Anaesthesia
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Management of the airway in an intubated patient during formation of a tracheostomy can be hazardous. The usual method involves withdrawal of the tracheal tube, which has been providing a secure airway, prior to inserting the tracheostomy tube. A method of airway management, using a microlaryngeal tube, has been devised with the aim of maintaining full tracheal intubation and ventilation until the correct position of the tracheostomy tube can be verified. An audit of 250 successive cases of percutaneous tracheostomy demonstrated this method to be safe and effective.
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We conducted an observational study to measure tracheal tube cuff pressures in the critical care environment, where prolonged intubation is common. Thirty-two patients were studied. ⋯ Critically ill patients are particularly vulnerable to tracheal injury due to prolonged intubation. We suggest that cuff pressures should be measured regularly.
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The object of this study was to assess patients' experience of pain management following day surgery. One hundred and two patients agreed to take part in a telephone survey, 2 and 4 days following day surgery. The majority of patients (73%) were broadly satisfied with the quality of pain management they received, however, there was room for improvement. ⋯ It was reported that day-case staff did not always ask patients whether they were in pain. Communication with patients is vital in the delivery of optimal care. More support and more information are needed to manage patients' pain effectively, whilst in the day-case wards and also following discharge, at home.