Pub Date : 2015-01-01DOI: 10.1097/ASA.0000000000000026
D. Auyong, S. Yuan
Learning Objectives: As a result of completing this activity, the participant will be able to Compare highlighted anatomic structures in photographs of fresh tissue dissections with anatomic structures on ultrasound images Summarize the anatomic relationships of nerves to surrounding structures that facilitate placement of nerve blocks and improve clinical efficacy of regional anesthesia Examine, at a gross anatomy level, why some nerve blocks are more appropriate than others for specific surgeries of the upper and lower extremity Recognize anatomic variations in ultrasound images and cadaver dissections and correlate how these variations affect regional anesthesia
{"title":"Virtual Cadaver Laboratory—Anatomy Pearls in Regional Anesthesia to Improve Clinical Success","authors":"D. Auyong, S. Yuan","doi":"10.1097/ASA.0000000000000026","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000026","url":null,"abstract":"Learning Objectives: As a result of completing this activity, the participant will be able to Compare highlighted anatomic structures in photographs of fresh tissue dissections with anatomic structures on ultrasound images Summarize the anatomic relationships of nerves to surrounding structures that facilitate placement of nerve blocks and improve clinical efficacy of regional anesthesia Examine, at a gross anatomy level, why some nerve blocks are more appropriate than others for specific surgeries of the upper and lower extremity Recognize anatomic variations in ultrasound images and cadaver dissections and correlate how these variations affect regional anesthesia","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"43 1","pages":"27–33"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62017203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-01-01DOI: 10.1097/ASA.0000000000000031
J. Abernathy
The cardiac operating room (OR) is a complex environment consisting of four teams of providers—surgeons, nurses, perfusionists, and anesthesiologists—and where a myriad of complicated equipment is often crammed into a space that might not have been designed for this purpose. Despite the obstacles, mortality and morbidity from cardiac surgery have steadily decreased over the past decade. Inevitably, however, humans continue to make errors. Gawande and colleagues found that adverse events occurred in 12% of cardiac surgical operations, compared with only 3% in a general surgery population. Some 28,000 of the 350,000 cardiac surgical patients in the United States each year will have an adverse, preventable event. Preventable errors are not related to failure of technical skill, training, or knowledge, but represent cognitive, system, or teamwork failures (Supplemental Digital Content 1, http://links.lww.com/ASA/A558). Jim Reason, the renowned human factors engineer, was the first to propose a simplified model of error, now referred to as the ‘‘Swiss cheese’’ model (Figure 1). This model eloquently describes how hidden—or, in human factors terminology, latent— errors can line up to create actual errors or patient harm. In one example, originally outlined by Pronovost et al., a patient suffered from a venous air embolism not because a doctor was careless, but because there were many hidden failures, often termed latent failures, that added up to create a catastrophe. In this example, components of latent error included poor communication, lack of protocols or lack of knowledge of protocols, inadequate training, and fear of retribution if the nurse spoke up. Resilient systems are designed to reduce the number of latent errors. If there are fewer latent errors, the holes in the Swiss cheese for an error to pass through are harder to align.
