Editor's picks for the pediatric anesthesia article of the day: March 2024
Melissa Brooks Peterson MD, Justin L. Lockman MD, MSEd, Myron Yaster MD
As previously announced, the PAAD has entered into a partnership with the journal Pediatric Anesthesia in which we provide the journal with our top 4-5 PAADs of the month which the journal then posts with short summaries and a hyperlink on their website.
You may be wondering how we pick these articles? The PAAD is published in a wonderful program/platform called Substack. Built into the Substack program are analytics that provide us with the number of people who open each PAAD and how many are opened more than once and/or reposted to others not on our regular mailing list. We pick the highest opened articles with the most reader responses. Although we call this “editor’s picks”, in reality, it is the readers who make the decision.
Going forward, we will (re)post these “editor’s picks” from the Pediatric Anesthesia website as a monthly PAAD feature. We think this may be a good opportunity for many of you to revisit some of these PAADs by simply clicking on the attached links.
Yours in life long learning!
TITLE: The weaponization of wellness
LINK: https://ronlitman.substack.com/p/the-weaponization-of-wellness
Original article: Rosenbaum L. Being well while doing well—distinguishing necessary from uneccessary discomfort in training. N Engl J Med. 2024;390(6):568-572. doi:10.1056/NEJMms2308228
https://www-nejm-org.proxy.hsl.ucdenver.edu/doi/abs/10.1056/NEJMc2403542
Summary: Wellness topics are king in business and medicine; particularly, in medical training and practice, wellness is worth discussing. This PAAD addresses wellness in the context of our medical training. It highlights the balance between necessary difficulties of medical training for purposes of effective learning versus the risk of denigration of personal and professional fulfillment that can come with too much difficulty in the same setting. This PAAD garnered the most “opens” and “reads” of the month—enjoy!
TITLE: Disposable laryngoscope handles and blades: “I'm mad as hell and I'm not going to take this anymore”
LINK: https://ronlitman.substack.com/p/disposable-laryngoscope-handles-and
Original article: Sherman JD, Raibley LA 4th, Eckelman MJ. Life cycle assessment and costing methods for device procurement: comparing reusable and single-use disposable laryngoscopes. Ansett Analg. 2018;127(2):434-443. doi:10.1213/ANE.0000000000002683
Summary: Does your institution use reusable blades and handles or single-use/disposable products? What is the evidence behind that choice? While more and more disinformation circulates about reusable versus single-use products, this PAAD serves as a review of a useful and thorough analysis of this question. It reviews a cost and life cycle analysis of different laryngoscope blades and handles in order to reveal the errors and highlight truths in our opinions around convenience, cost, regulatory decisions, and environmental concerns of single-use/disposable devices.
TITLE: Apneic oxygenation during pediatric tracheal intubation
LINK: https://ronlitman.substack.com/p/apneic-oxygenation-during-pediatric
Original article: Fuchs A, Koepp G, Huber M, Aebli J, Afshari A, Bonfiglio R, et al. Apnoeic oxygenation during pediatric tracheal intubation: a systematic review and meta-analysis. Br J Anaesth. 2024;132(2):392-406. doi:10.1016/j.bja.2023.10.039
https://www.bjanaesthesia.org/action/showPdf?pii=S0007-0912%2823%2900622-0
Summary: Apneic oxygenation has slowly gained traction in the pediatric anesthesiology literature as an effective deterrent against desaturation and adjunct associated with first-pass success at securing an airway. Is apneic oxygenation destined to be a new standard for our field? This PAAD presents a systematic review meta-analysis of the studies that have been performed to-date assessing apneic oxygenation and its utility in difficult and routine airway management.
TITLE: “Houston: We have a problem!” Well-being parameters and intention to leave current institution among academic physicians
LINK: https://ronlitman.substack.com/p/houston-we-have-a-problem-well-being
Original article: Ligibel JA, Goularte N, Berliner JI, Bird SB, Brazeau CMLR, Rowe SG, et al. Well-being parameters and intention to leave current institution among academic physicians. JAMA Netw Open. 2023;6(12):e2347894. doi:10.1001/jamanetworkopen.2023.47894
https://jamanetwork-com.proxy.hsl.ucdenver.edu/journals/jamanetworkopen/fullarticle/2812960
Summary: A second “best of” article this month about wellness, indicating clear interest from the PAAD reader base as well as themes we are seeing repeatedly in medical and nonmedical literature. This PAAD reviews an article from JAMA assessing well-being measured by burnout indices, the Professional Fulfillment Index (PFI) as well as intention to leave (ITL). It places Anesthesiologists as the highest ITL scores among all medical and surgical specialties and identifies the highest rates of burnout occur in female, younger, and nonwhite non-Asian cohorts. This PAAD highlights the call for institutional-level change to combat these concerning phenomena and to preserve our workforce in the face of staffing shortages, attrition, and loss of mentorship.