Anaesthesia and Intensive Care最新文献_第7页

Variations of nitrous oxide procurement per public hospital bed between Australian states and territories: A cross-sectional analysis. 澳大利亚各州和地区公立医院每张病床一氧化二氮采购量的变化：横截面分析。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.1177/0310057X241262796

Elizabeth P Hu, Hayden Burch, Eugenie Kayak, Forbes McGain

{"title":"Variations of nitrous oxide procurement per public hospital bed between Australian states and territories: A cross-sectional analysis.","authors":"Elizabeth P Hu, Hayden Burch, Eugenie Kayak, Forbes McGain","doi":"10.1177/0310057X241262796","DOIUrl":"10.1177/0310057X241262796","url":null,"abstract":"We aimed to identify variations in nitrous oxide (N2O) procurement between Australian states and territories per public hospital bed by undertaking a cross-sectional analysis of N2O procurement data for all Australian public hospitals from 1 January 2017 to 30 June 2022. Data were obtained from state and territory departments of health. All Australian public hospitals across six states and two territories were included. We obtained N2O procurement data from Department of Health representatives from all states and territories, accounting for all 697 Australian public hospitals and four public dental hospitals. The main outcome measured in this study was N2O procurement per public hospital bed by state or territory. Across the 5 years (1 January 2017 to 30 June 2022) an average of 242,054 (standard deviation (SD) 16,222) kg of N2O, equivalent to 64,144 (4299) tonnes of carbon dioxide emissions (CO2e), were procured per annum. CO2e emissions from N2O purchase varied more than threefold per public hospital bed between different states/territories (0.47-1.48 CO2e tonnes per hospital bed). There were significant variations in N2O procurement between Australian states and territories when adjusted for public hospital bed numbers. Further analysis of this variation to determine cause and to guide mitigation interventions is therefore warranted.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"321-327"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103613","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

The nature of the response to airway management incident reports in high income countries: A scoping review. 高收入国家对气道管理事件报告的反应性质：范围审查。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 DOI: 10.1177/0310057X241227238

Yasmin Endlich, Ellen L Davies, Janet Kelly

{"title":"The nature of the response to airway management incident reports in high income countries: A scoping review.","authors":"Yasmin Endlich, Ellen L Davies, Janet Kelly","doi":"10.1177/0310057X241227238","DOIUrl":"10.1177/0310057X241227238","url":null,"abstract":"Adverse events associated with failed airway management may have catastrophic consequences, and despite many advances in knowledge, guidelines and equipment, airway incidents and patient harm continue to occur. Patient safety incident reporting systems have been established to facilitate a reduction in incidents. However, it has been found that corrective actions are inadequate and successful safety improvements scarce. The aim of this scoping review was to assess whether the same is true for airway incidents by exploring academic literature that describes system changes in airway management in high-income countries over the last 30 years, based on findings and recommendations from incident reports and closed claims studies. This review followed the most recent guidance from the Joanna Briggs Institute (JBI). PubMed, Ovid MEDLINE and Embase, the JBI database, SCOPUS, the Cochrane Library and websites for anaesthetic societies were searched for eligible articles. Included articles were analysed and data synthesised to address the review's aim. The initial search yielded 28,492 results, of which 111 articles proceeded to the analysis phase. These included 23 full-text articles, 78 conference abstracts and 10 national guidelines addressing a range of airway initiatives across anaesthesia, intensive care and emergency medicine. While findings and recommendations from airway incident analyses are commonly published, there is a gap in the literature regarding the resulting system changes to reduce the number and severity of adverse airway events. Airway safety management mainly focuses on Safety-I events and thereby does not consider Safety-II principles, potentially missing out on all the information available from situations where airway management went well.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"283-301"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103612","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

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