{"title":"Patient Safety in the Cardiac Operating Room: What Can, Will, and Might Make Patients Safer and You Happier?","authors":"J. Abernathy","doi":"10.1097/ASA.0000000000000031","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000031","url":null,"abstract":"The cardiac operating room (OR) is a complex environment consisting of four teams of providers—surgeons, nurses, perfusionists, and anesthesiologists—and where a myriad of complicated equipment is often crammed into a space that might not have been designed for this purpose. Despite the obstacles, mortality and morbidity from cardiac surgery have steadily decreased over the past decade. Inevitably, however, humans continue to make errors. Gawande and colleagues found that adverse events occurred in 12% of cardiac surgical operations, compared with only 3% in a general surgery population. Some 28,000 of the 350,000 cardiac surgical patients in the United States each year will have an adverse, preventable event. Preventable errors are not related to failure of technical skill, training, or knowledge, but represent cognitive, system, or teamwork failures (Supplemental Digital Content 1, http://links.lww.com/ASA/A558). Jim Reason, the renowned human factors engineer, was the first to propose a simplified model of error, now referred to as the ‘‘Swiss cheese’’ model (Figure 1). This model eloquently describes how hidden—or, in human factors terminology, latent— errors can line up to create actual errors or patient harm. In one example, originally outlined by Pronovost et al., a patient suffered from a venous air embolism not because a doctor was careless, but because there were many hidden failures, often termed latent failures, that added up to create a catastrophe. In this example, components of latent error included poor communication, lack of protocols or lack of knowledge of protocols, inadequate training, and fear of retribution if the nurse spoke up. Resilient systems are designed to reduce the number of latent errors. If there are fewer latent errors, the holes in the Swiss cheese for an error to pass through are harder to align.","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"43 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62017276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-01-01DOI: 10.1097/ASA.0000000000000021
D. Healy
The unique surgical demands and characteristics of patients undergoing head and neck surgery have led to the gradual development of the subspecialty of Head and Neck Anesthesia. The expansion of the surgical specialties of otolaryngology, maxillofacial surgery, dentistry, neurotology, and facial plastic surgery in academic medical centers has led to a corresponding increase in and development of anesthetic expertise. Communication and teamwork are essential for the safe performance of any surgical procedure, but are of particular importance during operations that require the surgical and anesthesia teams to share the patient’s airway. Furthermore, multiple pathologic processes and surgical requirements may result in an increased incidence of difficulty encountered during airway management. As a result, providers specializing in this work require additional skill and experience in advanced airway management techniques such as awake flexible endoscopic intubation, jet ventilation, and transtracheal oxygenation. Many head and neck procedures have unique and challenging requirements for anesthesia care beyond airway management. Patients undergoing oncologic surgery of the head and neck often have comorbidities related to smoking, particularly ischemic heart disease, vasculopathies, and chronic obstructive pulmonary disease. This chapter provides a practical review of the anesthesia skills required for a variety of operations on the head and neck. It emphasizes patient safety, exploring preoperative airway risk assessment, and the prevention of avoidable complications such as intraoperative fire.
{"title":"Anesthesia for Head and Neck Surgery","authors":"D. Healy","doi":"10.1097/ASA.0000000000000021","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000021","url":null,"abstract":"The unique surgical demands and characteristics of patients undergoing head and neck surgery have led to the gradual development of the subspecialty of Head and Neck Anesthesia. The expansion of the surgical specialties of otolaryngology, maxillofacial surgery, dentistry, neurotology, and facial plastic surgery in academic medical centers has led to a corresponding increase in and development of anesthetic expertise. Communication and teamwork are essential for the safe performance of any surgical procedure, but are of particular importance during operations that require the surgical and anesthesia teams to share the patient’s airway. Furthermore, multiple pathologic processes and surgical requirements may result in an increased incidence of difficulty encountered during airway management. As a result, providers specializing in this work require additional skill and experience in advanced airway management techniques such as awake flexible endoscopic intubation, jet ventilation, and transtracheal oxygenation. Many head and neck procedures have unique and challenging requirements for anesthesia care beyond airway management. Patients undergoing oncologic surgery of the head and neck often have comorbidities related to smoking, particularly ischemic heart disease, vasculopathies, and chronic obstructive pulmonary disease. This chapter provides a practical review of the anesthesia skills required for a variety of operations on the head and neck. It emphasizes patient safety, exploring preoperative airway risk assessment, and the prevention of avoidable complications such as intraoperative fire.","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"43 1","pages":"66–72"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62016565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-01-01DOI: 10.1097/ASA.0000000000000034
