Anaesthesia and intensive care
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Anaesth Intensive Care · Jul 2010
Healthcare utilisation among patients discharged from hospital after intensive care.
Surviving critical illness can be life-changing and presents new healthcare challenges for patients after hospital discharge. This feasibility study aimed to examine healthcare service utilisation for patients discharged from hospital after intensive care unit stay. Following Ethics Committee approval, patients aged 18 years and older were recruited over three months. ⋯ Twenty-one general practitioners wrote comments: 10 reported insufficient information about ongoing needs/rehabilitation and two reported no mention of intensive care unit stay. Survivors of critical illness had increased healthcare needs and despite most returning home, had a low workforce participation rate. This requires further investigation to maximise the benefits of survival from critical illness.
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Anaesth Intensive Care · Jul 2010
Historical ArticleThe self-inflating resuscitator--evolution of an idea.
Based on animal experiments conducted in the sixteenth century by Vesalius, the Royal Humane Society recommended fireside bellows to resuscitate victims of drowning. In the mid-twentieth century, the bellows concept was adapted by Kreiselman and others, though none of these devices gained widespread popularity. ⋯ A similar product was soon developed by Asmund Laerdal of Norway, in collaboration with American anaesthesiologists Drs Elam and Safar. The self-inflating bag is such a simple device, yet it is extremely effective--it has enabled rescuers around the world to support life in virtually any environment, simply by squeezing a bag.
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Anaesth Intensive Care · Jul 2010
A retrospective study to determine whether accessing frequency affects the incidence of microbial colonisation in peripheral arterial catheters.
Peripheral arterial catheters are used for the continuous monitoring of blood pressure and repeated blood sampling in critically ill patients, but can be a source of catheter-related bloodstream infection. A common assumption is that the more frequently an arterial catheter is accessed, the greater the likelihood of contamination and colonisation to occur We sought to determine whether the accessing frequency has an influence on the rate of colonisation in a peripheral arterial catheter A retrospective, unmatched, nested case control study was conducted in our intensive care unit. The intensive care unit charts of 96 arterial catheters from 83 patients were examined to measure the number of times each respective arterial catheter was accessed. ⋯ Arterial catheters which had a high access rate of 8.1 or more times/day (five colonised of 32 patients: hazards ratio 1.69, 95% confidence interval 0.52 to 5.49; P = 0.77), or a medium access rate of 6.7 to 8.0 times/day (six colonised of 32 patients: hazards ratio, 1.35, 95% confidence interval, 0.37 to 4.92: P = 0.65) were not significantly more colonised when compared to arterial catheters which had a low access rate of O to 6.6 times/day (six colonised of 32 patients), adjusted for arterial catheter insertion site and place in hospital where the arterial catheter insertion was performed. We were unable to demonstrate that the accessing frequency of an arterial catheter was a major predisposing factor for the likelihood of colonisation. Other mechanisms other than hub colonisation should be investigated further.
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Anaesth Intensive Care · Jul 2010
Historical ArticleStorage, display and access--innovations at the Harry Daly Museum and the Richard Bailey Library of the Australian Society of Anaesthetists, Sydney.
Open storage with simple access to collection items and books is a well-established form of museum display. It is particularly suited to collections in which many examples of slightly differing artefacts are acquired during the process of research and field work. In the long run, open storage saves curatorial time, relieves storage space problems and increases visitor interest and participation. Simple access procedures are essential when busy professionals require information for their ongoing research or immediate application.
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Anaesth Intensive Care · Jul 2010
Randomized Controlled Trial Comparative StudyEffects of fluid preload (crystalloid or colloid) compared with crystalloid co-load plus ephedrine infusion on hypotension and neonatal outcome during spinal anaesthesia for caesarean delivery.
Preload with crystalloid or colloid solution is widely recommended for the prevention of maternal hypotension during spinal anaesthesia. A combination of simultaneous rapid crystalloid infusion with vasopressor has also been suggested. This study tested the hypothesis that ephedrine infusion with crystalloid loading at spinal anaesthesia would reduce hypotension and alter neonatal outcome compared with fluid preloading. ⋯ The incidence of nausea was significantly different between the crystalloid preload and ephedrine group. Umbilical blood gas analysis and Apgar scores were similar in all groups. A combination of an ephedrine infusion at 1.25 mg.minute(-1) with a crystalloid co-load was more effective than fluid preloading with crystalloid or colloid in the prevention of moderate and severe hypotension.