Anaesthesia and Intensive Care最新文献

Experiences and outcomes of patients participating in a perioperative shared decision-making pathway. 参与围手术期共同决策途径的患者的经历和结果。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-11-14 DOI: 10.1177/0310057X241265725

Heidi C Omundsen, Renee L Franklin, Mark S Omundsen, Trevor R Richardson

{"title":"Experiences and outcomes of patients participating in a perioperative shared decision-making pathway.","authors":"Heidi C Omundsen, Renee L Franklin, Mark S Omundsen, Trevor R Richardson","doi":"10.1177/0310057X241265725","DOIUrl":"https://doi.org/10.1177/0310057X241265725","url":null,"abstract":"The Complex Decision Pathway (CDP) is a novel perioperative shared decision-making pathway that was established in the Bay of Plenty, New Zealand in 2018. Unique features of the pathway include the use of a structured communication tool to facilitate a goals-of-care conversation in addition to medical assessment, and the use of a tikanga Māori framework for Māori patients. From May 2019 until May 2022, 81 patients attending the CDP clinic were recruited to a prospective study of their demographics, health status and experience at the time of presentation, along with outcomes and opinions over the subsequent 12 months. Participants were mostly elderly and frail with multiple comorbidities, and just over half of participants chose to undergo surgery. Participants who chose, or were recommended, not to undergo surgery were older, more comorbid and had worse outcomes over the subsequent 12 months. Qualitative data suggested an overall positive patient experience of the pathway, and an economic analysis demonstrated its cost-effectiveness. Overall, the data presented here suggested that the CDP assisted in risk-stratifying patients into operative and non-operative groups, provided a positive patient experience, and was a cost-effective intervention.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X241265725"},"PeriodicalIF":1.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Promoting behavioural change by educating anaesthetists about the environmental impact of inhalational anaesthetic agents: A systematic review. 通过教育麻醉师了解吸入麻醉剂对环境的影响来促进行为改变：系统综述。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2024-08-30 DOI: 10.1177/0310057X241263113

Brieana C Nolan, Michael J Hoskins, Bríd Phillips, Kiah L Evans

{"title":"Promoting behavioural change by educating anaesthetists about the environmental impact of inhalational anaesthetic agents: A systematic review.","authors":"Brieana C Nolan, Michael J Hoskins, Bríd Phillips, Kiah L Evans","doi":"10.1177/0310057X241263113","DOIUrl":"10.1177/0310057X241263113","url":null,"abstract":"Of the total carbon footprint of Australia, 7% is attributed to healthcare. In the UK, inhalational agents make up 5% of the healthcare carbon footprint. This systematic review aims to determine which methods of education about the environmental impact of inhalational anaesthetic agents can be utilised to promote behaviour change, reducing the anaesthetic-related carbon footprint. This systematic review sourced records from CINAHL, EMBASE, ERIC, JBI and MEDLINE from 1970 to March 2022. The search identified 589 records, 13 of which met eligibility criteria after the screening process, in which 10 of these records were conference abstracts. Education curricula focused on inhalational agent choice (69%), lowering the fresh gas flow during maintenance anaesthesia (69%), encouraging alternatives such as total intravenous anaesthesia (23%) and/or switching off the gas on transfer (8%). The most common teaching techniques utilised in education curricula were didactic lectures (85%), visual prompts (54%), emails (46%), and conversation forums (31%). All but one study reported a positive relationship between teaching sessions and behavioural change resulting in lower inhalational anaesthetic use by participants and their organisations, reducing healthcare-associated emissions. This systematic review has demonstrated that single education sessions as well as multi-focused, multimodal education curricula on the topic of greener anaesthesia can be beneficial in promoting behavioural change.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"356-368"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anaesthesia healthcare workers' interactions with COVID-19-positive and -suspect patients: A multi-site observational study from Queensland, Australia. 麻醉医护人员与 COVID-19 阳性和可疑患者的互动：澳大利亚昆士兰州的一项多站点观察研究。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2024-10-17 DOI: 10.1177/0310057X241265723

Adrian Chin, Christine Woods, Anita M Pelecanos, Angela Tognolini, Gunjan Chawla, Sheridan Bell, Ivan L Rapchuk, Jimmy Wang, Victoria A Eley

