Disruptive technology is a term used to describe new technology that disrupts the status quo. These technologies displace existing technology—dramatically changing the production, delivery, or use of a product or service. For example, 3D printing is an innovative method of producing three dimensional objects using digital prototypes and will change manufacturing as we know it. Although the term is traditionally used in a positive light, this technology, as its name ...

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Anesthesiology and obstructive sleep apnea: A patient safety challengeA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Obstructive sleep apnea (OSA) has been diagnosed in more than 18 million American adults, but there are likely millions of others who suffer with OSA, but are undiagnosed. While OSA is frustrating to the patient and the patient’s family, it is crucial to remember OSA is a significant ...

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Two recent articles highlight the challenges we will face as our healthcare system changes with regard to how care is delivered and reimbursed. The first article from the New York TimesMedicare Panel Urges Cuts to Hospital Payments for Services Doctors Offer for Less, notes that large hospital-centric systems of care do not necessarily serve patients well in terms of cost and sustainability. The second on the front page of ...

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I was a very shy child. I never felt comfortable speaking up, especially in groups or in new situations. When asked a question in class, my heart raced, my eyes teared up, and I felt sweaty. As I grew up, these physical reactions subsided as I learned to internalize and manage this fear. But at that time, I could not have imagined that my professional career would depend upon my ...

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Cockpit culture and using the two challenge rule in the OR With the crash of the Asiana 777, we're hearing a lot about cockpit culture and how communication across a hierarchy sometimes fails, even when the very lives of the folks communicating (or failing to do so) are on the line.  This isn't a new concept, and isn't unique to aviation.  Many parallels have been drawn between aviation communication and healthcare team communications, ...

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Next in a continuing series. Would you know what I mean if I describe whistling without whistling? Barely pursing the lips, making little quasi-audible windy sounds while inhaling and exhaling, in tune yet nearly silent? Unless there's music playing, that's what I do when I operate. And for reasons about which I have absolutely no clue, I nearly always "whistle" The Caisson Song. I've always wondered if anyone ...

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Sedasys for anesthesia: Can a machine guide sedation? Movie buffs and science fiction fans certainly remember HAL, the computer in 1968’s hit movie “2001:  A Space Odyssey”.  Considered one of the greatest villains in film history, HAL was capable of reasoning and language processing to assist the astronauts on their space mission.  Ultimately, however, HAL decided that its best course of action was to kill all the astronauts. “I am ...

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On June 10, 2013 a 32-year-old pregnant woman was reported to have died after having an ovary removed instead of her inflamed appendix. As the infected appendix festered, she became septic and succumbed to multiple organ failure. This tragedy occurred in the UK in late 2011, but has just come to light. How could this have happened? Let me count the ways. The surgery was performed by two trainee surgeons. Their ...

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Next in a continuing series. Let's make it easy on ourselves. I haven't yet established why -- other than liking the particular operation -- we're removing this nice person's colon. So since our patient has agreed to remain exposed and to do so for all to see, I declare s/he has diverticulitis. (Were it cancer, the operation would be largely the same, taking a bit more out.) Most likely ...

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It’s painful enough to lose a patient. But I found it even more painful to try to console a family whom I’d never met. Depending on your point of view, the limited patient contact afforded the anesthesiologist is a disappointment or a perk of the specialty. Anesthesiologists are steadily branching out into other areas of perioperative care where lengthier patient/family contact is necessitated but the preop encounter with the anesthesiologist is ...

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