Retrograde intubation is an historic technique that is now rarely used in difficult airway situations. Although not originally designed for this purpose, the use of an S-guide is a feasible option to aid retrograde intubation because of its malleable rigid body and atraumatic tip.
View Article and Find Full Text PDFAchieving a high participation rate is a common challenge in healthcare research based on web-based surveys. A study on local anesthetic systemic toxicity awareness and usage among medical practitioners at two Swiss university hospitals encountered resistance in obtaining personal email addresses from Heads of Departments. Participants were therefore divided into two groups: those who were directly invited via email (personal invitation group) and those who received a generic link through intermediaries (generic link group).
View Article and Find Full Text PDFThe problem of gender discrimination and sexual harassment in medicine is long-standing and widespread. This project aims to document and understand how gendered experiences encountered by final-year medical students in Switzerland are experienced by these individuals and how they influence their career choice. It also aims to identify representations and stereotypes linked to the different specialties.
View Article and Find Full Text PDFA double-lumen tube or bronchial blocker positioning using flexible bronchoscopy for lung isolation and one-lung ventilation requires specific technical competencies. Training to acquire and retain such skills remains a challenge in thoracic anesthesia. Recent technological and innovative developments in the field of simulation have opened up exciting new horizons and possibilities.
View Article and Find Full Text PDFCurr Opin Anaesthesiol
June 2024
Purpose Of Review: There is an increasing awareness of the significance of intraoperative pain during cesarean delivery. Failure of spinal anesthesia for cesarean delivery can occur preoperatively or intraoperatively. Testing of the neuraxial block can identify preoperative failure.
View Article and Find Full Text PDFBackground: A medical student's career choice directly influences the physician workforce shortage and the misdistribution of resources. First, individual and contextual factors related to career choice have been evaluated separately, but their interaction over time is unclear. Second, actual career choice, reasons for this choice, and the influence of national political strategies are currently unknown in Switzerland.
View Article and Find Full Text PDFBackground: The use of local anaesthetics (LAs) is usually associated with few adverse effects, but local anaesthetic systemic toxicity (LAST) can result in serious harm and even death. However, practitioner awareness regarding this risk has been little studied.
Methods: This was a closed, web-based study carried out at two Swiss university hospitals using a fully automated questionnaire.
Background: Local anesthetics (LAs) are regularly used to alleviate pain during medical or surgical procedures. Their use is generally considered safe, but exceeding the maximum recommended doses can lead to LA systemic toxicity, a rare but potentially lethal complication. Determining maximum safe doses is therefore mandatory before performing local anesthesia, but rules are often unclear and the factors affecting dose calculation are numerous.
View Article and Find Full Text PDF: Because of COVID-19, the 2020 written medical examinations were replaced by mandatory formative online assessments. This study aimed to determine students' performance, self-assessment of performance, and perception about the switch from a summative to a formative approach. : Medical students from year 2 to 5 (n=648) were included.
View Article and Find Full Text PDFBackground: Despite its importance in education and patient safety, simulation-based education and training (SBET) is only partially or poorly implemented in many countries, including most European countries. The provision of a roadmap may contribute to the development of SBET for the training of anaesthesiologists.
Objective: To develop a global agenda for the integration of simulation into anaesthesiology specialist training; identify the learning domains and objectives that are best achieved through SBET; and to provide examples of simulation modalities and evaluation methods for these learning objectives.
Headache is a common complaint in the postpartum period and is benign in most cases. Physiological adaptations during pregnancy and childbirth put women at risk of secondary headaches and the clinician must be able to identify them at an early stage. The management algorithm described in this article provides a systematic assessment based on 4 key points: the clinical presentation, which refers to specific clinical pictures or severity criteria, the clinical context and the evolution of symptoms focusing on potential complications and known associations between different diseases.
View Article and Find Full Text PDFA primigravida patient, with a history of hereditary haemorrhagic telangiectasia (HHT) manifesting as nasal angiodysplasia and hepatic arteriovenous malformations (AVM), presented for delivery planning and anaesthetic evaluation at 29 weeks of gestation. She was hospitalised several times during the second and third trimester for serious recurrent epistaxis, leading to severe anaemia. In total, she required the transfusion of 20 units of packed red blood cells during her pregnancy as well as surgical nasal haemostasis under general anaesthesia (GA).
