HEALTH, HEALTH CARE, AND CLIMATE CHANGE Climate change represents a defining challenge of our times, and tackling climate change could be the greatest global health opportunity of this century. Climate change poses clear environmental, technologic, and economic challenges that affect…
INTRODUCTION Human interest in sleep is as old as humanity itself, but the specialty of sleep medicine is less than 50 years old. The characterization of sleep into periods based on electroencephalography (EEG) and the presence or absence of rapid…
INTRODUCTION Patients with serious illnesses often have an intense burden of symptoms that are poorly treated, such as pain, dyspnea, anxiety, and depression. These patients also have frequent but often unsatisfying interactions with the health care team, often as a…
INTRODUCTION Clinical anesthesia practice is often considered a model for quality and safety in medicine. In 1999 the Institute of Medicine report, “To Err Is Human” specifically identified anesthesia as “an area in which very impressive improvements in safety have…
INTRODUCTION Background Injury is the leading cause of fatality worldwide, causing more than 5 million deaths—9% of the world's deaths—each year. According to the Centers for Disease Control and Prevention (CDC), trauma accounted for nearly 230,000 U.S. deaths in 2018,…
INTRODUCTION The practice of anesthesiology historically focused on the care of an individual patient undergoing surgery. The specialty has an impressive track record for improving quality and safety in patient care (also see Chapter 46 ). Although anesthesia practice continues…
Postoperative pain is a complex physiologic reaction to tissue injury. For many patients, the primary concern about surgery is how much pain they will experience after the procedure. Similarly, postoperative pain management is an integral part of anesthesia care. Postoperative…
The postanesthesia care unit (PACU) is managed by anesthesiologists, who provide general medical supervision and coordination of patient care. Historically, PACUs did not become a standard part of hospital design until the late 1940s, after an influential study of mortality…
Procedures performed outside the operating room (OR) fall under the term nonoperating room anesthesia (NORA), which refers to providing anesthesia care at any location away from traditional OR suites ( Box 38.1 ). In response to the need for minimally…
INTRODUCTION Ambulatory anesthesia is a rapidly growing field involving three distinct entities: outpatient anesthesia (the primary focus of this chapter), office-based anesthesia (OBA), and non–operating room anesthesia (NORA) (also see Chapter 38 ). The idea of outpatient anesthesia started over…