Sarah C. Smith
Although there have been ethical debates in medicine for centuries, only in the last few decades has bioethics, a term first coined in the 1970s, developed into a formalized and independent field of philosophy. Today, the influence of bioethics is far-reaching, impacting the drafting of laws pertaining to medicine and biotechnology, guiding the development of hospital policies and procedures, and even affecting the physician–patient relationship. Education about bioethics is incorporated into the curriculum for nurses, doctors, and other practitioners, and knowledge of the topic is assessed in many licensing and board certification examinations, including that of the American Board of Anesthesiology. Like bioethics, anesthesiology is also a relatively young field that has experienced tremendous growth in the modern era, and its history is marked by several prominent ethical debates. At one time, the use of anesthesia itself was quite controversial. Within months of William Morton’s successful demonstration of ether anesthesia on October 16, 1846, physicians around the world were utilizing this new discovery on countless surgical patients. Although the advent of painless surgery was met with widespread enthusiasm, it was also recognized almost immediately as a potentially dangerous new technology. Reports of anesthesia-related injuries and deaths were almost immediate and led many to recommend only its most cautious and judicious use. Surgeons at the Pennsylvania Hospital in Philadelphia went so far as to prohibit anesthesia altogether for a full 7 years after its introduction. The ethical debate of whether to utilize anesthesia was not simply limited to issues of safety, however. Many 19th century physicians subscribed to the philosophy of ‘‘natural healing’’ and the belief that pain and sickness arose from behavior that violated the laws of Nature. If anesthesia masked such pain, the patient would not rectify his or her behavior, and the illness would persist (Supplemental Digital Content 1, http://links.lww.com/ASA/A573).
{"title":"Do the Right Thing: Resolving Ethical Dilemmas in the OR","authors":"Sarah C. Smith","doi":"10.1097/ASA.0000000000000034","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000034","url":null,"abstract":"Although there have been ethical debates in medicine for centuries, only in the last few decades has bioethics, a term first coined in the 1970s, developed into a formalized and independent field of philosophy. Today, the influence of bioethics is far-reaching, impacting the drafting of laws pertaining to medicine and biotechnology, guiding the development of hospital policies and procedures, and even affecting the physician–patient relationship. Education about bioethics is incorporated into the curriculum for nurses, doctors, and other practitioners, and knowledge of the topic is assessed in many licensing and board certification examinations, including that of the American Board of Anesthesiology. Like bioethics, anesthesiology is also a relatively young field that has experienced tremendous growth in the modern era, and its history is marked by several prominent ethical debates. At one time, the use of anesthesia itself was quite controversial. Within months of William Morton’s successful demonstration of ether anesthesia on October 16, 1846, physicians around the world were utilizing this new discovery on countless surgical patients. Although the advent of painless surgery was met with widespread enthusiasm, it was also recognized almost immediately as a potentially dangerous new technology. Reports of anesthesia-related injuries and deaths were almost immediate and led many to recommend only its most cautious and judicious use. Surgeons at the Pennsylvania Hospital in Philadelphia went so far as to prohibit anesthesia altogether for a full 7 years after its introduction. The ethical debate of whether to utilize anesthesia was not simply limited to issues of safety, however. Many 19th century physicians subscribed to the philosophy of ‘‘natural healing’’ and the belief that pain and sickness arose from behavior that violated the laws of Nature. If anesthesia masked such pain, the patient would not rectify his or her behavior, and the illness would persist (Supplemental Digital Content 1, http://links.lww.com/ASA/A573).","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"43 1","pages":"104–111"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62017021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-01-01DOI: 10.1097/ASA.0000000000000029
E. Heitmiller, Justin T. Hamrick
