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  1. Article ; Online: Disposable laryngoscope intubation to reduce equipment failure in an emergency out of OR setting - a quality control case study.

    Simmons, Colby G / Eckle, Tobias / Rogers, Dustin / Williams, Jason D / Brainard, Jason C

    BMC anesthesiology

    2023  Volume 23, Issue 1, Page(s) 16

    Abstract: Background: Reusable laryngoscopes have been reported to be superior to disposable laryngoscopes with plastic blades during emergent intubations. Surprisingly, at our institution a quality reporting system revealed a high number of equipment failures ... ...

    Abstract Background: Reusable laryngoscopes have been reported to be superior to disposable laryngoscopes with plastic blades during emergent intubations. Surprisingly, at our institution a quality reporting system revealed a high number of equipment failures with reusable laryngoscopes in an emergency out-of-OR (operating room) setting. As recent studies indicated an improved quality of disposable laryngoscopes, we hypothesized that a thoroughly evaluated disposable laryngoscope would result in less equipment failure in an emergency out-of-OR setting.
    Methods: To perform a more standardized and time efficient analysis, four distinct disposable laryngoscope blade/handle configurations were trialed during standard intubations (n = 4 × 30) in the OR by experienced anesthesia providers who completed a 6-question, Likert-scale/open-ended survey for product evaluation. The 'best' disposable blade was implemented in an emergency out-of-OR setting and equipment failure rates were monitored over a 3-year period.
    Results: Different disposable laryngoscopes were equal regarding sturdiness, illumination and airway visualization. The laryngoscope with the highest overall score was significantly higher scored than the laryngoscope with the lowest overall score. All disposable laryngoscopes were more cost effective than the reusable ones, and the top scored laryngoscope demonstrated the highest 5-year cost-saving ($210 K). Implementation of the top scored disposable laryngoscope into an emergency out-of-OR setting reduced the equipment failure incidence from high 20s to 0.
    Conclusion: Disposable laryngoscopes are cost effective and superior to reusable laryngoscopes in an emergency out-of-OR setting. We demonstrate that the implementation of a disposable laryngoscope in the emergency out-of-OR setting resulted in a near elimination of equipment related quality submissions which ultimately enhances patient safety.
    MeSH term(s) Humans ; Laryngoscopes ; Intubation, Intratracheal ; Disposable Equipment ; Surveys and Questionnaires ; Equipment Failure ; Equipment Design
    Language English
    Publishing date 2023-01-10
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2091252-3
    ISSN 1471-2253 ; 1471-2253
    ISSN (online) 1471-2253
    ISSN 1471-2253
    DOI 10.1186/s12871-022-01956-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Patient Safety in Anesthesia: Hand Hygiene and Perioperative Infection Control.

    Simmons, Colby G / Hennigan, Andrew W / Loyd, Jacob M / Loftus, Randy W / Sharma, Archit

    Current anesthesiology reports

    2022  , Page(s) 1–8

    Abstract: Purpose of review: This review highlights the importance of the anesthesia team in minimizing perioperative infection risks and prevention of surgical site infection. Due to the immense financial and patient care burden that results from perioperative ... ...

    Abstract Purpose of review: This review highlights the importance of the anesthesia team in minimizing perioperative infection risks and prevention of surgical site infection. Due to the immense financial and patient care burden that results from perioperative infection, a foundational knowledge in preventive measures is essential.
    Recent findings: Perioperative infection control, the role of the anesthesia team in reducing infection risk, and more specifically the outsized importance of hand hygiene in this space have become increasingly apparent. Maintenance of workspace cleanliness along with hand hygiene forms the cornerstone of preventing microbial transmission. Unfortunately, improvements around perioperative infection control are lacking.
    Summary: The importance of the anesthesia team in maintaining proper hand hygiene, a clean work environment, and appropriate patient conditions to minimize risk of perioperative infection cannot be overstated. Poor clinical outcomes, economic burden, and external pressure from payers highlight the need for anesthesia providers to have an up-to-date knowledge of best practices in this area. In this article, we will review the current recommendations for hand hygiene practices and perioperative infection prevention.
    Language English
    Publishing date 2022-11-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057373-X
    ISSN 2167-6275 ; 1523-3855
    ISSN (online) 2167-6275
    ISSN 1523-3855
    DOI 10.1007/s40140-022-00545-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Airway and Hemodynamic Considerations for the Anesthetic Management of an Intraluminal Tracheal Plasmacytoma.

    Morabito, Joseph E / Simmons, Colby G / Zanotti, Giorgio / Mitchell, John D / Bartels, Karsten / Wilkey, Barbara J

    Seminars in cardiothoracic and vascular anesthesia

    2022  Volume 27, Issue 1, Page(s) 64–67

    Abstract: Central airway obstruction due to tracheal tumors presents unique challenges to the anesthesiologist. We present the case of a 44-year-old male taken to the OR for biopsy and resection of an undiagnosed tracheal mass. Intraoperative management was ... ...

