Anaesthesia and intensive care
-
Anaesth Intensive Care · Sep 2021
Inferior vena cava assessment in term pregnant women using ultrasound: A comparison of the subcostal and right upper quadrant views.
Point-of-care ultrasound can be used at the bedside to assess the haemodynamic status and fluid responsiveness of a pregnant woman. Previous studies demonstrated that views from the apical and parasternal windows are readily obtainable in labouring women. However, using the subcostal window to assess the inferior vena cava can be challenging because of the gravid uterus. ⋯ Both reviewers independently rated image adequacy to be significantly greater in the right upper quadrant window (73% and 57%) compared to the subcostal window (40% and 10%) (P=0.0213 and P=0.0005, respectively). Inter-rater agreement ranged between good (Cohen's kappa coefficient 0.64) for right upper quadrant windows to fair (Cohen's kappa coefficient 0.29) for subcostal windows. Inferior vena cava visualisation in term pregnant patients may take less time, be easier and provide better quality images when the right upper quadrant window is used compared to the subcostal window.
-
Anaesth Intensive Care · Sep 2021
John Davies Thomas: Chloroformist in London and pioneer South Australian doctor.
John Davies Thomas (1844-1893) described a two-ounce drop-bottle for chloroform in 1872 while he was a resident medical officer at University College Hospital, London. After working as a ship's surgeon, he settled in Australia. In May 1875, Thomas presented a paper on the mortality from ether and chloroform at a meeting of the Medical Society of Victoria in Melbourne, Victoria. ⋯ Thomas' paper was published in The Australian Medical Journal and reprinted by the Medical Society of Victoria for distribution to hospitals in the Colony of Victoria. Later that year, Thomas moved to Adelaide, South Australia, where he may have been influential at the Adelaide Hospital in ensuring that ether was administered more often than chloroform. It does not appear that Thomas' papers on anaesthesia had a significant effect on the conduct of anaesthesia in Victoria or New South Wales.
-
Anaesth Intensive Care · Sep 2021
More than half of front-line healthcare workers unknowingly used an N95/P2 mask without adequate airborne protection: An audit in a tertiary institution.
Front-line staff routinely exposed to aerosol-generating procedures are at a particularly high risk of transmission of severe acute respiratory syndrome coronavirus 2. We aimed to assess the adequacy of respiratory protection provided by available N95/P2 masks to staff routinely exposed to aerosol-generating procedures. We performed a prospective audit of fit-testing results. ⋯ This audit highlights that without fit-testing over 50% of healthcare workers were using an N95/P2 mask that provided insufficient airborne protection. This high unnoticed prevalence of unfit masks among healthcare workers can create a potentially hazardous false sense of security. However, fit-testing of different masks not only improved airborne protection provided to healthcare workers but also increased their confidence around mask protection.
-
Anaesth Intensive Care · Sep 2021
Historical ArticleCharles and Emma Darwin: Under the 'influence' of chloroform anaesthesia.
A number of Charles Darwin's biographies record the administration of chloroform by Darwin to his wife Emma, during her labour and delivery of her eighth child, Leonard. This occurred on 15 January 1850, a little over two years after James Young Simpson in Edinburgh described the analgesic action of inhaled chloroform. An online search of more than 9000 items of Darwin's correspondence at Cambridge University and other sources revealed that he was an active proponent and user of chloroform in midwifery, for euthanising animals he studied, as well as in botanical studies of carnivorous plants. He also discovered that the concurrent inhalation of chloroform, during its administration to his wife, alleviated his distressing anxiety which he suffered when present at her earlier confinements.
-
Anaesth Intensive Care · Sep 2021
Historical ArticleDoron medicum-the gift of medicine: How a rare 17th century medical translation positively impacted the community and predicted current analgesic techniques.
In 1683, a self-proclaimed apothecary physician and London professor of physick by the name of Guilelmus (William) Salmon authored a pharmacopoeia titled Doron medicum, the 'gift of medicine' (Greek/Latin translation). This text formulates an English supplement to the Latin Materia medica (16th century), discussing internal and external compound medicines of the late 17th century. This pharmacopoeia enabled those incapable of reading Latin to provide medical care to a challenging post-plague community. ⋯ A selection of opiate-based analgesic therapies, early critical care strategies and animal preparations are revisited. A small chronicle of William Salmon's life and professional achievements will be reviewed. Debate surrounding the opening of the first London Dispensary will be discussed in relation to William Salmon's contribution, echoing ongoing contemporary challenges in healthcare over 300 years later.