View Article and Find Full Text PDFAirway management is a core competency for many different medical specialties. Despite continuous improvements in equipment, clinical understanding, education and training, airway management complications remain a significant cause of morbidity and mortality worldwide. Several international airway management guidelines already exist, but there has never been a national consensus document for Switzerland.
View Article and Find Full Text PDFTeamwork is essential in emergency medicine, but in practice it can be polluted by communication difficulties, a lack of understanding of everyone's roles and responsibilities, and a discordant definition of operating methods and objectives. Today, there is a strong awareness of the need to train medical and healthcare teams in interprofessional collaborative practice to learn how to work as a team, reduce medical errors and improve patient safety. Simulation is a recognized and effective pedagogical modality for achieving these objectives.
View Article and Find Full Text PDFPrehospital endotracheal intubation (ETI) can be challenging, and the risk of complications is higher than in the operating room. The goal of this study was to compare prehospital ETI rates between anaesthesiologists and non-anaesthesiologists. This retrospective cohort study compared prehospital interventions performed by either physicians from the anaesthesiology department (ADP) or physicians from another department (NADP, for non-anaesthesiology department physicians).
View Article and Find Full Text PDFThe COVID-19 pandemics has deeply impacted academic teaching and forced a complete shift to distance learning formats during the first and second waves. Medical education, among other professional training programs, relies also on practical and clinical immersion, while some of these clinical activities had to be postponed. This article analyzes how one medical school was able to maintain its teaching while ensuring clinical training and taking into account the psychological impact imputed to the lockdown.
View Article and Find Full Text PDFBackground: The unfolding of the COVID-19 pandemic during spring 2020 has disrupted medical education worldwide. The University of Geneva decided to shift on-site classwork to online learning; many exams were transformed from summative to formative evaluations and most clinical activities were suspended. We aimed to investigate the perceived impact of those adaptations by the students at the Faculty of Medicine.
View Article and Find Full Text PDFEvaluate the effects of a fast-track (FT) protocol on costs and post-operative recovery. One hundred and seventy women undergoing total laparoscopic hysterectomy for a benign indication were randomized in a FT protocol or a usual care protocol. A FT protocol included the combination of minimally invasive surgery, analgesia optimization, early oral refeeding and rapid mobilization of patients was compared to a usual care protocol.
View Article and Find Full Text PDFPurpose: Qualitative research (QR) take advantage of a wide range of methods and theoretical frameworks to explore people's beliefs, perspectives, experiences, and behaviours and has been applied to many areas of healthcare. The aim of this review was to explore how QR has contributed to the field of perioperative anesthesiology.
Source: We performed a systematic scoping review of published QR studies pertaining to the field of perioperative anesthesiology in three databases (CINAHL, Pubmed, and Embase), published between January 2000 and June 2018.
Human resources are one of the six building blocks of a health system. In order to ensure that these resources are adequately trained to meet the evolving needs of populations, medical education reforms are needed. In Kyrgyzstan, like in many other low- and middle-income countries, human resources for health are a key challenge for the health system in both the quantity and having their training aligned with the health system priorities.
View Article and Find Full Text PDFLocal anesthetics systemic toxicity can lead to life-threatening situations. Correct calculation of the maximum safe dose is therefore paramount in preventing such complications. Different solutions have already emerged to support anesthesiologists but are seldom used in clinical practice as they require either access to a computer or specific documents to be at hand.
View Article and Find Full Text PDFBackground: Early cardiopulmonary resuscitation and prompt defibrillation markedly increase the survival rate in the event of out-of-hospital cardiac arrest (OHCA). As future health care professionals, medical students should be trained to efficiently manage an unexpectedly encountered OHCA.
Objective: Our aim was to assess basic life support (BLS) knowledge in junior medical students at the University of Geneva Faculty of Medicine (UGFM) and to compare it with that of the general population.