    Abstract Central airway obstruction due to tracheal tumors presents unique challenges to the anesthesiologist. We present the case of a 44-year-old male taken to the OR for biopsy and resection of an undiagnosed tracheal mass. Intraoperative management was complicated by bleeding and significant hemodynamic instability, necessitating rapid surgical and anesthetic intervention. This ultimately led to abortion of surgical resection. Pathologic examination revealed a primary tracheal plasmacytoma, a rare type of tracheal tumor. Here, we describe anesthetic and hemodynamic considerations for a tracheal plasmacytoma. We discuss the approach to airway management in variable intrathoracic tracheal obstruction and the unpredictability of tracheal tumors.
    MeSH term(s) Male ; Humans ; Adult ; Tracheal Neoplasms/complications ; Tracheal Neoplasms/pathology ; Tracheal Neoplasms/surgery ; Plasmacytoma/complications ; Plasmacytoma/pathology ; Plasmacytoma/surgery ; Trachea/surgery ; Airway Obstruction/etiology ; Anesthetics ; Airway Management
    Chemical Substances Anesthetics
    Language English
    Publishing date 2022-11-23
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2012371-1
    ISSN 1940-5596 ; 1089-2532
    ISSN (online) 1940-5596
    ISSN 1089-2532
    DOI 10.1177/10892532221140235
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: New frontiers in intraoperative neurophysiologic monitoring: a narrative review.

    Oliva, Anthony M / Montejano, Julio / Simmons, Colby G / Vogel, Scott A / Isaza, Carlos F / Clavijo, Claudia F

    Annals of translational medicine

    2023  Volume 11, Issue 11, Page(s) 388

    Abstract: Background and objective: Neurological insults during surgery arise from anatomic and/or physiologic perturbations. Intraoperative neurophysiologic monitoring (IONM) fills a critical role of ensuring that any neurological insults during certain surgical ...

    Abstract Background and objective: Neurological insults during surgery arise from anatomic and/or physiologic perturbations. Intraoperative neurophysiologic monitoring (IONM) fills a critical role of ensuring that any neurological insults during certain surgical procedures are caught in real-time to prevent patient harm. IONM provides immediate feedback to the surgeon and anesthesiologist about the need for an intervention to prevent a neurologic deficit postoperatively. As important as it seems to have IONM available to any patient having surgery where a neurological injury is possible, the truth is that IONM is unavailable to large swaths of people around the world. This review is intended to bring attention to all of the ways IONM is critically important for a variety of surgeries and highlight the barriers preventing most patients around the world from benefiting from the technology. Expansion of IONM to benefit patients from all over the world is the new frontier.
    Methods: We searched all English language original papers and reviews using Embase and MEDLINE/PubMed databases published from 1995 to 2022. Different combinations of the following search terms were used: intraoperative neuromonitoring, neurosurgery, low-income countries, cost, safety, and efficacy.
    Key content and findings: We describe common IONM modalities used during surgery as well as explore barriers to implementation of IONM in resource-limited regions. Additionally, we describe ongoing efforts to establish IONM capabilities in new locations around the world.
    Conclusions: In this paper, we performed a review of the literature on IONM with an emphasis on the basic understanding of clinical applications and the barriers for expansion into resource-limited settings. Finally, we provide our interpretation of "new frontiers" in IONM quite literally facilitating access to the tools and education so a hospital in Sub-Saharan Africa can incorporate IONM for their high-risk surgeries.
    Language English
    Publishing date 2023-07-26
    Publishing country China
    Document type Journal Article ; Review
    ZDB-ID 2893931-1
    ISSN 2305-5847 ; 2305-5839
    ISSN (online) 2305-5847
    ISSN 2305-5839
    DOI 10.21037/atm-22-4586
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Comparing Anesthesia and Surgery Controlled Time for Primary Total Knee and Hip Arthroplasty Between an Academic Medical Center and a Community Hospital: Retrospective Cohort Study.

    Nguyen, Thy B / Weitzel, Nathaen / Hogan, Craig / Kacmar, Rachel M / Williamson, Kayla M / Pattee, Jack / Jevtovic-Todorovic, Vesna / Simmons, Colby G / Faruki, Adeel Ahmad

    JMIR perioperative medicine

    2024  Volume 7, Page(s) e45126

    Abstract: Background: Osteoarthritis is a significant cause of disability, resulting in increased joint replacement surgeries and health care costs. Establishing benchmarks that more accurately predict surgical duration could help to decrease costs, maximize ... ...

