Yoel Donchin

Yoel Donchin
Hebrew University of Jerusalem | HUJI

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87
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Introduction
Skills and Expertise

Publications

Publications (87)
Article
Full-text available
Action research is a participatory research method based on active cooperation between researchers and subjects. In clinical practice, action research enables active involvement of workers in developing and implementing actions promoting patient safety. This article describes a participatory action research project that was conducted in the radiolo...
Article
Full-text available
Injuries to patients by the healthcare system (i.e., adverse events) are common and their impact on individuals and systems is considerable. Over the last decade, extensive efforts have been made worldwide to improve patient safety. Given the complexity and extent of the activities required to address the issue, coordinating and organizing them at...
Article
An adverse event in laparoscopic bariatric surgery that has not received much scrutiny involves tube/probe stapling or suturing during gastrectomy or gastroenterostomy. A retrospective analysis was performed using a questionnaire sent to all bariatric surgeons (n = 43) in Israel. Eight surgeons reported on 17 cases in which intraoperative nasogastr...
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Full-text available
Based on knowledge and methods from cognitive psychology and behavioural economics we introduced 'Gentle reminder.' This procedure calls for public planning of safety norms, and an agreement of all team members to help each other to adhere to this plan. Team members agree to gently remind their coworkers every time they deviate from the safety norm...
Article
Contemporary preoperative team briefings conducted to improve patient safety focus mainly on supplying identification details regarding the patient and the surgical procedure. Drawing on cognitive theory principles, in this study a briefing protocol was developed that presents a broader perspective model of the patient and the planned procedure. In...
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Full-text available
Labelling of high-risk drug infusions and lines is a well-recognised safety strategy to prevent medication errors. Although hospital wards characterised by multiple high-risk drug infusions use different types of labelling, little is known about the contribution of a colour-coded label (CCL) to patient safety. A quality improvement programme audit...
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Full-text available
Cases of retained foreign objects after surgery have been a problem since the beginning of modern surgery. However, the preventive measure to this problem has remained rather primitive – through manual surgical count by scrub nurses. The process of counting is subject to errors under stressful environment, such as time pressure, distractions, and h...
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Full-text available
A declaration by the Executive Committee of the European Society of Intensive Care Medicine. On behalf of the Executive Committee. ESICM Executive Committee Members Rui Moreno, Andrew Rhodes, Charles Sprung, Herwig Gerlach, Jean Daniel Chiche, Hans Flaaten, Daniel de Backer, Ruth Endacott, Christian Putensen, Massimo Antonelli, Marco Ranieri, an...
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Reviews of patient safety efforts suggest that technical/administrative change must be augmented by global factors such as organizational culture and climate. The objective was to outline a comprehensive model for healthcare climate and test one of its elements, the nursing subclimate, in terms of several patient safety outcomes. Measure organizati...
Article
Thousands of international aeromedical evacuations are conducted every year. An increasing number of travelers are elderly or have chronic illnesses, and there is more travel to regions where road trauma and infectious diseases are endemic but dependable medical care is not available. This review explains the indications for aeromedical evacuation,...
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Full-text available
Thorough, objective investigation of medical adverse events rarely happens due to the com- plexity of the environment, litigation, risk, and socio-political implications. Special concerns can, and do, undermine investigation depth, breadth, and quality. Healthcare's distinct differ- ence from other high hazard sectors requires a unique approach to...
Article
The Israeli population does not meet its transplantation organ needs. Therefore, liver transplantation (LTX) candidates are sometimes transported to centers abroad. We aimed to assess the demographic and clinical issues concerning this policy. Records of all candidates transported (2000-2004) were retrospectively reviewed. Data included etiology, d...
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This manuscript provides a critical review of the literature regarding the staffing of emergency medical services, with particular emphasis on anesthesiologists. Significant anesthesiology contributions to prehospital care include introduction of new airway management tools and improved physiological monitoring. Contributions to quality of care inc...
Article
Chemotherapy with bleomycin may cause a syndrome of pulmonary sensitivity to supranormal inspired oxygen concentrations that persists for an unknown period of time after exposure. We present a mentally retarded adolescent patient in whom supranormal inspired oxygen was temporarily necessary to manage her difficult airway. Subsequently her pulmonary...
Article
An essential part of nursing education in the early 1950s was to prepare a special “tray” for different procedures. A textbook, “ Tray and Trolley Setting ” by Helene Dickie,1 gave accurate instructions and drawings for the preparation of equipment and drugs for the most important procedures such as colonic lavage, mustard plaster application, and...
Article
Intensive care units (ICUs) were developed for patients with special needs and include an array of technology to support medical care. However, basic lessons in ergonomics, human factors, and human performance fail to propagate in this complex medical environment. Complicated, error-prone devices are commonly used. There are too many patient data f...
