Anaesthesia and intensive care
-
Anaesth Intensive Care · Jan 2011
Randomized Controlled TrialThe effects of positive or negative words when assessing postoperative pain.
Negative or harsh words such as 'pain' and 'sting' used to describe sensations prior to potentially painful procedures have been shown to increase pain. We aimed to determine whether the reporting of pain and its severity is affected by the way it is assessed during anaesthesia follow-up after caesarean section. Following caesarean section, 232 women were randomised prior to post-anaesthesia review. ⋯ The assessment of pain after caesarean section, using more positive words, decreases its incidence but does not affect its severity when measured by pain scores. Words that focus the patient on pain during its assessment may lead some to interpret sensations as pain which they might not do otherwise. These findings may have important implications when assessing and researching postoperative pain.
-
Anaesth Intensive Care · Jan 2011
Intensive care medicine trainees' perception of professionalism: a qualitative study.
The Competency-Based Training program in Intensive Care Medicine in Europe identified 12 competency domains. Professionalism was given a prominence equal to technical ability. However, little information pertaining to fellows' views on professionalism is available. ⋯ Professionalism is mainly learned 'on the job' from role models in the intensive care unit. Formal teaching courses and sessions addressing professionalism aspects were nevertheless valued, and learning from own and others' mistakes was considered especially useful. Self-reflection as a starting point for learning professionalism was stressed.
-
Anaesth Intensive Care · Jan 2011
Letter Case ReportsThe i-gel in failed obstetric tracheal intubation.
-
Anaesth Intensive Care · Jan 2011
Validation of the postoperative nausea and vomiting intensity score in gynaecological patients.
The Postoperative Nausea and Vomiting (PONV) Intensity Scale was developed to distinguish trivial from clinically important PONV perioperatively and has been validated in a general surgical population. This study aimed to assess the scale in gynaecological surgery patients. Seventy-three patients undergoing gynaecological surgery were included. ⋯ The median nausea visual analogue scale scores at four hours were 69 mm (interquartile range 69 to 76 mm) in patients with a clinically significant score vs 0 mm (0 to 9 mm) in patients without a clinically significant score (mean difference 56 mm, 95% confidence interval 41 to 72 mm, P < 0.0001). The PONV Intensity Scale is a valid, responsive and practically useful instrument in distinguishing trivial from clinically significant PON. The rate of clinically important PONV is considerably lower than the rate of any PONV symptoms perioperatively.
-
Anaesth Intensive Care · Jan 2011
Intensivists' opinion and self-reported practice of oxygen therapy.
Intensivists frequently prescribe oxygen therapy for critically ill patients, however little is known about how intensivists manage oxygen therapy, or what factors influence their decisions. We surveyed intensivists listed on the Australian and New Zealand Intensive Care Society Clinical Trials Group database to investigate how intensivists report their approach to the monitoring, prescription and management of risks associated with oxygen therapy. The response rate was 60.4% (99/164 intensivists). ⋯ For a ventilated acute respiratory distress syndrome patient, 36.8% (36/98 respondents) would not allow an SaO2 of < 85% for < or =15 minutes, and 27.6% (27/96 respondents) would not allow an SaO2 < 90% for > 24 hours. Respondents with < or = 14 years of specialty practice were more likely to specify the oxygen delivery device to be used (P = 0.014). Recognising the factors that currently influence oxygen administration decisions is a necessary prelude to the potential conduct of interventional studies, as well as for the development of better guidance for oxygen therapy in critical care.