Anaesthesia and intensive care
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Anaesth Intensive Care · Jul 2008
Sequential organ failure assessment score and comorbidity: valuable prognostic indicators in chronically critically ill patients.
Chronically critically ill patients are defined as those who survive initial life-threatening, possibly reversible organ failure(s) but are unable to recover rapidly to a point at which they are fully independent of life support. Accordingly, these patients require mechanical ventilation and medical resources for a long time in an intensive care unit (ICU). The present study analysed demographic, clinical and survival data of chronically critically ill patients, to identify condition(s) related to poor prognosis. ⋯ Non-survivors had a significantly higher Sequential Organ Failure Assessment (SOFA) score than survivors on day 21 of ICU admission, as well as having significantly lower changes of SOFA scores between days three and 21. Multivariate analysis demonstrated that the SOFA score on day 21 and the Charlson Comorbidity Index were the best predictor of survival for six months after hospital discharge. The SOFA score on day 21 and comorbidity in the ICU appears to be a valuable prognostic indicators in chronically critically ill patients.
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The history of the development of humidifiers as a necessary accompaniment to mechanical ventilation is a fascinating one. In New Zealand in the 1960s, Fisher and Paykel, an established importer of a variety of household appliances, launched into the design and manufacture of humidifiers following the requirements envisaged at that time, for optimal use in the intensive care setting. This was a completely new venture for the company and led to the establishment of a separate Fisher and Paykel Health Care company for medical equipment manufacture, which has continued successfully to the present day.
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Anaesth Intensive Care · Jul 2008
Anaesthesia trainees' exposure to airway management in an Australian tertiary adult teaching hospital.
The purpose of this study was to estimate the exposure of trainees to airway management techniques in an Australian tertiary adult teaching hospital. Anaesthesia records for all patients over a 20-week period were reviewed and the following data were obtained: the presence of a trainee, the type of airway used, the grade of the laryngoscopic view and the use of non-standard laryngoscopy for intubation. Data was recorded contemporaneously and analysed retrospectively. ⋯ As there is no previous study to determine experience gained by trainees, we are unable to establish whether there has been a decrease in experience, however we believe this is likely. Although competency is difficult to assess, it may be that this data has implications for training, unsupervised practice and rostering. Experience in certain airway skills may need to be supplemented using techniques such as simulation.
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Anaesth Intensive Care · Jul 2008
Historical ArticleThe Geoffrey Kaye Museum of Anaesthetic History: creating a meaningful display.
There have been several displays created at the Geoffrey Kaye museum over the last 20 years. The current display is the culmination of a new professional approach to the management of the collection. A timeline has been created to enhance conducted tours and to allow self-guided tours. The creation of this display brought new challenges to those responsible for the collection but has resulted in a contemporary and exciting display that has been appreciated by many visitors.
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Anaesth Intensive Care · Jul 2008
Historical ArticleHistory of analgesia and regional anaesthesia through philately.
Medical philately is the study of postage stamps commemorating events and pioneers in the field of medicine. In 1929, Dr Fielding H. ⋯ His prediction has hardly come to fruition in the years since then, with medical philatelic articles rarely seen in the medical press. The history of pain medicine is unique, diverse and extremely interesting, with many chemists, physicists, philosophers, contributing in their own way over centuries to pave the path to present day pain medicine.