Article
Morbidly obese or debilitated patients do not tolerate the prone position used for percutaneous nephrolithotripsy (PCNL) well and may suffer from severe cardiorespiratory compromise in this position. The purpose of this study is to demonstrate a simple way to overcome this difficulty. Two morbidly obese patients, ages 48 and 32 years, with Body Mas...
Article
The way to combat the high frequency of errors and mistakes that endanger both the physician and the patient is by root cause analysis of accidents as well as investigation of "near misses". There is a need for a new approach to error prevention by re-education of the medical teams. A few examples are presented on how to approach an untoward event...
Article
Pyridyldiphenyl triazine (PDT) and three of its analogues were compared as practical reagents for visualizing unseen impressions left on the hands of a person who has held a firearm. The parent compound, PDT, gave the best results using intensity and clarity as measuring criteria. The effectiveness of the PDT reaction was then studied on 147 volunt...
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Full-text available
This study examined perceptual-motor coordination with an apparatus that simulated a situation representative of endoscopic surgery. Participants were trained with one arrangement of the apparatus, then tested with an alternative arrangement in which either the positions of the camera, the surgeon, or the objects in the surgical field were altered....
Article
Adenosine antagonists may have therapeutic potential in cardiopulmonary resuscitation. Aminophylline, a widely available adenosine antagonist, is not included in the Guidelines for Advanced Life Support by the European Resuscitation Council or the American Heart Association. This report addresses a case of out-of-hospital cardiac arrest caused by i...
Article
Air travel can cause severe respiratory decompensation in a patient with advanced lung disease due to high altitude hypoxemia. We report our experience in flying 21 patients with advanced lung disease to a medical center remote from Israel for lung transplantation or pulmonary thromboendarterectomy (PTE). All patients had severe lung disease with m...
Article
In an attempt to develop a model to measure the competence of physicians providing emergency care under difficult field conditions, 75 Israeli army medical corps physicians were evaluated through the use of four instruments: a debriefing interview, peer assessment, self-assessment and written examination. The special on-site assessment model was de...
Article
The purpose of this study was to investigate the nature and causes of human errors in the intensive care unit (ICU), adopting approaches proposed by human factors engineering. The basic assumption was that errors occur and follow a pattern that can be uncovered. Concurrent incident study. Medical-surgical ICU of a university hospital. Two types of...
Article
A possible way to circumvent the continuing decline in the number of autopsies is to perform computed tomography after death. The present study compares the pathologic findings of postmortem CT tomography (PMCT) in trauma fatalities with those disclosed upon conventional forensic autopsy. Within 6 hours of death, the bodies of 25 trauma victims und...
Article
254 Physician Performance in Military Trauma Care: Field Quality Assessment - Volume 8 supplement - A Eldad, N Notzer, M Wiener, Y Donchin
Article
A panel session on undergraduate education in Emergency Medicine from a worldwide perspective was conducted at the Seventh World Congress of Emergency and Disaster Medicine in Montreal, in May, 1991. Desmond Colohan MD, of the University of Toronto (Canada) was the panel moderator. Panel speakers were: Louis Binder MD, Texas Tech University Health...
Article
To evaluate the relationship between presurgical levels of cardiac vagal tone and outcome in neurosurgical patients. Prospective series. Respiratory ICU in a university hospital. Fifty-one adults admitted to the respiratory ICU between 1982 and 1985. Forty-two patients were scheduled for elective neurosurgery, and nine patients suffered from head t...
Article
The system of care delivery of in-field trauma was assessed, leading to suggestions for improving the system and military medical training. This study reports the feasibility and validity of various methods of assessing the performance of Israel Defense Force physicians in administering trauma care. The methods included a standardized medical debri...
Article
Field anesthesia can be practiced safely and effectively but requires special training to acquire familiarity with the techniques. Because field anesthesia may be required even in sophisticated countries for entrapment situations, skill should be maintained by practicing the appropriate techniques on a regular basis. Field anesthetic techniques are...
Article
A heterogeneous group of 77 physicians on compulsory or reserve military service were exposed to a 5-day course in trauma management, specifically designed for military medical personnel. Cognitive knowledge of trauma care delivery of the medical officers was assessed by means of multiple-choice written tests, which were held before and upon comple...
Article
This article presents a few of the basic guidelines that must be considered once a decision is made to provide anesthesia and advanced surgical care in the battlefield--or in civilian catastrophes (for example, terrorist incidents, and man-made or natural disasters) that resemble the battlefield. However, it must be stressed that the most central c...
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The articel presents the main outcomes and conclusions of a two year research effort directed to study the causes of human errors in a Respiratory Intensive Care Unit (ICU). In the course of the study, doctors and nurses recorded errors in treatment routines that were committed during their daily work. Over a period of 4 months we collected 554 err...
Article
Severe pulmonary barotrauma occurred following smoke and toxic gas inhalation in a 20-year-old male. He developed pneumothorax, pneumomediastinum, and extensive facial subcutaneous emphysema which intensified during treatment with positive pressure ventilation. Following the appearance of diplopia and exotropia, orbital emphysema was demonstrated r...
