More surgery in December among US patients with commercial insurance is offset by unrelated but lesser surgery among patients with Medicare insurance.

Study Objective: Evaluate whether there is more surgery (in the US State of Florida) at the end of the year, specifically among patients with commercial insurance.

Design: Observational cohort study.

Setting: The 712 facilities in Florida that performed inpatient or outpatient elective surgery from January 2010 through December 2019.

Similarities Between Pediatric and General Hospitals Based on Fundamental Attributes of Surgery Including Cases Per Surgeon Per Workday.

Introduction Operating room (OR) management decision-making at both pediatric and adult hospitals is determined, in large part, by the same fundamental attributes of surgery and other considerations related to case duration prediction. These include the non-preemptive nature of surgeries, wide prediction limits for case duration, and constraints to moving or resequencing cases on the day of surgery. Another attribute fundamentally affecting OR management is the median number of cases a surgeon performs on their OR days.

Elective surgery growth at Florida hospitals accrues mostly from surgeons averaging 2 or fewer cases per week: A retrospective cohort study.

Study Objective: Hospital administrators often seek to increase operating room (OR) elective caseload. Previous studies from Iowa demonstrated that surgical growth is mostly from low-caseload surgeons (ie, ≤2 cases per week). We repeated that study using data from Florida, a much more populous state, to confirm the generalizability of the findings.

Most surgeons' daily elective lists in Florida comprise only 1 or 2 elective cases, making percent utilization unreliable for planning individual surgeons' block time.

Study Objective: Operating room (OR) utilization has been shown in multiple studies to be an inappropriate metric for planning OR time for individual surgeons. Among surgeons with low daily caseloads, percentage utilization cannot be measured accurately because confidence limits are extremely wide. In Iowa, a largely rural state, most surgeons performed only 1 or 2 elective cases on their OR days.

The Distributions of Weekday Discharge Times at Acute Care Hospitals in the State of Florida were Static from 2010 to 2018.

When hospital capacity is near census, either due to limits on the number of physical or staffed beds, delays in patients' discharge can result in domino effects of congestion for the emergency department, the intensive care units, the postanesthesia care unit, and the operating room. Hospital administrators often promote increasing the percentage of patients discharged before noon as mitigation. However, benchmark data from multiple hospitals are lacking.

Opioid prescriptions for acute pain after outpatient surgery at a large public university-affiliated hospital: Impact of state legislation in Florida.

Background: In response to the growing opioid crisis, Florida recently implemented a law restricting the duration of opioid prescriptions for acute pain. Little is known about the impact of such legislation on opioid prescription practices at the time of discharge after surgery. The objective of this study was to determine whether Florida's new legislation changed opioid prescription practices for analgesia after surgery.

Fibrinolysis Shutdown Is Associated With Thrombotic and Hemorrhagic Complications and Poorer Outcomes After Liver Transplantation.

Detrimental consequences of hypofibrinolysis, also known as fibrinolysis shutdown (FS), have recently arisen, and its significance in liver transplantation (LT) remains unknown. To fill this gap, this retrospective study included 166 adults who received transplants between 2016 and 2018 for whom baseline thromboelastography was available. On the basis of percent of clot lysis 30 minutes after maximal amplitude, patients were stratified into 3 fibrinolysis phenotypes: FS, physiologic fibrinolysis, and hyperfibrinolysis.

Airway Management of Near-Complete Tracheal Transection by Through-the-Wound Intubation: A Case Report.

We present an approach to airway management in a patient with machete injuries culminating in near-complete cricotracheal transection, in addition to a gunshot wound to the neck. Initial airway was established by direct intubation through the cricotracheal wound. Once the airway was secured, a bronchoscopy-guided orotracheal intubation was performed with simultaneous retraction of the cricotracheal airway to optimize the surgical field.

Determination of Geolocations for Anesthesia Specialty Coverage and Standby Call Allowing Return to the Hospital Within a Specified Amount of Time.

Background: For emergent procedures, in-house teams are required for immediate patient care. However, for many procedures, there is time to bring in a call team from home without increasing patient morbidity. Anesthesia providers taking subspecialty or backup call from home are required to return to the hospital within a designated number of minutes.

Obstetric hemorrhage.

Purpose Of Review: To provide a review of the current literature on the management of obstetric hemorrhage.

Recent Findings: Obstetric hemorrhage remains a prominent cause of maternal morbidity and mortality. When postpartum hemorrhage is refractory to manual and pharmacologic treatments, escalating interventions may be needed.

Airway management and initial resuscitation of the trauma patient.

Purpose Of Review: This review will analyze and comment on selected recent literature pertaining to airway management and initial fluid resuscitation in the trauma patient. It will also review airway devices currently being used in the trauma setting.

Recent Findings: Although a recent study has questioned the efficacy of manual inline immobilization, this technique continues to be endorsed by trauma guidelines and is safely used in most trauma centers.

Roentgenographic investigation of frequency and degree of canal curvatures in human permanent teeth.

Canal curvatures of 700 permanent human teeth were determined by measuring the angle and the radius of the curvatures and the length of the curved part of the canal. For each type of tooth (except third molars) 50 were selected at random and were investigated. Size 08 silver points were inserted into the canals, and the teeth were radiographed from a facial and proximal view by using a standardized technique.