Southern African Journal of Anaesthesia and Analgesia最新文献

{"title":"Comparison of point-of-care device DiaSpect against the HemoCue and laboratory analyser in an ICU population","authors":"B. Salmond, Z. Farina, R. von Rahden, R. Rodseth","doi":"10.36303/sajaa.2021.27.2.2379","DOIUrl":"https://doi.org/10.36303/sajaa.2021.27.2.2379","url":null,"abstract":"","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47309949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartphone and app usage amongst South African anaesthetic service providers","authors":"D. Shead, S. Chetty","doi":"10.36303/sajaa.2021.27.2.2461","DOIUrl":"https://doi.org/10.36303/sajaa.2021.27.2.2461","url":null,"abstract":"Background: Mobile medical applications have evolved rapidly in the 21st century, making it easier for anaesthetic service providers to utilise these for work-related queries. However, there is no South African data available to determine if this technology is being utilised. The usage patterns of mobile medical health applications and the accessibility of this technology to a resource-limited environment, along with a focus on what apps South African anaesthetic service providers are using was assessed and quantified. Secondly, the favourability of a South African-based app and any possible barriers to entry were examined. \u0000Methods: A prospective, contextual, descriptive study was conducted amongst anaesthetic service providers attending the 2018 South African Society of Anaesthesiologists National Congress in Cape Town. Two hundred and thirty-two (116 specialists and 116 registrars) surveys were completed voluntarily between 4 to 8 April 2018, and analysed. \u0000Results: 100% of participants utilise smartphones for work-related queries. 169/232 (72%) participants favoured a South African-based app. Drug referencing and calculator functionality were the most frequently used mobile applications. Specialists were more likely to admit to nonprofessional use of smartphones in theatre. High data costs contribute to decreased usage amongst respondents. \u0000Conclusions: A South African-based pharmacology app would be welcomed and utilised by the South African anaesthetic community. Smartphone and app usage patterns, as well as limitations to this technology usage in South Africa appear to reflect those seen worldwide. Poor internet connectivity and high data costs were limiting factors to technology utilisation.","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42249607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the clinical validity of an adjusted Marsh pharmacokinetic model using an effect-site rate constant (ke0) of 1.21 min-1","authors":"J. Coetzee, A. Links, A. Levin","doi":"10.36303/sajaa.2021.27.2.2583","DOIUrl":"https://doi.org/10.36303/sajaa.2021.27.2.2583","url":null,"abstract":"","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46346125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Career choice of anaesthetists in a department of anaesthesiology at a tertiary institution in South Africa","authors":"G. Manjooran, J. Scribante, H. Perrie, C. Redelinghuys","doi":"10.36303/sajaa.2021.27.2.2492","DOIUrl":"https://doi.org/10.36303/sajaa.2021.27.2.2492","url":null,"abstract":"Numerous factors that influence the choice of anaesthesiology as a career have been described. Previously, personality and intrinsic aspects of the job were marked as important influences in choosing anaesthesiology as a career.3,4 Recent literature, however, revealed a manageable lifestyle and better working conditions as more important.5,6 Other key influences noted were undergraduate and postgraduate exposure to the specialty, as well as role models within the specialty.3,6 Additional factors identified were related to the intrinsic nature of anaesthesiology: “hands-on”, practical, immediate gratification with the work (immediate results), and the applicability of physiology and pharmacology.4,6-8 Differences between gender have been identified, with females increasingly opting for specialties allowing for part-time work.3,9 Studies on choosing anaesthesiology as a career have been conducted in developing countries,10-13 including African countries such as Rwanda14 and Ghana,15 that have a severe shortage of anaesthetists. The findings of these studies are similar to those in developed countries.6-8,16 Studies have found that increased exposure to anaesthesiology at an undergraduate level as well as during an internship, improved the likelihood of someone choosing anaesthesiology as a career.13,14","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45533382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway management in COVID-19: Time to start thinking outside the box?","authors":"R. Hofmeyr, M. Sorbello","doi":"10.36303/SAJAA.2021.27.1.2594","DOIUrl":"https://doi.org/10.36303/SAJAA.2021.27.1.2594","url":null,"abstract":"Faced with limited time, severely constrained resources and a lack of manpower in the face of the overwhelming numbers in Xerxes’ invading Persian