Article
Patients undergoing surgery because of acute trauma have special anesthesia considerations. The principles and guildelines of anesthetic care, including use of central venous lines, establishing an airway, and inducting and maintianing anesthesia must be understood by anesthesiologists and surgeons who treat these patients.
Article
Heart rate and respiratory patterns were monitored in ten ambulatory female patients undergoing elective laparoscopy. The patients were anesthetized with isoflurane-nitrous oxide. An index of cardiac vagal tone determined from the heart rate pattern by quantifying the amplitude of respiratory sinus arrhythmia was elevated over four 10-min periods:...
Article
When metkephamid, a systemically active analog of methionine enkephalin, was administered intracisternally to male or female prepubescent lambs as early as the first week of life, we observed a behavioral pattern akin to Flehmen, which is a well-characterized grimace displayed by mature ungulates during mating. This metkephamid-induced Flehmen was...
Article
Respiratory sinus arrhythmia is a pattern of rhythmic variation in the heart rate that occurs at the frequency of respiration and is mediated principally by the vagus nerve. Spectral analysis can decompose the variance of a series of sequential measures into constituent frequencies to measure and verify whether there is respiratory sinus arrhythmia...
Article
The effect of epidural morphine on the duration of action of epidural 2-chloroprocaine was studied in a double-blind fashion in 30 patients following elective Caesarean section. When compared to epidural saline controls (n = 15), patients (n = 15) who received epidural morphine (4.0-5.0 mg) did not experience a prolongation or reduction in the dura...
Article
Maternal hyperventilation can cause transient reduction in fetal oxygen tension. Fifty women with normal and high-risk pregnancies, between the 32nd and 43rd week, were voluntarily hyperventilated; in 33, fetal heart rate (FHR) acceleration or transient tachycardia were observed (reactive FHR). Of the 33 pregnancies the outcome was good in 30 (91%)...
Article
Epidural morphine was evaluated for the control of postoperative pain after cesarean section (CS). Sixty-five patients undergoing elective CS with epidural bupivacaine were studied. Of these, 40 were given a single dose of 4 mg of morphine through an epidural catheter on termination of surgery. The remaining 25 patients received no postoperative ep...
Article
A computer program for renal function in critically ill patients is described. The program was developed for use in a pocket computer allowing bedside evaluation of kidney function and hydration.
Article
This is a report of successful management of a traumatic rupture of the thoracic aorta in pregnancy. Both mother and daughter are alive and well 24 months after the injury. The various aspects of the surgical and supportive treatment are discussed.
Article
Bupivacaine hydrochloride 0.25% and 0.50% solutions, were administered 115 times by the i.v. regional route to 64 surgical patients and in 38 subjects suffering from pain syndromes. The clinical effects were limb numbness up to 20 h following cuff release, while analgesia and weakness of the limb muscles were evident 5 h after the tourniquet. Clini...
Article
Changes in pH studied in vitro affected considerably the distribution of bupivacaine between the erythrocytes and incubation medium: in an acidic medium, the uptake of bupivacaine by erythrocytes was decreased. The acidosis induced in vivo in dogs' limbs during i.v. regional anaesthesia (IVRA) with bupivacaine was corrected by injecting sodium bica...
Article
Epidural administration of 2 mg of morphine to 16 patients who were undergoing induced abortion in the second trimester of pregnancy abolished labor pains in 10 of them within 10 to 20 minutes after treatment was begun. The pain did not recur until the abortion process started, sometimes hours later. In one patient, the relief of pain was achieved...
Article
The degree of anxiety of 26 male and female patients undergoing hernia repair while receiving lumbar extradural anaesthesia was measured using the galvanic skin response. The single, most anxiety-provoking feature during the surgical procedures proved to be verbal interactions directly concerned with the patient's well-being. The psychological impl...
Article
The incidence of tricyclic antidepressant (TCA) poisoning is increasing. Major symptoms include coma, seizures, and cardiac arrhythmias. Most publications recommend treatment with intravenous physostigmine salicylate. A patient with severe dibenzepin poisoning who regained consciousness 10 minutes after intravenous injection of 2 mg physostigmine i...
Article
A 25-year-old woman in the 7th month of pregnancy was operated upon for a ruptured cerebral aneurysm. Sodium nitroprusside was used to achieve effective controlled hypotension. Signs of foetal distress were transient. Subsequent delivery was spontaneous and uneventful. Development of the child at 2 yr was satisfactory. The various physiological asp...
Article
General anesthesia was administered with a Bain circuit during spontaneous ventilation, controlled ventilation, or intermittent mandatory ventilation. Blood pCO2 was easily controlled in all patients with this system. In addition, its advantages are that it has no valves, is very light, can be used for all ages, and is especially indicated in child...
Article
The landmarks and technique for interscalene brachial plexus block for surgical anesthesia and the results in 51 patients are described. Good results were obtained in 44 patients, while in 3 local infiltration had to be added. The remaining 4 cases were failures, and involved operations on the fingers. There were no complications. It is concluded t...
Article
A 5-year-old child sustained blunt trauma to the cervical trachea. Diffuse subcutaneous emphysema of the neck and thorax developed rapidly. Anaesthesia was induced with halothane through a face-piece and the patient breathed spontaneously until the lesion had been evaluated. This course is advocated in the management of such injuries.

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