International journal of obstetric anesthesia
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Int J Obstet Anesth · Jul 2009
Multicenter StudyA national survey of obstetric early warning systems in the United Kingdom.
Despite recommendations in the two most recent Confidential Enquiries into Maternal and Child Health (CEMACH) reports, and improvements in patient care using early warning scoring systems (EWS) in the general adult population, no validated system currently exists for the obstetric population. ⋯ The survey results support CEMACH recommendations for a nationally agreed obstetric EWS.
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Int J Obstet Anesth · Jul 2009
Multicenter StudyThe preparation and storage of anaesthetic drugs for obstetric emergencies: a survey of UK practice.
Traditionally anaesthetic drugs for obstetrics are prepared as a contingency and stored until they are required for emergency use or have expired. Expiry is based on presumed reduction in sterility and efficacy although evidence for this is inconsistent. Preparation in advance introduces the risk of error and potential for tampering by a third party. Discarding and re-preparing drugs daily represents significant wastage with associated cost implications. We predicted that practice of drug preparation would differ widely across the UK, so conducted a national survey. ⋯ The majority of UK obstetric units routinely draw up emergency drugs every 24h. With conflicting evidence regarding sterility and efficacy this represents tremendous wastage and potential for drug error and tampering. We propose that nationwide introduction of commercially- and pharmacy-prepared drugs with long shelf lives would improve safety and cost effectiveness.