Army, the Greeks strategised to halt their foe using two natural barriers which restricted movement: the Straits of Atremisium, and the narrow pass at Thermopylae. King Leonidas of Sparta led 7 000 mettlesome troops to engage at the Hot Gates, preparing to face a force today believed to have exceeded 150 000 fighters. When told that the Persians were so multitudinous that each volley of their arrows would block out the sun, Herodotus writes that the plucky Spartan soldier, Dienekes, replied laconically: “In the shade, then, we will fight!” The Battle of Thermopylae is history interwoven with legend, but speaks of the power of strategic interventions applied at the right place, at the right time, by the right people, even in the face of overwhelming odds.","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":"27 1","pages":"4-11"},"PeriodicalIF":0.3,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45090082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of cold-chain re-introduction on the molecular integrity of rocuronium bromide","authors":"D. Vermeulen, M. Wooding, K. Outhoff, T. Dippenaar","doi":"10.36303/SAJAA.2021.27.1.2415","DOIUrl":"https://doi.org/10.36303/SAJAA.2021.27.1.2415","url":null,"abstract":"Introduction: This study aimed to examine the effect of breakages and re-introduction into cold chain on the rocuronium bromide compound. Rocuronium bromide is frequently used in routine theatre lists and plays a vital role in modified rapid sequence induction and intubation for emergency patients who have contraindications to the primarily used muscle relaxant, succinylcholine. With the current practice of removing the drug from, and then reintroducing it into the cold chain, unpredictable clinical effects, including delayed onset of action and shortened duration of action have been observed. This may pose significant risks to the patient.\u0000\u0000Methods: Rocuronium bromide was subjected to different clinically applicable storage and temperature scenarios, after which the compound was analysed for integrity and quantities of the active compound, including detection of possible degradation products, by mass spectrometry, and compared to cold chain control samples.\u0000\u0000Results: There were no significant differences between any of the temperature exposure groups (18 °C or 24 °C) or between single or double exposures at these temperatures. No statistically significant difference could be demonstrated between the two control groups (cold chain preserved and room temperature controlled) with testing done at weeks one and six. However, week twelve analysis revealed a statistically significant result which translates to a 26 μg/ml difference, which clinically would have no effect. Substantial results were obtained with a secondary exposure to air; which lead to a 20% decrease in rocuronium concentration (p = 0.02).\u0000\u0000Conclusion: Practice should be adapted by keeping careful documentation as to when cold-chain was broken, and when the recommended 12 week period will lapse. Vial sharing as a standard is not recommended. If small quantities are repeatedly withdrawn from the vial during a prolonged case, the unused contents should be discarded after eight hours.","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46222311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of the successful use of regional anaesthesia and mixed sedative techniques in an adolescent with Duchenne muscular dystrophy","authors":"R. Tladi, R. Swart","doi":"10.36303/SAJAA.2021.27.1.2453","DOIUrl":"https://doi.org/10.36303/SAJAA.2021.27.1.2453","url":null,"abstract":"In this case report, we present a 12-year-old male who presented with clubbed feet for Achilles tenotomy with comorbid Duchenne muscular dystrophy and obesity. Owing to his prior surgical history and requirement for a prolonged intensive care unit stay with mechanical ventilation, we opted for a regional anaesthetic technique with mixed pharmacological and non-pharmacological sedation. The patient tolerated the nerve blocks with minimal sedation with midazolam and local anaesthesia and the surgery was performed successfully with light sedation and the help of his favourite song.","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":"1 1","pages":"48-50"},"PeriodicalIF":0.3,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48777000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of a Perspex intubation box on time to intubation: a simulation-based randomised crossover study","authors":"R. Swart, Cmj Strydom, G. Joubert","doi":"10.36303/SAJAA.2021.27.1.2452","DOIUrl":"https://doi.org/10.36303/SAJAA.2021.27.1.2452","url":null,"abstract":"Background: Standard personal protective equipment guidelines are insufficient to prevent contamination of healthcare workers with droplet spread during the COVID-19 crisis The added challenge of adequate aerosol protection has led to the development of an initial prototype intubation box The primary objective was to determine the impact of an intubation box on the mean