Global AnaesthesiaPub Date : 2020-07-01DOI: 10.1093/med/9780198809821.003.0008
R. Collis, Rebecca Jones, S. O'Neill
{"title":"Obstetrics and Gynaecology","authors":"R. Collis, Rebecca Jones, S. O'Neill","doi":"10.1093/med/9780198809821.003.0008","DOIUrl":"https://doi.org/10.1093/med/9780198809821.003.0008","url":null,"abstract":"In low-resource settings, obstetrics and gynaecology frequently forms a large part of the anaesthetist’s workload. The chapter serves both as an aide-memoire for those who are not regular practitioners in obstetric anaesthesia and as a guide to adapting your practice in low-resource settings. It contains practical advice on analgesia in labour and anaesthesia for Caesarean section, including spinal, general anaesthesia, and local anaesthesia techniques. It contains advice on drug alternatives in the absence of commonly used obstetric drugs, e.g. spinal bupivacaine. There are also sections on management of pre-eclampsia and obstetric haemorrhage, both of which are commonly encountered in low-resource settings. Neonatal resuscitation and non-obstetric surgery in the pregnant patient are also covered.","PeriodicalId":330377,"journal":{"name":"Global Anaesthesia","volume":"133 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127366761","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}
Global AnaesthesiaPub Date : 2020-07-01DOI: 10.1093/med/9780198809821.003.0001
T. Bashford, Julian Gore-Booth, J. James, S. Pickering, Becky Paris, O. Ross, N. Shamambo
{"title":"Context","authors":"T. Bashford, Julian Gore-Booth, J. James, S. Pickering, Becky Paris, O. Ross, N. Shamambo","doi":"10.1093/med/9780198809821.003.0001","DOIUrl":"https://doi.org/10.1093/med/9780198809821.003.0001","url":null,"abstract":"The chapter provides the reader with information on the non-clinical background to working as an anaesthetist in a low-resource setting. It concentrates on important concepts that should inform the way you practise and teach, rather than technical aspects of anaesthesia. Although technical aspects of delivering anaesthesia are usually uppermost in the minds of anaesthetists new to working in low-resource settings, it is often the case that adapting successfully to the local context proves the more challenging aspect. Topics covered include humanitarian and developmental principles, teaching anaesthesia, looking after your own health, being a good visitor, and how to adapt your practice.","PeriodicalId":330377,"journal":{"name":"Global Anaesthesia","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115064695","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}
Global AnaesthesiaPub Date : 2020-07-01DOI: 10.1093/med/9780198809821.003.0009
S. Hodges, S. Janjanin, Judith Kendell, N. Lubis, D. Nott, Nelson Olim
{"title":"Trauma","authors":"S. Hodges, S. Janjanin, Judith Kendell, N. Lubis, D. Nott, Nelson Olim","doi":"10.1093/med/9780198809821.003.0009","DOIUrl":"https://doi.org/10.1093/med/9780198809821.003.0009","url":null,"abstract":"In low- and middle-income countries, trauma, often from road traffic collisions, is one of the leading causes of morbidity and mortality. The approach to treating trauma in resource limited settings can be quite different to that in high-resource settings, requiring a lot of improvisation. The concepts of damage control surgery and resuscitation are covered, as are considerations for difficult patient groups such as head injuries, burns, and spinal injuries. The injury patterns seen as a result of armed conflicts (gun shots, blast injuries) will be unfamiliar to most anaesthetists and are also addressed in the chapter.","PeriodicalId":330377,"journal":{"name":"Global Anaesthesia","volume":"245 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133905048","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}
Global AnaesthesiaPub Date : 2020-07-01DOI: 10.1093/med/9780198809821.003.0011
A. Bosenberg, Jey Jeyanathen
{"title":"Regional Anaesthesia","authors":"A. Bosenberg, Jey Jeyanathen","doi":"10.1093/med/9780198809821.003.0011","DOIUrl":"https://doi.org/10.1093/med/9780198809821.003.0011","url":null,"abstract":"In low-resource settings regional anaesthesia forms an essential part of anaesthetic practice, especially in the context of poor access to postoperative analgesia and recovery facilities, or where general anaesthesia is not available or may be high risk. Safe practice for performance of regional anaesthesia is outlined as well as the emergency management of local anaesthetic toxicity. The chapter covers a range of upper limb, lower limb, and trunk blocks. It describes, where possible, ultrasound, nerve stimulator, and landmark techniques for each block since available equipment may vary. Neuraxial techniques for neonates, infants, and children are described along with local anaesthetic dosages.","PeriodicalId":330377,"journal":{"name":"Global Anaesthesia","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129476456","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}
Global AnaesthesiaPub Date : 2020-07-01DOI: 10.1093/med/9780198809821.003.0005
T. Bashford, W. Morriss, C. Roques, N. Shamambo, Matt Wilkes
{"title":"Perioperative Care","authors":"T. Bashford, W. Morriss, C. Roques, N. Shamambo, Matt Wilkes","doi":"10.1093/med/9780198809821.003.0005","DOIUrl":"https://doi.org/10.1093/med/9780198809821.003.0005","url":null,"abstract":"The chapter covers pre-op assessment in the context of limited availability to tests and investigations outlining the key considerations that should be made in assessing fitness for and appropriateness of surgery. Key aspects of consent within different cultural contexts are explored as well as important consent considerations for quality improvement and research projects. A practical approach to the assessment and management of pain in the context of limited availability of medications and trained staff is taken including the management of acute pain, non-surgical pain, pain related to cancer, chronic pain, and neuropathic pain. In the last section, key aspects of anaesthesia and resuscitation at high altitude are covered.","PeriodicalId":330377,"journal":{"name":"Global Anaesthesia","volume":"137 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134056236","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}
Global AnaesthesiaPub Date : 2020-07-01DOI: 10.1093/med/9780198809821.003.0012
P. Marshall-Brown, F. Mazzola, B. Mccormick, K. Stephens
{"title":"Critical Care","authors":"P. Marshall-Brown, F. Mazzola, B. Mccormick, K. Stephens","doi":"10.1093/med/9780198809821.003.0012","DOIUrl":"https://doi.org/10.1093/med/9780198809821.003.0012","url":null,"abstract":"The concept of critical care in low-resource settings covers a very broad range of circumstances and settings from the ability to offer ventilation and inotropes through to an area with simply enhanced observations and/or nursing ratios. Low staffing and training levels on the general wards may necessitate admission of patients who simply require frequent observations and rapid recognition of deterioration; admission criteria may therefore be different to those in highly resourced settings. The chapter starts by describing the limits and challenges of providing critical care in low-resource settings and goes on to describe approaches to organ support. It then goes on to describe a pragmatic approach to caring for specific conditions in a low-resource critical care.","PeriodicalId":330377,"journal":{"name":"Global Anaesthesia","volume":"994 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113995214","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}
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