Southern African Journal of Anaesthesia and Analgesia最新文献

{"title":"Preparing anaesthesiologists to safely care for patients with COVID-19: an observational study of a simulation course","authors":"E. Thackeray, D. A. Axelrod, M. Curtis, A. Stuart, K. Johnson, N. Pace, H. Hopf","doi":"10.36303/sajaa.2022.28.1.2602","DOIUrl":"https://doi.org/10.36303/sajaa.2022.28.1.2602","url":null,"abstract":"Background: Anaesthesiologists are at high risk for exposure to SARS-CoV-2. We describe the development, implementation and efficacy of a high-fidelity simulation course for anaesthesiologists in response to this threat. Methods: This is an observational study of preparedness conferred by a simulation course. The following four knowledge gaps were identified: i) personal protective equipment (PPE) selection and donning/doffing;ii) operating room and anaesthesia machine turnover;iii) routine and difficult airway management;and iv) emergent airway management and Advanced Cardiac Life Support (ACLS) protocols. Four simulations were developed and offered to faculty, residents and Certified Registered Nurse Anaesthetists (CRNAs) at an anaesthesiology department. A survey estimated prior knowledge and assessed knowledge gained after the course. Results: Prior to the simulations, 27% and 26% of the participants estimated ability, respectively, to don and doff PPE, compared to 99% of the participants who demonstrated knowledge after the simulations: donning, odds ratio (OR) = infinity (19.6, infinity);doffing, OR = infinity (19.9, infinity). Prior to the simulations, 28% of the participants estimated knowledge specific to airway management;while after the simulations, 84% of the participants identified correct principles of airway management (OR = 9.1 [4.3, 20.2]). Prior to the simulations, 15% of the participants estimated knowledge of principles guiding emergency airway management and/or ACLS protocols, compared to 94% of the participants who correctly identified those principles after the simulations (OR = infinity [21.9, infinity]). Only 18% of clinicians estimated that they were competent prior to the simulations, while 89% of clinicians demonstrated competency on the written survey after the simulations (OR = 37 [10.8, 212]). Conclusion: Our results suggest that this simulation course effectively prepared anaesthesiology faculty, residents and staff to select appropriate PPE, and don and doff it, as well as apply best practices during airway management and ACLS protocols.","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48103731","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":"Physiology and pathophysiology of chronic pain (Part II): how does pain become chronic?","authors":"A. Isa, Seshree Chetty","doi":"10.36303/sajaa.2022.28.1.2497","DOIUrl":"https://doi.org/10.36303/sajaa.2022.28.1.2497","url":null,"abstract":"","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41457918","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":"Cervical spine injury and tracheal intubation: are we protecting patients or physicians?","authors":"M. Wiles","doi":"10.36303/sajaa.2021.27.6.2753","DOIUrl":"https://doi.org/10.36303/sajaa.2021.27.6.2753","url":null,"abstract":"South Afr J Anaesth Analg 2021; 27(6) http://www.sajaa.co.za Southern African Journal of Anaesthesia and Analgesia. 2021;27(6):1260-264 https://doi.org/10.36303/SAJAA.2021.27.6.2753 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 South Afr J Anaesth Analg ISSN 2220-1181 EISSN 2220-1173 © 2021 The Author(s)","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44040566","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":"Perioperative ultrasound among South African anaesthetists: a survey of current practice and availability","authors":"Mis Kathrada, M. Jagga, YN Mzoneli, J. Swanevelder, MW Gibbs","doi":"10.36303/sajaa.2021.27.6.2636","DOIUrl":"https://doi.org/10.36303/sajaa.2021.27.6.2636","url":null,"abstract":"Point-of-care ultrasound (POCUS) plays an important role in vascular access placement, regional nerve blocks, and heart and lung assessments in the perioperative period. Its use has been shown to reduce failure and complication rates, thereby improving patient safety and procedural efficiency.1 Ultrasound (US) use among anaesthesiologists has gained greater importance in postgraduate training. Specialist training milestones, such as those developed by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Anesthesiology (ABA), have incorporated US for nerve blocks, vascular access and certain pain procedures.2","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47547206","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 descriptive study of the relationship between preoperative body temperature and intraoperative core temperature change in