Development of Airway Hemorrhage Simulation Scenarios With Pilot of an Airway Team Leader Assessment Tool.

Introduction: Airway hemorrhage requires rapid treatment to prevent adverse patient outcomes. Simulation education programs are challenged to recreate learning environments with adequate fidelity for team management of airway hemorrhage.

Methods: We developed Airway Hemorrhage Simulation Scenarios consisting of low-cost partial-task simulators to mimic airway hemorrhage (nasopharyngeal, oropharyngeal, expanding neck hematoma) and multiple methods to assess team leader performance in emergent airway management [Airway Team Leader Assessment Tool (ATLAT), Airway Checklist Performance, and Global Performance Rating].

Novel minimally invasive transoral surgery bleeding model implemented in a nationwide otolaryngology emergencies bootcamp.

Post-operative hemorrhage is the most concerning complication after minimally invasive transoral surgery, as can result in airway compromise. Simulation-based medical education provides trainees with structured learning in an intensive and immersive environment allowing deliberate practice of skills and behaviors in the management of real-life situations. We implemented a novel post-oropharyngeal surgery bleeding model in a nationwide otolaryngology emergencies bootcamp, to teach and evaluate technical and non-technical skills required to competently manage this clinical scenario.

Teach the teacher: Training otolaryngology fellows to become academic educators.

Objectives/hypothesis: Fellowship is the capstone of academic training and serves as preparation for an academic career. Fellows are expected to educate medical students and residents during and long after fellowship. However, little time is typically spent teaching fellows to become effective educators.

Assessing Use Errors Related to the Interface Design of Electrosurgical Units.

Medical device use errors, such as instrument connection errors made with electrosurgical units (ESUs), can lead to adverse events. Current device acquisition processes at health care facilities do not typically include a proactive evaluation of use-error risk before device purchase. We conducted an evaluation to identify ESU user interface design features that can help prevent or mitigate instrument connection errors during clinical care.

Label Design Affects Medication Safety in an Operating Room Crisis: A Controlled Simulation Study.

Objective: Several factors contribute to medication errors in clinical practice settings, including the design of medication labels. The objective of this study was to quantify the impact of label design on medication safety in a realistic, high-stress clinical situation.

Methods: Ninety-six anesthesia trainee participants were randomly assigned to either the redesigned or the current label condition.

Perioperative process errors and delays in otolaryngology at a Veterans Hospital: prospective study.

Objectives/hypothesis: To understand the leading causes for process errors and delays in the otolaryngology operating room and recognize the impact of process errors and delays on patient safety, operating room resources and hospital costs.

Study Design: Prospective, observational study.

Methods: A 4-week study was conducted during 1 calendar month in 2012, evaluating 23 elective otolaryngology cases.

Challenges and opportunities in managing the dizzy older adult.

Balance disorders are common in elderly people, not only resulting in distressing sensations but also leading to reduced activity levels and quality of life. It has been estimated that 30% of elderly patients experience a balance disorder. Managing these disorders is a substantial challenge for patients and their caregivers and physicians.

Supraglottic swelling may not correlate with tongue swelling in angiotensin converting enzyme inhibitor-induced angioedema.

Angioneurotic edema of upper airway tissues due to angiotensin converting enzyme inhibitor (ACEI) usage is a known perioperative complication of this class of medications. Swelling can begin rapidly, and typically involves the tongue and oral cavity. We have recently encountered four cases in which supraglottic edema developed after onset of tongue swelling and progressed despite resolving tongue edema.

Hoarseness.

Preview A patient's complaint of hoarseness cannot be taken lightly. Although the cause may simply be a limited illness, a life- threatening disease could be the underlying problem. The authors review the necessary observations in history taking and physical examination of the hoarse patient; these cover a wide range of behaviors, conditions, and situations.