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pre-mRNA Processing02:01

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In eukaryotic cells, transcripts made by RNA polymerase are modified and processed before exiting the nucleus. Unprocessed RNA is called precursor mRNA or pre-mRNA to distinguish it from mature mRNA.
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IR Frequency Region: Fingerprint Region01:03

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IR spectra are divided into two main regions: the diagnostic region and the fingerprint region. The diagnostic region of the spectrum lies above 1500 cm−1. The absorptions resulting from single-bond vibrations of the N–H, C–H, and O–H stretch at higher wavenumbers and appear on the left side of the spectrum. The stretching absorptions of the C≡C and C≡N occur between 2100–2300 cm−1. In contrast, those arising from stretching absorptions of the...
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In eukaryotic cells, transcripts made by RNA polymerase are modified and processed before exiting the nucleus. Unprocessed RNA is called precursor mRNA or pre-mRNA to distinguish it from mature mRNA.
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The double-stranded structure of DNA has two major advantages. First, it serves as a safe repository of genetic information where one strand serves as the back-up in case the other strand is damaged. Second, the double-helical structure can be wrapped around proteins called histones to form nucleosomes, which can then be tightly wound to form chromosomes. This way, DNA chains up to 2 inches long can be contained within microscopic structures in a cell. A double-stranded break not only damages...
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LAST Double Check - A Comprehensive Pre-Regional Checklist for the Busy Institution.

Angelica G Mancone1, Alyssa R Dickey1, Brian M Fitzgerald2

  • 1Department of Anesthesia, Anesthesiology Residency, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr., JBSA Ft. Sam Houston, TX.

Military Medicine
|March 20, 2018
PubMed
Summary
This summary is machine-generated.

The LAST Double Check Checklist prevents regional anesthesia errors, including wrong-site blocks and anticoagulation issues. This comprehensive tool enhances patient safety without causing delays in care.

Keywords:
anticoagulationchecklistnerve blockregional

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Area of Science:

  • Anesthesiology
  • Patient Safety
  • Quality Improvement

Background:

  • Wrong-site peripheral nerve blocks are considered "never events" by national quality organizations.
  • Previous checklists, like the ASRA's Regional Block Preprocedural Checklist, aimed to reduce these errors.
  • Errors involving anticoagulation prior to regional anesthesia highlighted the need for a more robust safety measure.

Purpose of the Study:

  • To develop and evaluate the effectiveness of the LAST Double Check Checklist.
  • To identify and mitigate errors in regional anesthesia delivery, focusing on wrong-site blocks and anticoagulation management.
  • To assess the checklist's impact on procedural delays.

Main Methods:

  • An expert panel developed the LAST Double Check Checklist.
  • The checklist underwent two 30-day trial periods with data collection on errors and delays.
  • Feedback from the trial periods was used to refine the checklist for broader implementation.

Main Results:

  • No procedures were performed on patients with unmanaged anticoagulation, nor were case delays reported during the trials (350 anesthetics).
  • One instance of incorrect anticoagulation (enoxaparin) was identified and prevented a planned regional anesthetic.
  • Post-implementation, over 1,000 regional anesthetics were performed without reported events during an 11-month period.

Conclusions:

  • The LAST Double Check Checklist is a comprehensive tool for preventing regional anesthesia errors.
  • It effectively addresses wrong-site blocks, anticoagulation issues, and improves care team coordination.
  • Implementation did not lead to delays in patient care, enhancing overall safety.