Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2015
Multidisciplinary team training reduces the decision-to-delivery interval for emergency Caesarean section.
Emergency Caesarean section is performed when the life of the pregnant woman and/or the foetus is considered at risk. A 30-min standard for the decision-to-delivery interval (DDI) is a common practice and is supported by national organisations including The Danish Society of Obstetrics and Gynaecology. Danish obstetric departments report the DDI to a national database. A national arbitrarily set standard recommends that 95% of ECSs should be achieved within the 30-min DDI standard. In 2011, 34.4% of ECSs, performed at our hospital, were achieved within the 30-min time frame. This study aims to evaluate the effect of a simulation-based team training programme on the proportion of ECSs achieved within a 30-min time frame. ⋯ Team training may contribute positively to an increase in the proportion of ECSs achieved within a 30-min time frame.
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Acta Anaesthesiol Scand · Nov 2015
Crew Resource Management in the Intensive Care Unit: a prospective 3-year cohort study.
Human factors account for the majority of adverse events in both aviation and medicine. Human factors awareness training entitled "Crew Resource Management (CRM)" is associated with improved aviation safety. We determined whether implementation of CRM impacts outcome in critically ill patients. ⋯ Our data indicate an association between CRM implementation and reduction in serious complications and lower mortality in critically ill patients.
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Acta Anaesthesiol Scand · Nov 2015
Case ReportsManagement of labour and delivery in congenitally corrected transposition of great arteries.
A descriptive case report of the labour and delivery management of a 28-year-old woman who presented with congenitally corrected transposition of great arteries, dextrocardia, systemic ventricular dysfunction and junctional tachycardia. Patients with congenitally corrected transposition have a thin-walled morphological right ventricle as the systemic circulatory pump. The stress of increased cardiac output can lead to congestive heart failure, systemic atrioventricular valve regurgitation and arrhythmias. We used minimally invasive continuous cardiac output monitoring, fluid balance optimization and good maternal pain control to prevent decompensation and achieve vaginal delivery with a good maternal and neonatal outcome.