Anaesthesia and intensive care
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Anaesth Intensive Care · Sep 2013
Approaches to learning for the ANZCA Final Examination and validation of the revised Study Process Questionnaire in specialist medical training.
When evaluating assessments, the impact on learning is often overlooked. Approaches to learning can be deep, surface and strategic. To provide insights into exam quality, we investigated the learning approaches taken by trainees preparing for the Australian and New Zealand College of Anaesthetists (ANZCA) Final Exam. ⋯ Minimal reference was made to the ANZCA syllabus as a guide for learning. These findings indicate that, although trainees found the exam generally relevant to practice and adopted predominantly deep learning approaches, there was considerable variation between the four components. These results provide data with which to review the existing ANZCA Final Exam and comparative data for future studies of the revisions to the ANZCA curriculum and exam process.
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Anaesth Intensive Care · Sep 2013
Binding of local anaesthetics to the lipid emulsion Clinoleic™ 20%.
Lipid emulsions have been used to treat cardiovascular collapse due to local anaesthetic toxicity. However, there are few data available on the comparative efficiency of the partitioning properties of available lipid emulsions in clinical use. This in vitro study compared the buffering properties of the lipid emulsions Clinoleic™ 20% (Baxter, Old Toongabbie, NSW) and Intralipid® 20% (Fresenius Kabi, Pymble, NSW) using both bupivacaine (Marcain® 0.5%, AstraZeneca, North Ryde, NSW) and ropivacaine (Naropin® 1%, AstraZeneca, North Ryde, NSW). ⋯ Bupivacaine was more effectively bound by the lipid agents, with a 40% reduction in initial concentration. Ropivacaine demonstrated a 20% reduction in concentration with the addition of lipid agents. Importantly, there was no significant difference between Intralipid and Clinoleic in terms of their buffering behaviour, suggesting equivalent binding efficacy.
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Anaesth Intensive Care · Sep 2013
Historical ArticlePioneering paediatric intensive care medicine in New Zealand.
The origin of New Zealand's paediatric intensive care medicine lay in the formal establishment of Auckland Hospital's Central Respiratory Unit within the hospital's Infectious Diseases Unit (December 1958). It was initially established for the care of critically ill children, chiefly with airway and respiratory disorders or tetanus. Senior Specialist Anaesthetist Matthew Spence soon took charge, his first annual report (1960) briefly describing six children among 19 admissions and another six consulted on elsewhere. ⋯ Dr James Judson computerised record-keeping from 1984 and developed a large database, containing details of children with numbers approaching 2000. At the end of 1991, the (now) Department of Critical Care Medicine completed its paediatric role over three decades, with care of children passing to a paediatric intensive care unit in the new Auckland paediatric hospital (soon to be called "Starship"). Regional intensive care units still make a substantial contribution to paediatric intensive care countrywide.
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This survey was designed to evaluate the factors affecting mental health and welfare in Australian anaesthetists and to investigate current sources of support. An electronic survey was sent to 500 randomly selected Fellows and trainees of the Australian and New Zealand College of Anaesthetists. Questions were related to: anxiety, stress, depression, substance misuse, self-medication, suicide, reporting illness, and help-seeking. ⋯ Despite a low response rate, and the possibility of responder bias, the mental health of Australian anaesthetists would appear to be subject to common and persistent risk factors, many of which are well described in previous studies. We identify general practitioners as particularly valuable in targeting initiatives for improvements in mental health and welfare. The significant prevalence of suicidal ideation and reluctance to approach senior colleagues with concerns about mental health or welfare issues are specific causes for concern and suggest that further investigation, education and a potential review of support networks is required.