Anaesthesia and intensive care
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Anaesth Intensive Care · Oct 1998
Obstetricians' knowledge and attitudes toward epidural analgesia in labour.
A survey of all registered obstetrician/gynaecologists in Western Australia (n = 79) was conducted to obtain information regarding their level of knowledge about epidural analgesia (EA) in labour and its complications, their sources of information about EA, and their opinions regarding its role in labour and effect on progress of labour. Response rate was 68%. Most respondents had only received lectures about EA after specialist training and 20% did not achieve an adequate knowledge score. ⋯ Seventy-seven per cent believed EA prolonged the second stage of labour, though opinion varied regarding EA effects on the duration and progress of first and third stages. Up to thirty minutes delay before epidural placement is acceptable to 87%. This survey suggests that there is both a demand and a need for greater education about EA in labour, particularly with respect to EA side-effects, complications and effects on labour, in the subgroup of obstetricians who have been in obstetric practice more than five years.
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Anaesth Intensive Care · Oct 1998
Case ReportsClearance of an obstructed endotracheal tube with an arterial embolectomy catheter with the patient in the prone position.
The obstruction of an endotracheal tube with the patient in the prone position creates major anaesthetic difficulties that may result in patient morbidity and mortality. We describe a case involving the clearing of a blocked endotracheal tube with an arterial embolectomy catheter and discuss the relevance to anaesthetic practice.
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Anaesth Intensive Care · Oct 1998
Optimal assessment of cervical spine trauma in critically ill patients: a prospective evaluation.
There is no uniformly accepted protocol for the radiological assessment of the cervical spine in critically ill trauma patients. The Alfred Trauma Centre receives about 40% of Victorian patients with major trauma. A protocol was developed for cervical spine evaluation, comprising three plain X-rays and a swimmer's view added when necessary to visualize C7-T1, CT and/or MRI for abnormal regions, and functional (flexion/extension) X-rays to exclude cervical spine instability due to soft tissue trauma. ⋯ Functional cervical X-rays added $42.00 per patient and were uncomplicated. Collar complications were common when collars remained on for more than 72 hours. This low detection rate is clinically important because of the enormous potential social and economic costs of missed unstable cervical spine fractures.
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Anaesth Intensive Care · Oct 1998
Letter Case ReportsTarget-controlled infusion of propofol for the difficult airway.