Pediatric advanced life support guidelines published by the American Heart Association are designed for resuscitation in a broad range of scenarios and environments. The perioperative environment is unlike most others in that the majority of arrests are witnessed, the patients are being monitored at the time of arrest, and the reason for the arrest may be related to the intervention or treatment. In this chapter, the perioperative period is defined as the period during which the patient is cared for by the anesthesia team and focuses on events that occur in the operating room, procedural areas, and diagnostic imaging areas from the time the patient is first seen by the anesthesia team until the patient is transferred to another service or is discharged home or to another facility. Cardiac arrest is defined as a ‘‘no-flow’’ state requiring chest compressions (open or closed chest) or failure to wean from cardiopulmonary bypass. The overall goal of all perioperative resuscitative efforts is to minimize this no-flow period and to maximize the chance for return of spontaneous circulation. Whereas the indications for resuscitation outside of the operating room may be simple (loss of consciousness, loss of pulse, etc.), the indications in the perioperative period may be more complex. They may include inadequate heart rate or blood pressure based on age, inadequate minute ventilation, cyanosis, failure of noninvasive blood pressure monitoring or pulse oximetry, loss of arterial waveform, or a sudden change in the end-tidal carbon dioxide (ETCO2) waveform or value. 1
{"title":"Pediatric Advanced Life Support for the Anesthesiologist","authors":"E. Heitmiller, Justin T. Hamrick","doi":"10.1097/ASA.0000000000000029","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000029","url":null,"abstract":"Pediatric advanced life support guidelines published by the American Heart Association are designed for resuscitation in a broad range of scenarios and environments. The perioperative environment is unlike most others in that the majority of arrests are witnessed, the patients are being monitored at the time of arrest, and the reason for the arrest may be related to the intervention or treatment. In this chapter, the perioperative period is defined as the period during which the patient is cared for by the anesthesia team and focuses on events that occur in the operating room, procedural areas, and diagnostic imaging areas from the time the patient is first seen by the anesthesia team until the patient is transferred to another service or is discharged home or to another facility. Cardiac arrest is defined as a ‘‘no-flow’’ state requiring chest compressions (open or closed chest) or failure to wean from cardiopulmonary bypass. The overall goal of all perioperative resuscitative efforts is to minimize this no-flow period and to maximize the chance for return of spontaneous circulation. Whereas the indications for resuscitation outside of the operating room may be simple (loss of consciousness, loss of pulse, etc.), the indications in the perioperative period may be more complex. They may include inadequate heart rate or blood pressure based on age, inadequate minute ventilation, cyanosis, failure of noninvasive blood pressure monitoring or pulse oximetry, loss of arterial waveform, or a sudden change in the end-tidal carbon dioxide (ETCO2) waveform or value. 1","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"43 1","pages":"73-79"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62017066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.1097/ASA.0000000000000005
A. Varon
A lmost one out of every 10 deaths in the world is the result of injury. In the United States, trauma is the leading cause of death among children, adolescents, and young adults, and accounts for more years of potential life lost than cancer and heart disease combined. Although few anesthesiologists care exclusively for trauma patients, most care for trauma patients at one time or another in their clinical practice. This chapter provides a concise review of the essential elements in the management of the severely injured trauma patient and identifies new trends in trauma and anesthesiology practice that impact their care. INITIAL EVALUATION AND MANAGEMENT
{"title":"Trauma Anesthesia","authors":"A. Varon","doi":"10.1097/ASA.0000000000000005","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000005","url":null,"abstract":"A lmost one out of every 10 deaths in the world is the result of injury. In the United States, trauma is the leading cause of death among children, adolescents, and young adults, and accounts for more years of potential life lost than cancer and heart disease combined. Although few anesthesiologists care exclusively for trauma patients, most care for trauma patients at one time or another in their clinical practice. This chapter provides a concise review of the essential elements in the management of the severely injured trauma patient and identifies new trends in trauma and anesthesiology practice that impact their care. INITIAL EVALUATION AND MANAGEMENT","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"42 1","pages":"154–162"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62015131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.1097/ASA.0000000000000004
A. Abouleish
Learning Objectives: As a result of completing this activity, the participant will be able to Determine whether the myths discussed are ‘‘Confirmed,’’ ‘‘Plausible,’’ or ‘‘Busted’’ Discuss strategies to improve operating room throughput Explain how anesthesia care is billed and paid and how duration of surgery affects the charges Show how comparing yearly compensation for different anesthesia providers can result in incorrect conclusions about the cost of care Show why using ‘‘per provider’’ measurements can lead to inaccurate benchmarking of clinical productivity
