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CSA Resident Research Day - Shared screen with speaker view
Taraz Nosrat, MD
11:22
Needs to share screen
Justin T. Ward, MD
11:35
Can someone say something?
Rita Agarwal
14:12
Please feel free to ask question on Q&A button
Justin T. Ward, MD
17:13
There is no option for me to ask a question. Only to view open/answered/dismissed questions
Rita Agarwal
18:52
If Q&A doesn’t work. Feel free to use the chat function
CSA
18:54
As a panelist you aren't able to ask a question, I don't see a work around for that. Sorry!
Rita Agarwal
19:36
Rachel, Q&A button doesn’t work
CSA
20:00
I'm not sure why. Its clicked as active in the set up of the webinar. Let me try something else
CSA
22:44
it works for attendees. Dr Doyle just tested. Panelists cannot do Q and A
Rita Agarwal
24:29
Varina this is from Adam Milam What are the implications if we block RV hypertrophy in the presence of pHTN?
Rita Agarwal
26:11
Ronald Pearl 09:13 AMVarina from Dr. Pearl, perhaps answer later? What was the relative decrease in pulmonary hypertension with Snail and why was it not l
Rita Agarwal
27:14
Please ask questions during the sessions, we only have one minute for Q&A after each session for questions. I will forward any questions asked after the presentation to the speakers
Varina R. Clark, BS
29:23
Thanks for these questions - We still do not know if Snail inhibition has effects on lung vasculature (will investigate as future stpes
Varina R. Clark, BS
29:34
steps*
CSA
29:49
Dr pearl click the down arrow and pick "panelist and attendees" the judges wont see this otherwise
Karen Sibert MD FASA
30:18
Great presentations!!!
Rita Agarwal
32:11
Rachel do we know where Taylor is?
CSA
33:20
I don't. I just tried calling it went straight to VM
Taraz Nosrat, MD
33:41
i was able to text him, he was mistaken on the start time
Rita Agarwal
34:12
We will try and fit him in, when/if he calls in.
CSA
34:37
oh thanks taraz! I sent an email too. We can get him in before stephanie I think Rita
Varina R. Clark, BS
35:16
@Adam Milam- we observed decrease in RV hypertrophy, but not a complete blockade. Some RV hypertrophy may be needed to preserve RV function, as this is a compensatory response to pressure overload. In our experiments, we observed improved RV function. For lung vasculature, there may be effects with Snail --but we specifically observed the improved RV functioning/remodeling that serves to unload some pressure overload
CSA
35:20
I just sent him a new link in case he missed that too.
CSA
38:52
HI everyone! Facebook live is hanging up at the join process. If you had anyone joining that way, there is also the registration link on our Facebook so they can still join us. Sorry for the technical difficulty.
CSA
40:49
We can move him to the very end and he should be okay.
CSA
41:30
Rita see note above RE: Taylor. Should be okay by end
Rita Agarwal
41:51
Rachel I can’t see the questions
CSA
42:59
The Q&A questions? you are a co host I can see them you should too
Adam Milam
44:17
How was the sample of residents selected? Does the music distract residents/flow when enterinig the room?
Rita Agarwal
44:43
It stopped opening for me
CSA
44:57
Let me un co host you and re co host you
CSA
45:34
Did that help Rita? I can hand type in if you cant see them so you have a question to pick from
Rita Agarwal
46:02
Never mind I found them, they had moved off my screen
Taraz Nosrat, MD
46:50
It is ideal when the patient chooses their own music, as each individual has a different response to different genres, ie classical music may be relaxing to some, and disco music for others. The music’s greatest distraction is lulling OR personnel into a sense of calm, however we recommend pausing the music for surgical time out and induction to focus on the patient!
Rita Agarwal
46:56
Manuel Pardo 09:27 AMIs there data whether lower tech techniques such as listening to music will have the same impact as VR?Adam Milam 09:33 AMHow was the sample of residents selected? Does the music distract residents/flow when enterinig the room?Ronald Pearl 09:34 AMSending these out to Taraz. You should be able to answer on Q&A tabDid you get any patient satisfaction data?
