Anaesthesia and intensive care
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Anaesth Intensive Care · Nov 2024
Case ReportsA case of cardiorespiratory collapse following bilateral sub-Tenon's blocks from brainstem anaesthesia.
Sub-Tenon's block has a superior safety profile and life-threatening complications such as cardiovascular collapse and brainstem anaesthesia are extremely rare. We report a case of cardiorespiratory collapse following bilateral sub-Tenon's blocks at the conclusion of a laser photocoagulation procedure under general anaesthesia. The cause was most likely brainstem anaesthesia. ⋯ It highlights the importance of maintaining vigilance following an eye block. Attention should not falter upon completing a block or at the conclusion of a case, regardless of its type or safety profile. This case also illustrates how the presence of general anaesthesia may obscure and delay the diagnosis of brainstem anaesthesia.
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Anaesth Intensive Care · Nov 2024
A comprehensive audit of difficult airway trolleys in selected Victorian hospitals.
This study aimed to assess the availability, design, and contents of difficult airway trolleys in hospitals in Victoria, Australia. A survey audit was conducted with a 92.3% reply rate, and the responses from 22 major Victorian hospitals were analysed. The results showed that difficult airway trolleys were available in 100% of operating theatres, emergency departments and intensive care units, and the rate of standardisation was high. ⋯ The carriage of non-essential items was reduced compared with earlier audits. However, there was heterogeneity in the brands of supraglottic airway devices, videolaryngoscopes and cognitive aids used. The study highlights the need for ongoing improvement to the organization and content of difficult airway trolleys, and for further discussion regarding the safety of equipment variation across institutions.
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Anaesth Intensive Care · Nov 2024
Maximising environmental sustainability on the return to in-person conferencing: Report from a 2500-person anaesthesia meeting in Sydney, Australia.
The COVID-19 pandemic disrupted medical conferences, where restrictions on public gatherings resulted in the postponement or cancellation of in-person meetings. Virtual events emerged as a substitute, providing a mechanism for scientific collaboration and continuing medical education with the additional benefit of low environmental impact. However, digital events may not meet all the needs of delegates, such as professional networking and social connection. ⋯ Post-event calculations assessed the conference as better than carbon-neutral; however, delegate travel was not included in the analysis and therefore this result is tempered. Off-site workshops including virtual offerings were also not included in the analysis. We encourage medical conference organisers to collaborate with all stakeholders to embed low carbon-generation choices for their meetings where education, networking and social needs are also met.
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Anaesth Intensive Care · Nov 2024
Promoting behavioural change by educating anaesthetists about the environmental impact of inhalational anaesthetic agents: A systematic review.
Of the total carbon footprint of Australia, 7% is attributed to healthcare. In the UK, inhalational agents make up 5% of the healthcare carbon footprint. This systematic review aims to determine which methods of education about the environmental impact of inhalational anaesthetic agents can be utilised to promote behaviour change, reducing the anaesthetic-related carbon footprint. ⋯ The most common teaching techniques utilised in education curricula were didactic lectures (85%), visual prompts (54%), emails (46%), and conversation forums (31%). All but one study reported a positive relationship between teaching sessions and behavioural change resulting in lower inhalational anaesthetic use by participants and their organisations, reducing healthcare-associated emissions. This systematic review has demonstrated that single education sessions as well as multi-focused, multimodal education curricula on the topic of greener anaesthesia can be beneficial in promoting behavioural change.