Anaesthesia and intensive care
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Anaesth Intensive Care · Jan 2009
Multicenter StudyDrug administration errors: a prospective survey from three South African teaching hospitals.
This prospective study was undertaken to determine the incidence of drug administration errors by anaesthetists at three tertiary South African hospitals. Hospitals A and C treat adults predominantly, whereas Hospital B is a paediatric hospital. Anaesthetists completed an anonymous study form for every anaesthetic performed over a six-month period. ⋯ No major complication attributable to a drug administration error was reported. Despite an increasing awareness of the problem together with suggestions in the literature to reduce the incidence, drug administration errors remain fairly common in South Africa. Failure to institute suggested solutions will continue to compromise patient safety.
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Anaesth Intensive Care · Jan 2009
Multicenter StudyUsers' opinions on intensive care unit alarms--a survey of German intensive care units.
Monitoring of physiologic parameters in critically ill patients is associated with an enormous number of alarms, leading to reduced clinical value with high sensitivity but low specificity. To evaluate opinions of intensive care unit (ICU) staff on current monitoring we conducted a survey of German ICUs. Furthermore, the survey aimed to assess requirements and requests for future alarm systems. ⋯ Free text commentaries focused on the need for reducing alarms caused by artefacts and called for improvement of the monitor-user interfaces. Our survey demonstrates the dissatisfaction of clinical staff with the current alarm systems regarding alarm frequency and specificity in German ICUs, thereby confirming data raised in single institutions. ICU staff's acceptance for new alarm algorithms like signal extraction or detection of trends as a basis for smart monitoring appealed to the majority of users.
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Anaesth Intensive Care · Dec 2007
Multicenter StudyCritically ill children in non-paediatric intensive care units: a survey, review and proposal for practice.
Despite strong arguments in favour of centralising care of critically ill children to paediatric intensive care units, around 2000 children per year are cared for in non-paediatric intensive care units in Australia and New Zealand. This paper reports a survey of consultants from 13 such units that admitted over 50 children in 2002 and 2003, to find out what factors affect the decision to keep critically ill children locally or transfer them to a paediatric intensive care unit and what infrastructure existed to support local care of these children. The results of this survey form the basis for a proposal to improve care of critically ill children in the non-paediatric intensive care units. The four key elements of this proposal are: the use of protocols, routine consultation with the regional paediatric intensive care unit, the use of telemedicine, and enhancing skills and experience of local staff Evidence supporting these measures as well as the evidence for centralising care of critically ill children is reviewed.
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Anaesth Intensive Care · Oct 2007
Multicenter StudyAnticoagulation, bleeding and blood transfusion practices in Australasian cardiac surgical practice.
We surveyed contemporary Australasian cardiac surgical and anaesthetic practice, focusing on antiplatelet and antifibrinolytic therapies and blood transfusion practices. The cohort included 499 sequential adult cardiac surgical patients in 12 Australasian teaching hospitals. A total of 282 (57%) patients received red cell or component transfusion. ⋯ Despite frequent (67%) use of antifibrinolytic therapy, there was a marked variability in red cell transfusion rates between centres (range 17 to 79%, P < 0.001). This suggests opportunities for improvement in implementation of guidelines and effective blood-sparing interventions. Many patients presenting for surgery receive antiplatelet and/or antifibrinolytic therapy, yet the subsequent benefits and risks remain unclear.
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Anaesth Intensive Care · Aug 2007
Multicenter StudyAirway management equipment in a metropolitan region: an audit.
Difficult airway equipment containers are commonly found in operating rooms, but the availability of airway equipment beyond that environment is unknown. Using the Difficult Airway Society (U. K.) and American Society of Anesthesiologists' guidelines, we conducted an inspection audit of airway equipment at all anaesthetic sites in our region. ⋯ One third of the items with an expiry date were expired. Quality control and implementation of airway guidelines could rectify these deficiencies. Anaesthesia organisations should be encouraged to publish detailed equipment guidelines.