Anaesthesia and intensive care
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Anaesth Intensive Care · Aug 2007
Multicenter StudyAfter-hours discharge from intensive care increases the risk of readmission and death.
Despite reports showing night discharge from an intensive care unit (ICU) is associated with increased mortality, it is unknown if this has resulted in changes in practice in recent years. Our aim was to determine prevalence, trends and effect on patient outcome of discharge timing from ICU throughout Australia and New Zealand. Two datasets from the Australian and New Zealand Intensive Care Society Adult Patient Database (ANZICS APD) were examined: (1) All submissions to the APD from 1.1.2003 to 31.12.2004 to determine contemporary practices. (2) Forty hospitals which had submitted continuous data between 1.1.2000 and 31.12.2004 to determine trends in practice over time. ⋯ After-hours discharge from ICU is associated with increased risk of death and readmission to ICU. It has become more frequent. The risk of death increases as more after-hours discharges occur.
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Anaesth Intensive Care · Aug 2007
Examining the occurrence of adverse events within 72 hours of discharge from the intensive care unit.
Adverse events have negative consequences for patients, including increased risk of death or permanent disability. Reports describe suboptimal patient care on hospital wards and reasons for re-admission to the intensive care unit (ICU) but limited data exists on the occurrence of adverse events, their characteristics and outcomes in patients recently discharged from the ICU to the ward. This prospective observational study describes the incidence and outcomes of adverse events within 72 hours of discharge from an Australian ICU over 12 weeks in 2006. ⋯ Delay in taking action for abnormal physiological signs and infrequent charting were evident. Whilst the adverse event rate compared favourably with other reports, 64% of the events were considered preventable. A review of support systems and processes is recommended to better target transition from the ICU.
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Anaesth Intensive Care · Aug 2007
Comparative StudyInvestigation of a new echogenic needle for use with ultrasound peripheral nerve blocks.
A new 'texturing method' has been developed for nerve block needles in an attempt to improve the ultrasonic image of the needles. Using a synthetic phantom, these textured needles were compared to currently available needles. The textured needle had improved visibility under ultrasound. This type of needle may assist the anaesthetist perform ultrasound-guided regional anaesthesia.
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Anaesth Intensive Care · Aug 2007
Comment Letter Case ReportsAnother cause of leak during propofol target controlled infusion.