Rita Agarwal
47:44
How were residents selected
Rita Agarwal
53:07
Sydney Thomson M.D. ,FASA 09:42 AMPart of the problem is when the orthopedic surgeon wants the anesthesologist to be a DJ and have the music blaring from the anethesia work station. I moved the music player to the circulator’s station behind the Surgeon so I could hear the alarms. How many health care workers in the OR have Tinnitus/hearing loss?
Taraz Nosrat, MD
57:41
Re: Dr. Thomson: Our responsibility is ultimately to patient care and staying vigilant, which necessitates needing to hear the machine alarms. There is never an excuse of being unable to hear the alarms, and at that point it’s our responsibility to step up and turn the music down or the alarms up. Also, in my experience, it is the lower quality speakers (cell phones, computer speakers) that are very trebly that cause more hearing loss and distraction
Rita Agarwal
58:12
Anonymous Attendee 09:47 AMi use a bluetooth speaker placed by nurse but control music and level of sound by my phone helps to adjust for key points in anesthesia and surgery
Taraz Nosrat, MD
58:29
Beautiful.
Karen Sibert MD FASA
01:02:59
And thank you to Dr. Agarwal and Dr. Brock-Utne for organizing this, and of course to Rachel Hickerson!
Rita Agarwal
01:03:00
TO Alexandra Johanna Schwarzenberger 09:52 AMAre you considering to take cortisol levels and Hgb Aic 1 as a way of judging the longterm effects of sleep disturbance/deprivation?
Rita Agarwal
01:03:55
Alexandra when you answer try to answer to all attendees thank you
Alexandra Ruan, MD
01:04:30
@Brendan Carvalho: We did not specifically ask residents what activities they were doing outside of the OR during the study period, but we did keep track of whether they were on call before and after night float. Unfortunately we were unable to control for the amount of hours worked during these weeks given that it was an observational study only
Brendan Carvalho
01:05:32
Agree. Thanks to all organizers and presenters...excellent studies and presentations!
Christina Menor
01:06:18
Did you have any patient concerns about wearing a band showing they take OCPs?
Alexandra Ruan, MD
01:06:42
@Chein Chow: Thank you for that interesting suggestion! I would love to expand the study beyond Stanford, especially to get a sense of regional/national resident metrics on wellbeing. Feel free to send me an email if you are interested (aruan@stanford.edu) in expanding the project to your institution!
Brendan Carvalho
01:06:53
How was confidentiality handled?
Rita Agarwal
01:10:51
Evan can you answer Dr Carvallho and Dr JBU’s questions. Change the tag to “All Panelists and all Attendees
Taraz Nosrat, MD
01:11:54
Re: Dr. Thomson 09:43 AM: Our responsibility is ultimately to patient care and staying vigilant, which necessitates needing to hear the machine alarms. There is never an excuse of being unable to hear the alarms, and at that point it’s our responsibility to step up and turn the music down or the alarms up. Also, in my experience, it is the lower quality speakers (cell phones, computer speakers) that are very trebly that cause more hearing loss and distraction
Evan Sleipness, MD
01:15:24
Thanks for the questions. So far, no patient concerns about confidentiality, a couple have asked why we ask at check-in; when advised it has to do with periooperative drug interactions they understand. We didn’t want to spell out ‘birth control’ on wristband for reasons of confidentiality (nor did we want to spell out ‘sugammadex’, but wanted to keep the wristband from being too cryptic for discharging nurses.
Sydney Thomson M.D. ,FASA
01:17:24
Dear Taraz: I agree so I turned over the tinny blue tooth speaker and music selection to the nurse and deployed it closer to the surgeon. I enjoy music for the patient and calming music for the room—but in private practice you would be surprised how much push back an anesthesiologist gets when we point out their music is impeding the ability to hear alarms. Ironically, some surgeons can’t stand the sound of the Pulse ox—I refused to turn that off. I applaud any studies that protects our hearing and the team’s ability to communicate!
Evan Sleipness, MD
01:20:40
Regarding neostigmine, there is no departmental policy on administering neostigmine if a patient is on hormonal contraceptives; this decision is left to individual anesthesia providers. Regarding productivity…this is a difficult thing to quantify because we don’t know how many unexpected pregnancies are due to ‘quenching’ of birth control by perioperative drug interactions. In the end, I think that we are working to forestall events that are likely uncommon, but inevitably have profound consequences for patients and their shipmates every time they do occur.
