Anaesthesia and Intensive Care最新文献_第5页

Just-in-time training for nasotracheal intubation: A report of a pilot study. 鼻气管插管的即时培训：试点研究报告。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-09-03 DOI: 10.1177/0310057X241261389

Nellie Dick, Jacqueline H Byrne, Debbie L Massey, Kersi J Taraporewalla

引用次数: 0

Patient rating of postoperative outcome measures. 患者对术后结果的评分。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-09-03 DOI: 10.1177/0310057X241261391

Chloe J Ashhurst, Natalie A Smith

引用次数: 0

Hirudin and the evolution of leeches in medicine. 水蛭素和水蛭在医学中的演变。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 DOI: 10.1177/0310057X241265610

Christine M Ball, Peter J Featherstone

引用次数: 0

A single-centre retrospective study of the utility of routine chest X-ray post intrathoracic drain removal in cardiothoracic surgical patients. 一项关于心胸外科患者胸腔内引流管移除后常规胸部 X 光检查效用的单中心回顾性研究。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.1177/0310057X241257529

Reece D Rowbottom, Hemang P Doshi, David Bowen

{"title":"A single-centre retrospective study of the utility of routine chest X-ray post intrathoracic drain removal in cardiothoracic surgical patients.","authors":"Reece D Rowbottom, Hemang P Doshi, David Bowen","doi":"10.1177/0310057X241257529","DOIUrl":"10.1177/0310057X241257529","url":null,"abstract":"Routine chest X-ray (CXR) post intrathoracic drain removal in cardiac surgical patients is common practice to identify the presence of a pneumothorax following drain removal. Such pneumothoraces occur infrequently and rarely require intervention. We investigated the utility of routine CXR post drain removal and hypothesised that the practice is unnecessary and a possible area for significant cost saving. We conducted a single-centre, retrospective study of 390 patients who underwent cardiac surgery over a one-year period. Routine CXR post drain removal was reviewed for the presence of a pneumothorax. Rates of intervention post routine CXR were analysed to assess for clinical benefit obtained from this practice. Potential cost savings were calculated by the cost of a mobile CXR and by considering the radiographer's time. There were 15 pneumothoraces detected on routine CXR post drain removal. All pneumothoraces detected on routine post drain removal CXR were defined as small. No patients had a clinically significant pneumothorax requiring re-insertion of a chest drain. The potential cost saved by omitting routine CXR post drain removal was estimated to be approximately A$7750 per year. This study did not detect any clinically significant pneumothoraces requiring intervention. It also suggests that routine CXR post drain removal does not provide any clinical benefit and indicates that current practice should be reviewed.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"314-320"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103608","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

Oesophageal intubations in anaesthetic practice across Australia and New Zealand: A webAIRS analysis of 109 incidents. 澳大利亚和新西兰麻醉实践中的食管插管：对 109 起事件的网络 AIRS 分析。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-08-31 DOI: 10.1177/0310057X241244809

Yasmin Endlich, Thomas P Fox, Martin D Culwick, Christopher J Acott

{"title":"Oesophageal intubations in anaesthetic practice across Australia and New Zealand: A webAIRS analysis of 109 incidents.","authors":"Yasmin Endlich, Thomas P Fox, Martin D Culwick, Christopher J Acott","doi":"10.1177/0310057X241244809","DOIUrl":"10.1177/0310057X241244809","url":null,"abstract":"Oesophageal intubations are more common than may be realised and can potentially cause significant patient harm even if promptly identified and corrected. Reports of morbidity due to unrecognised oesophageal intubation continue to present in coroner and media reports. Therefore, it would be helpful to identify mechanisms to prevent these events and implement strategies to avoid and identify incorrect endotracheal tube placement. This analysis of oesophageal intubations reported to webAIRS aims to provide an in-depth analysis of all events in which oesophageal intubation occurred. WebAIRS is a web-based, bi-national incident reporting system collecting voluntarily reported anaesthetic events across Australia and New Zealand, with more than 10,500 incidents registered. A structured search through the webAIRS database identified 109 reports of oesophageal intubation reported between July 2009 and September 2022. A common cause of oesophageal intubation was the misidentification of the larynx due to a poor laryngeal view. Desaturation directly attributed to the misplaced endotracheal tube occurred in 43% of all reports. The authors precisely defined early recognised oesophageal intubation and delayed or unrecognised oesophageal intubation. Most reports (74%) described early recognition of the misplaced intubation, of which 27% led to directly contributed to hypoxia. Cardiovascular collapse as a direct consequence of the late recognition of oesophageal intubation was described in five (18%) of these events. There was inconsistency in end-tidal carbon dioxide monitoring and interpretation of the resulting waveform. Findings show that oesophageal intubation continues to be an issue in anaesthesia. Incidents described confusion in diagnosis, human factors issues and cognitive bias. Clear diagnostic guidance and treatment strategies are required to be developed, tested and implemented.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"302-313"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103609","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

Taipan envenoming … south of the border. 氹仔......南部边境。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-09-05 DOI: 10.1177/0310057X241247852

Rachel Heap, Aaron Kennedy, William Davies, Theo Tasoulis, Geoffrey K Isbister

引用次数: 0

A pre and post interventional audit of an 'apple juice on arrival' protocol to reduce excessive clear fluid fasting times in paediatric patients. 对 "到达时喝苹果汁 "方案进行干预前后审核，以减少儿科患者禁食过多清水的时间。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.1177/0310057X241263112