time to completion of intubation in a simulated airway Secondary objectives included the best laryngoscopic view, the effect of intubator seniority and mode of laryngoscopy on intubation Methods: This was a randomised crossover study of the influence of an intubation box on mean time to completion of intubation of an airway management part-task trainer Senior anaesthesiology staff were assigned to two groups and recordings of their attempts at intubation were analysed by two independent observers Results: The intubation box led to a significantly longer mean time to completion of intubation of 7 6 seconds (95% CI 3 1;12 2;p = 0 001) with direct laryngoscopy and 9 2 seconds (95% CI 3 8;14 7;p = 0 001) with videolaryngoscopy It did not influence best glottic view Conclusion: We found that the use of an intubation box significantly prolonged the time to completion of intubation, but the clinical significance of the effect size is uncertain © 2021 The Author(s)","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":"27 1","pages":"24-28"},"PeriodicalIF":0.3,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44586322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheal resection following prolonged intubation in a COVID-19 patient","authors":"A. Milner","doi":"10.36303/SAJAA.2021.27.1.2495","DOIUrl":"https://doi.org/10.36303/SAJAA.2021.27.1.2495","url":null,"abstract":"Only six months into the SARS-CoV-2 epidemic in South Africa, we present the first post-coronavirus disease (COVID-19) subglottic stenosis seen at Morningside Clinic. Ten weeks prior to the current admission, this 48-year old patient with diabetes, obesity and hypertension developed severe COVID-19 pneumonia. He was admitted to the intensive care unit (ICU) for 14 days of mechanical ventilation and intermitted prone positioning for optimal V/Q matching.","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":"27 1","pages":"51-52"},"PeriodicalIF":0.3,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44364757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaesthetic nurse training in KwaZulu-Natal government hospitals: exploring strengths and deficiencies","authors":"A. Maharaj, L. Cronjé, S. Jithoo","doi":"10.36303/SAJAA.2021.27.1.2481","DOIUrl":"https://doi.org/10.36303/SAJAA.2021.27.1.2481","url":null,"abstract":"Background: The anaesthetic nurse is a key assistant to the anaesthetist and integral to the provision of safe anaesthesia. Inadequate undergraduate training in South Africa necessitates anaesthetic nurses to acquire the requisite skills and knowledge in the workplace. Few studies explore the challenges faced by practising nurses to acquire such skills. This study sought to explore the experiences of working anaesthetic nurses to gain their perspectives on workplace-based learning, skills acquisition and how to improve anaesthetic nurse training.\u0000\u0000Methods: We used qualitative methodology comprising an English-medium, self-administered, anonymous questionnaire. A purposive sampling method was used, and 73 anaesthetic nurses working in five government hospitals in eThekwini, KwaZulu-Natal were recruited. Questionnaires were thematically analysed, and simple statistical analysis was used for quantitative data.\u0000\u0000Results: Most anaesthetic nurses received little or no undergraduate anaesthesia training and participants identified subsequent workplace-based training as inconsistent, and insufficient. Despite most participants’ arbitrary allocation to the position of anaesthetic nurse, the majority found their work stimulating and identified themselves as team-players, adaptable, and willing to learn. Further training and hands-on skills acquisition were keenly sought. Factors impacting positively on their learning and job satisfaction included a confident anaesthetist who was willing to teach and collaborate on learning, provide positive feedback, and include the anaesthetic nurse in case planning. Participants identified crucial areas for further development. In theatre teaching and practical group tutorials led by anaesthetists were suggested as preferred training modalities. Responses to hypothetical case scenarios demonstrated qualities in the participants that are valued in the anaesthetists’ non-technical skills framework.\u0000\u0000Conclusion: It is evident that there is insufficient formal training and inconsistent training methods of the current anaesthetic nurses in the five study hospitals. The workplace-based learning experiences of our study participants has given us a unique perspective from practising anaesthetic nurses and may be used to inform the formulation of appropriate training curricula and improve the learning partnership with anaesthetists. This should ultimately improve anaesthetic nurse job satisfaction and the theatre team experience.","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":"1 1","pages":"15-23"},"PeriodicalIF":0.3,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46132245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}