simulation theatre: a means to enhanced learning in the 21[st] century

The increasing role of simulation in medical education has paralleled advancement of this technology. Full environment simulation [FES] can be employed to effectively replicate rare medical catastrophes with exacting realism. It has been suggested that emotion can significantly enhance learning by producing memories that are processed and stored via the amygdaloid complex which is relatively impervious to extinction and thus forgetting. Theoretically the addition of emotional content to simulated crises during FES can be used to affect such changes in the participants and thus facilitate learning. We discuss the theoretic benefit and the use of FES with emotional enhancement as it relates to improved memory and learning

Management of the patient at high risk for postoperative nausea and vomiting

Postoperative nausea and vomiting continue to be problematic areas in anesthesia as evidenced by frequent reports of therapies in the literature. No single therapy has been proven curative for all cases, in part because of the several emetic centers, all of which may be blocked by different classes of drugs and the diverse risk factors which act alone or in combination to cause vomiting. Identification of the patient most at risk allows for cost effective prophylactic management. An appropriate anesthetic technique can be planned that, relying on evidence based medicine, will decrease if not prevent the incidence of this most troubling complication

Management of the patient reporting an allergy to penicillin

Recent emphasis on the prevention of surgical wound infection has highlighted the role of the anesthesiologist as the physician responsible for administering appropriate antibiotic prophylaxis. Patients often report a distant or unclear history of penicillin allergy. Administering an antibiotic to which the patient has a true allergy can provoke a life threatening reaction. The anesthesiologist should be aware of the prevalence, severity, and manifestations of allergies to antibiotics, as well as the available alternatives. Unnecessary administration of more powerful broad-spectrum antibiotics leads to the development of antimicrobial resistance and should be avoided. It is the anesthesiologists' duty to balance these issues when selecting appropriate antibiosis