# BOB Ped Surg 2023 - Joshua Ramjist, CAPS  - Presentation — GCMD Library

<p>Watch Joshua Ramjist, MD, present his presentation on "Development of a five point enhanced recovery protocol for pectus excavatum surgery."</p>


Type: video · posted 2023-02-06
Canonical: https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351

## Chapters
- [0:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=0) Introduction and Background
- [1:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=60) Five-Point Enhanced Recovery Protocol
- [3:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=180) Study Design and Patient Population
- [4:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=240) Results: Length of Stay and Opioid Consumption
- [5:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=300) Conclusions

## Statements
- "Pectus excavatum is the most common congenital chest deformity" — Joshua Ramjist (epidemiological) [0:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=0)
- "Pectus excavatum affects one in 400 births" — Joshua Ramjist (epidemiological) [0:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=0)
- "Pectus excavatum affects patients at a vulnerable time in their lives in the childhood and adolescent years" — Joshua Ramjist (clinical) [0:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=0)
- "The Nuss procedure has been revolutionary in correcting pectus excavatum deformity" — Joshua Ramjist (opinion) [0:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=0)
- "Despite an excellent operation, the post-operative period has been plagued by pain which has resulted in significant morbidity and increased length of stay" — Joshua Ramjist (clinical) [0:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=0)
- "The five-point ERAS protocol spans the entirety of the patient's perioperative experience" — Joshua Ramjist (clinical) [1:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=60)
- "The protocol includes perioperative education and counseling to establish reasonable expectations using educational materials and a boarding pass" — Joshua Ramjist (clinical) [1:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=60)
- "The transitional pain service facilitates both pharmacologic and non-pharmacologic interventions to manage patient pain" — Joshua Ramjist (clinical) [1:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=60)
- "Multimodal analgesia intraoperatively includes serratus anterior block and cryoablation at the time of procedure" — Joshua Ramjist (clinical) [1:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=60)
- "A perioperative bowel regimen was included in the protocol" — Joshua Ramjist (clinical) [1:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=60)
- "The boarding pass was a primary instrument to facilitate shared decision making and establish a therapeutic relationship between the team and patients" — Joshua Ramjist (clinical) [1:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=60)
- "This is a single institution study at the Hospital for Sick Children with retrospective data for the pre-ERAS cohort and prospective data after implementation" — Joshua Ramjist (clinical) [3:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=180)
- "53 patients were recruited from August 2015 to December 2021" — Joshua Ramjist (clinical) [3:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=180)
- "All patients were approximately 15 years of age at the time of repair" — Joshua Ramjist (clinical) [3:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=180)
- "Haller indices were typically above 4.5" — Joshua Ramjist (clinical) [3:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=180)
- "92% of patients expressed satisfaction with their overall experience" — Joshua Ramjist (clinical) [3:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=180)
- "There was a significant decrease in length of stay by 50%, from 4 days to just under 2 days" — Joshua Ramjist (clinical) [4:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=240)
- "The mean length of stay was 1.8 days" — Joshua Ramjist (clinical) [4:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=240)
- "The majority of patients were leaving on post-operative day one" — Joshua Ramjist (clinical) [4:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=240)
- "There was a significant decrease in opioid consumption in the post-operative period from 6.36 to 3.12 morphine milliequivalents" — Joshua Ramjist (clinical) [4:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=240)
- "Surgery remains a team sport" — Joshua Ramjist (opinion) [5:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=300)
- "Successful surgical outcomes are predicated on a multi-disciplinary team working in each phase of care to optimize the patient's experience" — Joshua Ramjist (opinion) [5:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-joshua-ramjist-caps-presentation-6351?t=300)

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Not medical advice · citation policy: https://library.globalcastmd.com/ai