{"title":"MythBusters Episode: Anesthesia Economic Issues","authors":"A. Abouleish","doi":"10.1097/ASA.0000000000000004","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000004","url":null,"abstract":"Learning Objectives: As a result of completing this activity, the participant will be able to Determine whether the myths discussed are ‘‘Confirmed,’’ ‘‘Plausible,’’ or ‘‘Busted’’ Discuss strategies to improve operating room throughput Explain how anesthesia care is billed and paid and how duration of surgery affects the charges Show how comparing yearly compensation for different anesthesia providers can result in incorrect conclusions about the cost of care Show why using ‘‘per provider’’ measurements can lead to inaccurate benchmarking of clinical productivity","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"16 1","pages":"12-17"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62014967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.1097/ASA.0000000000000000
C. Koch
Learning Objectives: As a result of completing this activity, the participant will be able to Describe the role of guidelines in the clinical practice setting Enumerate issues related to variation in current transfusion practices Analyze how clinical practice guidelines on blood transfusion represent a component of a comprehensive blood management strategy Explain effective patient-centered blood management
{"title":"Introducing Blood Conservation Into Clinical Practice: Can the New Guidelines Lead Us?","authors":"C. Koch","doi":"10.1097/ASA.0000000000000000","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000000","url":null,"abstract":"Learning Objectives: As a result of completing this activity, the participant will be able to Describe the role of guidelines in the clinical practice setting Enumerate issues related to variation in current transfusion practices Analyze how clinical practice guidelines on blood transfusion represent a component of a comprehensive blood management strategy Explain effective patient-centered blood management","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"42 1","pages":"83–91"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62015029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.1097/ASA.0000000000000003
Lena S. Sun
Learning Objectives: As a result of completing this activity, the participant will be able to Explain the drug-labeling process for drugs used in pediatric anesthesia and what is a ‘‘black box warning’’ Discuss the controversy regarding the labeling of succinylcholine for use in children Discuss the evolution of data related to anesthetic neurotoxicity in the young Describe recent clinical studies related to association of neurocognitive changes and anesthesia exposure in early childhood
{"title":"Controversies in Pediatric Anesthesia: Drug Labeling and Clinical Update on Anesthetic Neurotoxicity","authors":"Lena S. Sun","doi":"10.1097/ASA.0000000000000003","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000003","url":null,"abstract":"Learning Objectives: As a result of completing this activity, the participant will be able to Explain the drug-labeling process for drugs used in pediatric anesthesia and what is a ‘‘black box warning’’ Discuss the controversy regarding the labeling of succinylcholine for use in children Discuss the evolution of data related to anesthetic neurotoxicity in the young Describe recent clinical studies related to association of neurocognitive changes and anesthesia exposure in early childhood","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"42 1","pages":"136–143"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62015347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.1097/ASA.0000000000000006
S. Curry
There has been much talk in the media and the literature about professionalism. What is it? Why is it important? Do I really need to pay attention to this? I do not have time for it! These are statements heard across the profession, and not just in anesthesiology. But there is compelling evidence that professionalism is an important factor in our day-today lives. In fact, professionalism can affect the health of our patients as well as our own, the practitioners. My purpose in this chapter is to illustrate that point and suggest some ideas on how to make professionalism work for us and our patients. First, we must review the goals of professionalism, particularly with respect to anesthesiology. Then, we must show how professionalism affects our daily lives and, finally, show how it can impact the care of our patients.
{"title":"Tired of Not Being Taken Seriously? Professionalism and How It Affects You","authors":"S. Curry","doi":"10.1097/ASA.0000000000000006","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000006","url":null,"abstract":"There has been much talk in the media and the literature about professionalism. What is it? Why is it important? Do I really need to pay attention to this? I do not have time for it! These are statements heard across the profession, and not just in anesthesiology. But there is compelling evidence that professionalism is an important factor in our day-today lives. In fact, professionalism can affect the health of our patients as well as our own, the practitioners. My purpose in this chapter is to illustrate that point and suggest some ideas on how to make professionalism work for us and our patients. First, we must review the goals of professionalism, particularly with respect to anesthesiology. Then, we must show how professionalism affects our daily lives and, finally, show how it can impact the care of our patients.","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"42 1","pages":"31-36"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62015694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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