Christine Doyle
01:22:21
Separate from the Sugammadex issue, there are issues with antibiotics, so it’s not likely that there is much “over counseling” overall.
Rita Agarwal
01:23:12
For Dr. Wang Johanna Schwarzenberger 10:11 AMWhere the home visits done at the same time of the day for each patient? How did activity status correlate with the data?
Taraz Nosrat, MD
01:27:42
Justin, have you stopped using a bair hugger because of this data?
Evan Sleipness, MD
01:28:28
Excellent point Dr. Doyle, the antibiotic interactions are why we felt the process outlined was reasonable. I elected not to discuss antibiotics because of time constraints (but a couple of the references cited deal with antibiotics and contraception)
Sydney, Hemphill, BS (MS-4)
01:29:59
@Manuel Pardo: We are not aware of any head to head studies comparing VR to music therapy (could be an interesting question for the next phase of our study). The literature does show that increased cognitive load increases distractibility and decreases pain perception.
Annie Wang, M.D.
01:30:24
The home visits were done in the morning from 8 am to 12 noon. We are currently doing an ongoing investigation to look at how the activity status correlates with our data.
Rita Agarwal
01:33:44
Presenters remember to change your to: Tag to All Panelsit and attendees when you answer questions, that way everyonne can see them
Justin T. Ward, MD
01:33:49
We have not stopped using the Bair Hugger, but we are working on addressing this data with the hospital
Justin T. Ward, MD
01:33:58
and manufacturer
Karen Sibert MD FASA
01:34:09
Would guess sugammadex and video laryngoscopes should get much of the credit
Christina Menor
01:35:09
Awesome presentations everyone!
Jeffrey Poage
01:35:14
Terrific presentations. Great job everyone!!
Vivianne Tawfik
01:35:56
Really great presentations everyone! Thank you all!
Taraz Nosrat, MD
01:36:00
Thanks everybody for attending
Jane Moon
01:36:26
On behalf of the CSA History Committee, CONGRATULATIONS to Dr. Stephanie Gilbert and co-author Dr. Tuyen Nguyen on winning our contest!!
Rita Agarwal
01:38:56
Thank you to all our amazing and wonderful presenters and all the trainees that submitted an abstract to our Virtual Resident Research Day. Rachel Hickerson, you are awesome for setting and running this. Dr. JBU and Pearl and all the members of the judging and research committee thank you for all your hard work
CSA
01:40:48
dr pearl I just sent you an email from one of the judges
Christina Menor
01:41:19
Great talk!
Phillip Richardson
01:42:21
Great job everyone.
Christina Menor
01:42:24
Thank you Drs Agarwal, JBU, and Pearl and Rachel for planning and making today happen! Thank you
Chien Chow
01:42:43
Great presentations, everyone.
Adam Milam
01:43:04
Well done everyone !!!
CSA
01:43:07
Congratulations!
Christina Menor
01:43:12
Congratulations winners!
Christina Menor
01:43:24
Medical Students thank you for your contributions and keep up the work!
Brendan Carvalho
01:43:29
Congrats!!!
MARK ZAKOWSKI
01:43:33
congrats to all - very well done, high quality studies
Christina Menor
01:43:42
Thank you also to Dr. Applegate!
Daniel S Orlovich MD PharmD
01:43:43
Great work everyone! Thank you to the CSA for organizing and advocating on our behalf
CSA
01:43:49
Raise hands if you have anything you'd like to talk through please.
Sydney Thomson M.D. ,FASA
01:43:57
Great Virtual Presentations on a wide variety of topics! Thank you to all the leaders who made this happen.
Varina R. Clark, BS
01:44:01
Thank you all for this wonderful opportunity! Great highlight to the start of my MS4 year!
CSA
01:44:41
Varina Clark 1st place
CSA
01:44:53
Syndey Hemphill 2nd place
CSA
01:45:09
Alexandra Ruan 3rd place
Ronald Pearl
01:45:20
Congratulations to all the presenters. Great performances!
Rita Agarwal
01:46:55
Can anyone not talking mute please
Jeffrey Poage
01:47:24
Nicely said, Adam!!
Alexandra Ruan, MD
01:47:31
Nice job everyone!
Vivianne Tawfik
01:47:57
And big thank you to Dr. Adam Milam for spearheading this session!