Challenges in Assessment and Management of Postoperative Agitation and Delirium in a Stroke Patient with Limited English Proficiency: Case Report.

While Title VI of the Civil Rights Act of 1964 mandates use of interpreters for patients with limited English proficiency, significant disparities persist in intensive postsurgical care. We present the case of a 60-year-old Vietnamese-speaking man with a Type A aortic dissection requiring postoperative mechanical ventilation and stroke care. Despite use of a remote video interpreter, our language-discordant nursing and physician providers faced challenges in managing agitation and delirium and assessing neurological function.

Limited English Proficiency and Perioperative Patient-Centered Outcomes: A Systematic Review.

This systematic review assesses whether limited-English proficiency (LEP) increases risk of having poor perioperative care and outcomes. This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 99 articles were identified in Embase and PubMed and screened by 2 independent reviewers.

Misinterpreting Paced Heart Rhythms: A Case Report.

We describe 2 cases in which failure to properly interpret paced heart rhythms in patients with cardiac implantable electronic devices (CIEDs) undergoing surgery resulted in adverse consequences including unnecessary invasive procedures, surgical delays, and patient dissatisfaction. Both cases occurred even though experienced clinicians were involved, and all perioperative recommendations were followed. Although it is sometimes argued that anesthesiologists are not directly responsible for CIED management, they are often held accountable when problems arise.

Language preference does not influence stroke patients' symptom recognition or emergency care time metrics.

Introduction: Our objective was to determine whether acute ischemic stroke (AIS) patients' language preference is associated with differences in time from symptom discovery to hospital arrival, activation of emergency medical services, door-to-imaging time (DTI), and door-to-needle (DTN) time.

Methods: We identified consecutive AIS patients presenting to a single urban, tertiary, academic center between 01/2003-05/2014 for whom language preference was available. Data were abstracted from the institution's Research Patient Data Registry and Get with the Guidelines-Stroke Registry.

Preoperative Intravenous Iron and Erythropoietin to Treat Severe Anemia in Patient With Stage 4 Kidney Disease Before Oncologic Surgery: A Case Report.

Preoperative treatment of anemia with intravenous iron is inconsistent despite known risks of anemia and allogeneic blood transfusions. Limited research exists on the effectiveness of preoperative intravenous iron for chronic kidney disease (CKD) patients. We discuss a patient with severe anemia from advanced CKD, endometrial cancer, and menometrorrhagia.

Challenges and opportunities caring for neurology outpatients across language differences.

Background: With over 66 million Americans who speak over 350 languages other than English at home, we sought to examine attitudes and behaviors of neurology clinicians and staff when communicating across language differences.

Methods: We conducted an electronic-enabled cross-sectional survey of clinicians and patient services coordinators working at an academic neurology outpatient clinic. Questions focused on professional medical interpreter (PMI) services usage, satisfaction, and perceived barriers to utilization.

Cognitive impairment and postoperative outcomes in patients undergoing primary total hip arthroplasty: A systematic review.

Study Objective: Total hip arthroplasty (THA) is a common surgical procedure in the elderly. Varying degrees of cognitive impairment (CI) are frequently seen in this patient population. To date, there has been no systematic review of the literature specifically examining the impact of CI on outcomes after elective THA.

Postoperative Outcomes in Primary Total Knee Arthroplasty Patients With Preexisting Cognitive Impairment: A Systematic Review.

Introduction: To evaluate the body of evidence on the predictive value of preoperative cognitive impairment on in-hospital, short-term, and midterm postoperative outcomes for elderly patients undergoing total knee arthroplasty (TKA).

Significance: With an aging population, an increasing percentage of the U.S.

Postoperative Outcomes in SAVR/TAVR Patients With Cognitive Impairment: A Systematic Review.

To assess the predictive value of preoperative cognitive impairment on postoperative in-hospital, short-term, and mid-term outcomes among patients undergoing surgical or transcatheter aortic valve replacement. The review was conducted according to PRISMA guidelines. Articles were identified in EMBASE, Medline, and PubMed.

Professional Medical Interpreters Influence the Quality of Acute Ischemic Stroke Care for Patients Who Speak Languages Other than English.

Background: The inability to communicate effectively in a common language can jeopardize clinicians' efforts to provide quality patient care. Professional medical interpreters (PMIs) can help provide linguistically appropriate health care, in particular for the >25 million Americans who identify speaking English less than very well. We aimed to evaluate the relationship between use of PMIs and quality of acute ischemic stroke care received by patients who preferred to have their medical care in languages other than English.