4 resultados para Pre-history Regional
em University of Washington
Resumo:
Introduction: Assessment of expertise in regional anesthesia techniques is traditionally based upon quota fulfillment of procedures during training. Validation of practitioner proficiency in performing procedures in surgical specialties has moved from simple measurement of technical skills to evaluation of global patient outcomes. Complete absence of pain as a result of nerve blockade is the most important clinical endpoint but patient, technical and procedural factors influence results. The purpose of this study was to measure the postoperative pain scores and associated analgesic medication requirements for patients administered sciatic nerve blockade by nurse anesthetists and determine patient or procedural factors that influenced this outcome. Methods: Either nerve stimulator or ultrasound guided sciatic nerve blockade was administered by nurse anesthetists under the supervision of regional anesthesia faculty. Patient demographic data that was collected included gender, body mass index, surgical procedure, and pre-existing chronic pain with associated opioid use. Patient self-reported pain scores and opioid analgesic dosages in the preoperative, intraoperative, immediate postoperative and 24 hour post procedure intervals were recorded. Results: 22 nurse anesthetists administered sciatic nerve blockade to 48 patients during a 36 month interval. Transition from a nerve stimulator to ultrasound guided sciatic nerve block technique resulted in lower mean pain scores. Patients reporting chronic opioid use were observed to have elevated perioperative opioid analgesic requirements and pain scores compared to opioid naïve patients. Conclusion: Effective analgesia is a prime measure for assessing expertise in regional anesthesia and continuous evaluation of this outcome in everyday practice is proposed.
Resumo:
This report presents the results of stratigraphic analysis of the southwestern quadrant of the Cedar Hills Regional Landfill (CHRLF). My report was intended to incorporate the recent Area 8 borehole data into the pre-existing analyses. This analysis was conducted during the preparation of the Area 8 Hydrogeologic Report, but is my independent investigation and does not represent the opinion of UEC or their associates. The CHRLF, in Maple Valley, WA, south of Squak Mountain, is a municipal solid waste landfill that has been in operation since the 1960s. A network of borings, the product of previous investigations, exists for the study area. I utilized the compiled boring logs, previous investigations, and the recently acquired data to produce a series of interpretative cross-sections for the study area. I recognized 9 distinct stratigraphic units, including fill. My interpreted stratigraphic units are similar to those identified in previous investigations such as the Area 7 Hydrogeologic investigation (HDR Engineering and Associates, 2008). These units include pre-Olympia aged non-glacial alluvium, glacial alluvium, and glacial till. Additionally, younger, Vashon-aged deposits of glacial till, recessional outwash, recessional lacustrine, and ice-contact were observed. An isolated “till-like” deposit was observed below the Vashon till. This could possibly represent an older till as mapped by Sweet Edwards (1985) and Booth (1995). I cite the continuity of the lower contact of the Vashon till (Unit 5, Table 2) and the upper contact pre-Vashon non-glacial fluvial deposits (Unit 9, Table 2) as evidence that faults or other structural features do not offset the deposits in the study area. This conclusion supports the findings of the pre-existing body of work within the landfill property and the nearby Queen City Farms property.
Resumo:
Thesis (Ph.D.)--University of Washington, 2016-06
Resumo:
Thesis (Ph.D.)--University of Washington, 2016-06
