Anaesthesia and intensive care
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Anaesth Intensive Care · Sep 2010
Case ReportsUltrasound-guided bilateral superior laryngeal nerve block to aid awake endotracheal intubation in a patient with cervical spine disease for emergency surgery.
Ultrasound has been widely used to locate nerves for various nerve blocks. The potential advantages of using ultrasound imaging for nerve blocks include reduction in the amount of local anaesthetic required, improved success rate, reduced time to perform the block and reduced complication rate. We describe the successful performance of ultrasound-guided bilateral superior laryngeal nerve block to facilitate awake fibreoptic intubation in a patient presenting for emergency surgery on the cervical spine.
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Anaesth Intensive Care · Sep 2010
Estimating the net effect of unmeasured ions in human extracellular fluid using a new mathematical model. Part I: Theoretical considerations.
A theoretical framework for the formulation of a derived variable to be used for the prediction of the net effect of unmeasured charged species present in human extracellular fluid was explored. This new variable was based on contemporary strong ion and classical buffer base theories and tested against the standard base excess using simulation. It proved to be more accurate in predicting the existence of unmeasured charged species in the extracellular fluid when disturbances of either strong ions, weak acids or both were present.
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Anaesth Intensive Care · Sep 2010
Anaesthesia-related morbidity in Victoria: a report from 1990 to 2005.
This report involves a review of 736 cases of anaesthesia-related morbidity reported from 1990 to 2005 by the Victorian Consultative Council on Anaesthetic Mortality and Morbidity. Using a combination of an established classification system, emerging categorisation definitions and appropriate keywords, an analysis of the clinical issues and contributory factors was undertaken. Airway-related morbidity, respiratory complications and drug-related adverse events are the most commonly reported. Organisational issues are increasingly implicated in adverse anaesthesia outcomes.
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Anaesth Intensive Care · Sep 2010
The provision of anaesthesia for children by non-subspecialist anaesthetists: expectations of newly qualified consultant anaesthetists and their prospective employers in Victoria.
We surveyed newly qualified consultant anaesthetists and their prospective employers in Victoria, regarding their expectations for the provision of paediatric anaesthesia by anaesthetists who have not completed subspecialty training in paediatric anaesthesia (generally-trained anaesthetists). Responses were received from 15 of 19 (79%) eligible Directors and 26 of 37 (70%) newly qualified Australian and New Zealand College of Anaesthetists (ANZCA) Fellows. Of those responding, 80% of Directors and 82% of Fellows would expect a generally-trained anaesthetist to anaesthetise children two years of age or older Regional Directors expected generally-trained anaesthetists to anaesthetise younger children than metropolitan Directors, and Directors' expectations were not influenced by their own practice. ⋯ Only 50% agreed they still met all the requirements of the ANZCA paediatric module and only 37.5% had the level of confidence they achieved during their paediatric rotations. We suggest that current training provides capacity to routinely anaesthetise well children two years of age or older However it appears more training would be required for most anaesthetists undertaking anaesthesia for younger patients or more complex paediatric cases. This raises the question of subspecialty endorsements within ANZCA Fellowship.
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Anaesth Intensive Care · Sep 2010
Letter Case ReportsRocuronium and sugammadex in myotonic dystrophy.