adults under general anaesthesia","authors":"F. Steyn, Lilo du Toit, T. Naidoo, R. Hofmeyr","doi":"10.36303/sajaa.2021.27.6.2600","DOIUrl":"https://doi.org/10.36303/sajaa.2021.27.6.2600","url":null,"abstract":"Inadvertent perioperative hypothermia is defined as an unplanned core temperature of less than 36 °C occurring during the perioperative period.1,2 It is associated with numerous adverse patient outcomes3-5 including increased surgical site infection rates,4-6 blood loss,5,7 length of hospital stay6 and cost of care.1,8-10 Despite the ubiquity of guidelines to prevent perioperative hypothermia, the reported incidence ranges between 20% and 90%.3,11","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46344688","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":"Global airway management of the unstable cervical spine survey (GAUSS)","authors":"G. Stegmann, R. Llewellyn, R. Hofmeyr","doi":"10.36303/sajaa.2021.27.6.2657","DOIUrl":"https://doi.org/10.36303/sajaa.2021.27.6.2657","url":null,"abstract":"Unstable cervical fractures pose a twofold challenge: patients may present with a difficult airway and the airway intervention itself could cause or exacerbate spinal cord injury. Reasons for a difficult airway may include limited mouth opening as well as limited movement due to spinal motion restriction techniques employed. Patients can be hypotensive, hypovolaemic, hypoxic, or present with a threatened airway due to spinal cord or associated injuries.5 Maxillofacial injuries and/or intraoral bleeding may further complicate management while the mean blood pressure should be maintained at 90 mmHg, or above.6 The clinician is tasked with multiple problems that require simultaneous management, so that these patients can often be challenging for the anaesthetist.","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44014986","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":"Perception about anaesthesia and anaesthesiologists among non-medical graduate professionals","authors":"R. Renuka","doi":"10.36303/sajaa.2021.27.6.2634","DOIUrl":"https://doi.org/10.36303/sajaa.2021.27.6.2634","url":null,"abstract":"","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43198927","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":"Point-of-care ultrasound for all – teaching, training and use at every opportunity","authors":"E. Turton","doi":"10.36303/sajaa.2021.27.6.2752","DOIUrl":"https://doi.org/10.36303/sajaa.2021.27.6.2752","url":null,"abstract":"","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45513665","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":"Perioperative management of caesarean section-related haemorrhage in a maternal near-miss population: a retrospective study","authors":"R. Iputo, S. Maswime, P. Motshabi","doi":"10.36303/sajaa.2021.27.6.2613","DOIUrl":"https://doi.org/10.36303/sajaa.2021.27.6.2613","url":null,"abstract":"The World Health Organization (WHO) considers any health condition attributed to or aggravated by pregnancy and childbirth which has negative effects on maternal wellbeing, as maternal morbidity.1 Severe acute maternal morbidity is also referred to as a maternal near-miss (MNM) and has been defined by the WHO as any woman who nearly dies from either a complication of pregnancy or within 42 days of delivery or termination of the pregnancy.1 The MNM classification was first described by Mantel et al.2 who subdivided these criteria into an organ-based system classification (end organ dysfunction) and a management-based system classification (emergency hysterectomy and massive blood transfusion), and which has been widely used internationally.","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42022252","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":"Physiology and pathophysiology of chronic pain (Part I)","authors":"A. Isa, S. Chetty","doi":"10.36303/sajaa.2021.27.6.2491","DOIUrl":"https://doi.org/10.36303/sajaa.2021.27.6.2491","url":null,"abstract":"Chronic pain imposes a significant health burden on society and has a debilitating impact on individuals and their productivity.1 Chronic pain has been reported to affect 20% of people worldwide.2 With the current world population at 7.8 billion, it is estimated that approximately 1.5 billion people suffer from chronic pain. The socioeconomic burden of chronic pain in the USA is between US$560 and US$635 billion annually.3 The impact of chronic pain in Africa is also worrisome: Nigeria has a prevalence 5.5%,4 while approximately 1 in 5 South Africans (18.3%) has been reported to suffer from chronic pain.5","PeriodicalId":21769,"journal":{"name":"Southern African Journal of Anaesthesia and Analgesia","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48304531","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}