusively on cost reduction and efficiency during times of rapid change ultimately do not fare well. 4–6 As a result, anesthesiologists need to become change agents who envision, lead, and implement initiatives that ultimately result in greater patient safety, better patient outcomes, improved quality, and sustainable finances.
Radiofrequency Ablation Within the First Intercoccygeal Disk for Coccygodynia: A Case Report
Link to Research Gate web page
Interventional procedures for coccydynia (coccygodynia) are limited. This is a case report of long-term improvement following radiofrequency ablation (RFA) within the 1st intercoccygeal disk. Case Presentation: A 44-year-old female presented with a 1 year history of coccydynia following a fall. Examination under fluoroscopy localized her pain at the disk between the 1st and 2nd coccygeal vertebrae. Provocation with needle entry reproduced the patient's pain, and the 1st intercoccygeal disk was injected with 40 mg of methylprednisolone. This gave the patient excellent relief for about 3 weeks. The procedure was repeated at 4 weeks, providing with the same response. Decision was then made to proceed with RFA. Her symptoms were reproduced in response to stimulation at 50 Hz with 0.9 V, and stimulation at 2 Hz at 2 V did not result in any motor stimulation.
Establishing a partnership with patients to improve outcomes
Link to Research Gate web page
Through effective communication, physicians and other health care providers can assist patients in successfully managing asthma. Clinicians in the role of a coach can help patients recognize the symptoms of an exacerbation, respond appropriately, and determine whether further care is necessary. Once clinicians have built a rapport with their patients, they can tailor an asthma plan to their patients' individual goals; specific objectives, including how to control environmental triggers, should be discussed at each visit.
Asthma education: Getting the patient involved
Link to Research gate web page
By establishing a relationship that enables effective communication, you can support your patients in successfully managing their asthma. As a coach, you can help patients acquire the specific skills and confidence needed to recognize the symptoms of an exacerbation, respond appropriately, and determine whether further care is necessary. After you have built a rapport with the patient, you can help tailor an asthma plan to his or her own goals. Specific objectives, including how to control environmental triggers, should be kept in mind for each patient visit. Building an effective connection with patients requires careful listening and questioning, analyzing their needs, and organizing and appropriately delivering your messages. To make sure patients understand what you have discussed, ask them to restate information or key instructions.