    Abstract Background: Osteoarthritis is a significant cause of disability, resulting in increased joint replacement surgeries and health care costs. Establishing benchmarks that more accurately predict surgical duration could help to decrease costs, maximize efficiency, and improve patient experience. We compared the anesthesia-controlled time (ACT) and surgery-controlled time (SCT) of primary total knee (TKA) and total hip arthroplasties (THA) between an academic medical center (AMC) and a community hospital (CH) for 2 orthopedic surgeons.
    Objective: This study aims to validate and compare benchmarking times for ACT and SCT in a single patient population at both an AMC and a CH.
    Methods: This retrospective 2-center observational cohort study was conducted at the University of Colorado Hospital (AMC) and UCHealth Broomfield Hospital (CH). Cases with current procedural terminology codes for THA and TKA between January 1, 2019, and December 31, 2020, were assessed. Cases with missing data were excluded. The primary outcomes were ACT and SCT. Primary outcomes were tested for association with covariates of interest. The primary covariate of interest was the location of the procedure (CH vs AMC); secondary covariates of interest included the American Society of Anesthesiologists (ASA) classification and anesthetic type. Linear regression models were used to assess the relationships.
    Results: Two surgeons performed 1256 cases at the AMC and CH. A total of 10 THA cases and 12 TKA cases were excluded due to missing data. After controlling for surgeon, the ACT was greater at the AMC for THA by 3.77 minutes and for TKA by 3.58 minutes (P<.001). SCT was greater at the AMC for THA by 11.14 minutes and for TKA by 14.04 minutes (P<.001). ASA III/IV classification increased ACT for THA by 3.76 minutes (P<.001) and increased SCT for THA by 6.33 minutes after controlling for surgeon and location (P=.008). General anesthesia use was higher at the AMC for both THA (29.2% vs 7.3%) and TKA (23.8% vs 4.2%). No statistically significant association was observed between either ACT or SCT and anesthetic type (neuraxial or general) after adjusting for surgeon and location (all P>.05).
    Conclusions: We observed lower ACT and SCT at the CH for both TKA and THA after controlling for the surgeon of record and ASA classification. These findings underscore the efficiency advantages of performing primary joint replacements at the CH, showcasing an average reduction of 16 minutes in SCT and 4 minutes in ACT per case. Overall, establishing more accurate benchmarks to improve the prediction of surgical duration for THA and TKA in different perioperative environments can increase the reliability of surgical duration predictions and optimize scheduling. Future studies with study populations at multiple community hospitals and academic medical centers are needed before extrapolating these findings.
    Language English
    Publishing date 2024-02-26
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-9128
    ISSN (online) 2561-9128
    DOI 10.2196/45126
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Correction to: Benchmarking of Anesthesia and Surgical Control Times by Current Procedural Terminology (CPT®) Codes.

    Simmons, Colby G / Alvey, Nicholas J / Kaizer, Alexander M / Williamson, Kayla / Faruki, Adeel A / Kacmar, Rachel M / Jevtovic-Todorovic, Vesna / Weitzel, Nathaen S

    Journal of medical systems

    2022  Volume 46, Issue 9, Page(s) 60

    Language English
    Publishing date 2022-08-11
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 423488-1
    ISSN 1573-689X ; 0148-5598
    ISSN (online) 1573-689X
    ISSN 0148-5598
    DOI 10.1007/s10916-022-01849-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Benchmarking of Anesthesia and Surgical Control Times by Current Procedural Terminology (CPT®) Codes.

    Simmons, Colby G / Alvey, Nicholas J / Kaizer, Alexander M / Williamson, Kayla / Faruki, Adeel A / Kacmar, Rachel M / Jevtovic-Todorovic, Vesna / Weitzel, Nathaen S

    Journal of medical systems

    2022  Volume 46, Issue 4, Page(s) 19

    Abstract: Over half of hospital revenue results from perioperative patient care, thus emphasizing the importance of efficient resource utilization within a hospital's suite of operating rooms (ORs). Predicting surgical case duration, including Anesthesia- ... ...

    Abstract Over half of hospital revenue results from perioperative patient care, thus emphasizing the importance of efficient resource utilization within a hospital's suite of operating rooms (ORs). Predicting surgical case duration, including Anesthesia-controlled time (ACT) and Surgical-controlled time (SCT) has been significantly detailed throughout the literature as a means to help manage and predict OR scheduling. However, this information has previously been divided by surgical specialty, and only limited benchmarking data regarding ACT and SCT exists. We hypothesized that advancing the granularity of the ACT and SCT from surgical specialty to specific Current Procedural Terminology (CPT
    MeSH term(s) Anesthesia/methods ; Benchmarking ; Current Procedural Terminology ; Humans ; Operating Rooms ; Operative Time ; United States
    Language English
    Publishing date 2022-03-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 423488-1
    ISSN 1573-689X ; 0148-5598
    ISSN (online) 1573-689X
    ISSN 0148-5598
    DOI 10.1007/s10916-022-01798-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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