Anaesthesia and intensive care
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Anaesth Intensive Care · Dec 2005
Comparative StudyLong-term survival of surgically treated hip fracture in an Australian regional hospital.
This study was undertaken to identify factors influencing outcome in elderly patients operated for hip fracture. In particular, this study examined factors related to mortality at least 30 months post-fracture. Hospital records and death registrations were analysed for 463 patients aged 60 or more years treated for hip fracture at a Queensland regional hospital between 1997 and 2001. ⋯ No major determinants of length of hospital stay were identified. Patient health status was the main determinant for surgical delay. Our results confirm the persistently high mortality in this group of patients, and suggest that the main determinants of outcome are patient- rather than process-related.
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Anaesth Intensive Care · Dec 2005
Anaesthetists' knowledge of the QT interval in a teaching hospital.
Many drugs used in anaesthesia may prolong the QT interval of the electrocardiogram (ECG), and recent U. S. Food and Drug Administration guidelines mandate monitoring of the ECG before, during and after droperidol administration. ⋯ When asked to name drugs that altered the QT interval, droperidol was included by 11 of the 40 respondents (28%); trainees 10% vs consultants 45%, OR 7.4 (95% CI: 1.3-41), P=0.013. Torsades de Pointes was correctly identified as a possible consequence of a prolonged QT interval by 65% of trainees and 70% of consultants, P=0.83. The results suggest that QT interval measurement is not widely practised by anaesthetists, although its clinical significance is well known, and interpretation would be unreliable without further education.
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Anaesth Intensive Care · Dec 2005
Comparative StudyEvaluation of the SLIPA (streamlined liner of the pharynx airway), a single use supraglottic airway device, in 60 anaesthetized patients undergoing minor surgical procedures.
The Streamlined Liner of the Pharyngeal Airway, SLIPA (Hudson RCI) is a new disposable supraglottic airway device that has no inflatable cuff and has features designed to reduce aspiration risk. This study aimed to assess the insertion success and effectiveness of the SLIPA in 60 patients who presented for elective surgery. Ethics committee approval was obtained. ⋯ Group B reported that use of the device was very easy in 16%, easy in 76%, difficult in 5%, and very difficult in 3%. The SLIPA proved to be a reliable airway providing adequate ventilation in both spontaneous breathing and assisted respiration. Most users found the SLIPA to be easy or very easy to use.
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Anaesth Intensive Care · Dec 2005
Case ReportsAnaphylaxis to cisatracurium following negative skin testing.
General anaesthesia for the patient with a history of anaesthesia-related anaphylaxis is challenging. Precautions against anaphylaxis and the use of skin test negative drugs can reduce but not eliminate the risk. ⋯ However, the absence of a clearly identified triggering agent increases the difficulties facing the anaesthetist. We present a case of anaphylaxis to cisatracurium following a negative skin test.
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Anaesth Intensive Care · Dec 2005
Comparative StudyFibreoptic intubation skills among anaesthetists in New Zealand.
The aim of this study was to investigate methods of practice, assess skill level, and evaluate attitudes towards fibreoptic intubation in the anaesthetic community of New Zealand. A postal survey questionnaire was sent to all vocationally registered anaesthetists in New Zealand and to all New Zealand anaesthetic trainees registered with the Australian and New Zealand College of Anaesthetists. There were 611 survey questionnaires posted and 386 (63%) respondents. ⋯ Only 18% of trainees had a formal airway management program available to them at their place of work. There appears to be a need to increase available opportunities to perform fibreoptic intubation to enable maintenance and improvement of fibreoptic skills in our community. A formalized program of teaching fibreoptic intubation may offer greater opportunity for learning and skill development.