{"title":"Anaesthesia healthcare workers' interactions with COVID-19-positive and -suspect patients: A multi-site observational study from Queensland, Australia.","authors":"Adrian Chin, Christine Woods, Anita M Pelecanos, Angela Tognolini, Gunjan Chawla, Sheridan Bell, Ivan L Rapchuk, Jimmy Wang, Victoria A Eley","doi":"10.1177/0310057X241265723","DOIUrl":"10.1177/0310057X241265723","url":null,"abstract":"Occupationally acquired COVID-19 is a hazard for healthcare workers (HCWs). In four hospitals of the Metro North Hospitals and Health Service in Queensland, Australia, we invited HCWs to report the nature of any anaesthesia interactions with COVID-19-positive and COVID-19-suspect patients. This was to assist workforce planning in future pandemics. Data collection consisted of three phases; 1) participating HCWs recorded details of episodes of care (EOCs) with COVID-19-positive or COVID-19-suspect patients; 2) these HCWs were invited to complete a follow-up survey about their own health status regarding COVID-19 infections; 3) electronic health records were used to assess patient demographics, infectious status and outcomes. Between 21 March 2020 and 17 May 2022, 63 anaesthesia HCWs reported 90 EOCs with 67 unique patients. The median (interquartile range (IQR)) age of the HCWs was 40.5 years (34-46); 55% (34/62) were male, 62% (39/63) were consultants and 21% (13/63) were registrars. The median (IQR) age of patients was 39 (28-63) years. Personal protective equipment (PPE) was deemed to be appropriate by the HCWs in (86/88) 98% of the EOCs. Twenty-four HCWs (38%) responded to a follow-up survey. Of 12 HCWs who subsequently tested positive to COVID-19, only four had cared for a COVID-19-positive patient in the two weeks prior to their diagnosis. Most responding HCWs perceived they contracted COVID-19 in the community, experiencing mild illness. We found relatively low COVID-19 case numbers, high PPE use and low transmission of COVID-19 within the hospital setting.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"377-385"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Skin injury: Associations with variables related to perfusion and pressure. 皮肤损伤：与灌注和压力相关变量的联系。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2024-10-12 DOI: 10.1177/0310057X241264575

Christopher J Roberts, Jennifer A Popies, Abrahim N Razzak, Xi Fang, Octavio A Falcucci, Paul J Pearson, Aniko Szabo

{"title":"Skin injury: Associations with variables related to perfusion and pressure.","authors":"Christopher J Roberts, Jennifer A Popies, Abrahim N Razzak, Xi Fang, Octavio A Falcucci, Paul J Pearson, Aniko Szabo","doi":"10.1177/0310057X241264575","DOIUrl":"10.1177/0310057X241264575","url":null,"abstract":"Skin injuries are a major healthcare problem that are not well understood or prevented in the critically ill, suggesting that underappreciated variables are contributing. This pilot study tested the hypothesis that perfusion-related factors contribute to skin injuries diagnosed as hospital-acquired pressure injuries (HAPIs). A total of 533 adult patients were followed over 2574 critical care days (mean age 62.4, standard deviation (SD) 14.3 years, mean body mass index 30.4 (SD 7.4) kg/m2, 36.4% female). This was a secondary analysis of prospective, non-randomised clinical data from an intensive care unit at a large urban teaching hospital. Factors related to perfusion, specifically two or more infusions of vasopressors/inotropes, temporary mechanical circulatory support (MCS), extracorporeal membrane oxygenation, and durable MCS, were analysed to determine whether they were more strongly associated with HAPIs than immobility due to prolonged mechanical ventilation (>72 h) or operating room time (>6 h). Patients diagnosed with a HAPI had a statistically significant higher risk of being exposed to variables related to perfusion and immobility (P < 0.05 for each variable). Perfusion-related variables, except durable MCS, had a larger effect on skin breakdown (number needed to harm (NNH) 4-10) than immobility-associated variables (NNH 12-17). The finding that perfusion-related variables predicted HAPIs may warrant consideration of alternative diagnoses, such as skin failure due to impaired perfusion as a pathophysiological process that occurs concurrently with multisystem organ failure. Differentiation of skin injuries primarily from circulatory malfunction, rather than external pressure, may guide the development of more effective treatment and prevention protocols. This pilot study suggests that the contribution of perfusion to skin injuries should be explored further.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"386-396"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dr Gilbert Reynolds Troup: A founder of the Australian Society of Anaesthetists. 吉尔伯特-雷诺兹-特鲁普博士：澳大利亚麻醉师协会创始人。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-11-01 DOI: 10.1177/0310057X241267928

Michael G Cooper

引用次数: 0

Survival in hostile environments: The fight to understand and protect against acceleration-induced visual disturbance and loss of consciousness in pilots of powered, heavier-than-air aircraft. 在恶劣环境中生存：努力了解和防止动力重于空气的飞机飞行员因加速度引起的视觉干扰和意识丧失。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-11-01 DOI: 10.1177/0310057X241286298

Peter J Featherstone, Christine M Ball

引用次数: 0

A comprehensive audit of difficult airway trolleys in selected Victorian hospitals. 对维多利亚州部分医院的困难气道推车进行全面审计。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2024-09-23 DOI: 10.1177/0310057X241265722

Yaodong Tang, Teresa Pham, William Pl Bradley, Fiona M Brewster, David J Brewster

引用次数: 0

MET call prevention. 防止 MET 呼叫。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2024-09-03 DOI: 10.1177/0310057X241261392

William Pl Bradley, Simon Reilly, Alexander D Smith

引用次数: 0

A case of cardiorespiratory collapse following bilateral sub-Tenon's blocks from brainstem anaesthesia. 一例脑干麻醉后双侧腱膜下阻滞后心肺功能衰竭的病例。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2024-09-23 DOI: 10.1177/0310057X241265729

Steven C Cai, Anne-Marie Amie W Dempster, Alfred Wy Chua

引用次数: 0

A comment on the clinical experience of cardiothoracic anaesthesia trainees in a tertiary Australian hospital. 对澳大利亚一家三级医院心胸麻醉实习生临床经验的评论。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-11-01 Epub Date: 2024-10-17 DOI: 10.1177/0310057X241272109

Lay Teng Tan, Ivan L Rapchuk

引用次数: 0