Ashley R Webb, Ikram Kalam, Nicholas Lui, Rachael M Loughnan, Samuel Leong

{"title":"A pre and post interventional audit of an 'apple juice on arrival' protocol to reduce excessive clear fluid fasting times in paediatric patients.","authors":"Ashley R Webb, Ikram Kalam, Nicholas Lui, Rachael M Loughnan, Samuel Leong","doi":"10.1177/0310057X241263112","DOIUrl":"10.1177/0310057X241263112","url":null,"abstract":"Many studies have reported prolonged fasting times in children, associated with negative metabolic and behavioural outcomes. We felt that although our paediatric preoperative clear fluid fasting guideline was only for 2 hours, prolonged fasting still occurred for some patients. We conducted an audit of paediatric fasting times, before and after introducing a new protocol of 'apple juice on arrival', in which, on arrival to the children's ward, all children received 3 ml/kg of apple juice. Data were collected prospectively from patients and their parents for two 4-week periods (before and after introduction of the protocol). Data included fasting time (solids and clear fluids), capillary blood glucose levels, knowledge of fasting requirements and sources of fasting information before surgery. Thirty-nine and 40 children, respectively, were included in each group before and after protocol introduction. Clear fluid fasting times reduced from an average of 9.9 hours pre-intervention to 3.5 hours post intervention (P < 0.01). In addition, mean preoperative blood sugar levels increased from 4.9 mmol/L (pre-intervention group) to 5.6 mmol/L in the post-intervention group (P < 0.001). The implementation of an apple juice on arrival protocol appeared to be an effective method to reduce clear fluid fasting times in children in our institution.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"328-334"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103607","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

Is patient data measurement and recording important in advancing healthcare studies? 患者数据的测量和记录对推进医疗保健研究是否重要？

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-09-05 DOI: 10.1177/0310057X241253853

Martin D Culwick, Rachel Ling, Kavita Sen, Yasmin Endlich, André A van Zundert

引用次数: 0

Routine cognitive screening for older people undergoing major elective surgery: Benefits, risks and costs. 对接受重大择期手术的老年人进行常规认知筛查：益处、风险和成本。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.1177/0310057X241232421

Luke Km Chan, Alwin Chuan, Christophe R Berney, Daniel Ky Chan

{"title":"Routine cognitive screening for older people undergoing major elective surgery: Benefits, risks and costs.","authors":"Luke Km Chan, Alwin Chuan, Christophe R Berney, Daniel Ky Chan","doi":"10.1177/0310057X241232421","DOIUrl":"10.1177/0310057X241232421","url":null,"abstract":"Cognitive impairment and older age are major risk factors for postoperative delirium. Professional societies have advocated preoperative screening to identify at-risk individuals for implementation of interventions, which have moderate effectiveness in preventing delirium. However, it remains unclear from the guidelines whether screening should be completed routinely for all older individuals or targeted, and also which specific screening tool is preferred. In addition, the responsibility for screening remains undesignated in the guidelines provided. We reviewed the benefits and risks of routine screening. We also performed a cost-benefit analysis of routine screening (versus no screening). Furthermore, we summarised the sensitivities and specificities of commonly used screening tools and reviewed evolving screening tools that may have an increasing role in future practice. We concluded that routine screening is useful and appears to be cost-effective for reducing postoperative delirium, with a cost-benefit ratio of 2.89 (adjusted ratio of 2.34), and has additional advantages over other approaches such as targeted screening or routine intervention.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"275-282"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103611","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

Experiences of pursuing an intensivist career in regional and rural Australia: An interview study. 在澳大利亚地区和农村地区从事重症监护职业的经历：访谈研究。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-07-01 Epub Date: 2024-06-16 DOI: 10.1177/0310057X241242813

Benjamin K Cheung, James G Anderson, Alexander J Giles, Priya Martin

{"title":"Experiences of pursuing an intensivist career in regional and rural Australia: An interview study.","authors":"Benjamin K Cheung, James G Anderson, Alexander J Giles, Priya Martin","doi":"10.1177/0310057X241242813","DOIUrl":"10.1177/0310057X241242813","url":null,"abstract":"The regional and rural intensivist workforce is vital to delivering high standards of healthcare to all Australians. Currently, there is an impending workforce disaster, with higher senior medical officer vacancy rates among regional and rural intensive care units, with these units being staffed by junior doctors who are in earlier stages of their training, which in turn increases supervisory burden. There is a lack of comprehensive literature on the barriers and enablers of training, recruiting and retaining regional and rural intensivists. To address this gap, a qualitative study was conducted, involving 13 in-depth, structured interviews with full-time and part-time intensivists from eight Australian regional and rural hospitals. Content analysis of the interview data resulted in the identification of four major categories: unique practice context, need for a broad generalist skill set, perks and challenges of working in a regional/rural area and workforce implications. The study findings revealed that regional and rural intensive care practice offers positive aspects, including work satisfaction, supportive local teams and an appealing lifestyle. However, these benefits are counterbalanced by challenges such as a heavier burden of on-call work, a higher proportion of junior staff which increase supervisory burden and limited access to subspecialist services. The implications of these findings are noteworthy and can be utilised to inform government policies, hospitals, the College of Intensive Care Medicine and the Australian and New Zealand College of Anaesthetists in developing strategies to enhance the provision of intensive care services and improve workforce planning in regional and rural areas.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"223-231"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327033","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