A Comparative Analysis of the Impact of Two Different Cognitive Aid Bundle Designs on Adherence to Best Clinical Practice in Simulated Perioperative Emergencies.

Stress and human error during perioperative emergency situations can significantly impact patient morbidity and mortality. Previous research has shown that cognitive aid bundles (CABs) minimize critical misses by 75%. This study aimed to compare the effectiveness of two different CAB designs with the same content in reducing missed critical management steps for simulated perioperative emergencies.

The horizon of pediatric cardiac critical care.

Pediatric Cardiac Critical Care (PCCC) is a challenging discipline where decisions require a high degree of preparation and clinical expertise. In the modern era, outcomes of neonates and children with congenital heart defects have dramatically improved, largely by transformative technologies and an expanding collection of pharmacotherapies. Exponential advances in science and technology are occurring at a breathtaking rate, and applying these advances to the PCCC patient is essential to further advancing the science and practice of the field.

Comparison of adequacy of anaesthesia monitoring with standard clinical practice monitoring during routine general anaesthesia: An international, multicentre, single-blinded randomised controlled trial.

Background: Previous studies have suggested that monitoring the levels of both hypnosis and antinociception could reduce periods of inadequate anaesthesia. However, the evidence regarding associated benefits of this monitoring is still limited.

Objective: The primary objective of this study was to confirm that guidance of anaesthesia by depth of hypnosis and antinociception monitoring decreases the number of inadequate anaesthesia events in comparison with standard clinical practice.

The effectiveness of a low-dose esketamine versus an alfentanil adjunct to propofol sedation during endoscopic retrograde cholangiopancreatography: A randomised controlled multicentre trial.

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most complex gastrointestinal endoscopic procedures. Currently, it is still unclear which sedation regimen best facilitates an ERCP. The N-methyl-D-aspartate receptor antagonist esketamine has anaesthetic, analgesic and sympathomimetic properties and is known to cause less cardiorespiratory depression than other sedatives.

Effect of Cognitive Aids on Adherence to Best Practice in the Treatment of Deteriorating Surgical Patients: A Randomized Clinical Trial in a Simulation Setting.

Importance: Failure to rescue causes significant morbidity and mortality in the surgical population. Human error is often the underlying cause of failure to rescue. Human error can be reduced by the use of cognitive aids.

Safety of moderate-to-deep sedation performed by sedation practitioners: A national prospective observational study.

Background: In the Netherlands, a significant proportion of moderate-to-deep sedation is performed by sedation practitioners under the indirect supervision of an anaesthesiologist but there are limited safety data available.

Objective: To estimate the rate of sedation-related adverse events and patient relevant outcomes (PRO).

Design: This was a prospective national observational study.

The emergency paediatric surgical airway: A systematic review.

Background: Although an emergency surgical airway is recommended in the guidelines for a paediatric cannot intubate, cannot oxygenate (CICO), there is currently no evidence regarding the best technique for this procedure.

Objective: To review the available literature on the paediatric emergency surgical airway to give recommendations for establishing a best practice for this procedure.

Design: Systematic review: Considering the nature of the original studies, a meta-analysis was not possible.

Sedation with propofol during ERCP: is the combination with esketamine more effective and safer than with alfentanil? Study protocol for a randomized controlled trial.

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a gastrointestinal procedure that requires a relatively motionless patient during the intervention. Deep sedation by intravenous propofol combined with an opioid has recently become the preferred sedation technique. However, when high doses of propofol are used, side effects, namely respiratory depression, may occur.

Cognitive aids: 'a must' for procedures performed by multidisciplinary sedation teams outside the operation room?

The human brain might not perform optimally during stressful situations. Cognitive aids can help in such situations to carry out all necessary treatment steps in a correct order. We present the case of a severe anaphylactic reaction during a percutaneous radiological intervention to drain an echinococcosis cyst on the radiology suite outside the operation room (OR), in which cognitive aids were successfully used to optimise patient care by a multidisciplinary team.

European implementation of the "2014 ESC/ESA guideline on non-cardiac surgery: cardiovascular assessment and management".

Background: Substandard implementation of a guideline is a major factor contributing to poor guideline adherence and has the potential to result in preventable patient harm. This study aims to quantify the uptake of the European guideline on non-cardiac surgery by European anesthetists.

Methods: This is a questionnaire-based cross-sectional study.

[Cognitive aid for emergencies in the OR--AMC bundle helps ensure that no steps are left out].

Crucial management steps in unexpected perioperative emergencies are frequently omitted by OR teams because of the suboptimal performance of the brain under stress.A cognitive aid is a tool that will help care providers to perform and speed up all the necessary management steps of a critical event. We have created a Dutch adaption of the Stanford Emergency Manual, a bundle of cognitive aids to manage a number of life threatening emergencies in the operating theatre.

Establishing a regional enterocutaneous fistula service: the Royal London hospital experience.

Background: The development of enterocutaneous fistula (ECF) is one of the most challenging complications encountered in colorectal surgery. Currently, only two supra-regional centres are nationally designated in the United Kingdom to treat ECF patients. The aim of this study was to assess clinical outcome measures following the implementation of an ECF service at The Royal London Hospital.