Anaesthesia
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Multicenter Study
Review of patient safety incidents submitted from Critical Care Units in England & Wales to the UK National Patient Safety Agency.
We reviewed and classified all patient safety incidents submitted from critical care units in England and Wales to the National Patient Safety Agency for the first quarter of 2008. A total of 6649 incidents were submitted from 141 organisations (median (range) 23 (1-268 incidents)); 786 were unrelated to the critical care episode and 248 were repeat entries. ⋯ There were 2789 incidents classified to more than one main group. The incident analysis highlights ways to improve patient safety and to improve the classification of incidents.
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Multicenter Study
A national survey of support and counselling after maternal death.
The 2000-2002 Confidential Enquiry into Maternal and Child Health report highlighted several cases of maternal death where the staff who had been involved, were not offered support. The report recommended that 'Trusts must make provision for the prompt offer of support and/or counselling for all staff who have cared for a woman who has died.' We conducted a postal survey to firstly establish whether Trusts had implemented this, and also to ascertain the experience of consultant obstetric anaesthetists. ⋯ Furthermore, 69% were unaware of policies within their own Trusts for the provision of support services. We suggest that a formal structure should exist within all units that offers confidential support services and/or debriefing facilities to all staff involved in a maternal death or other traumatic event.
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Propofol is a commonly used anaesthetic agent and is rarely associated with seizure-like phenomena. This case report presents a young woman with seizure-like phenomena lasting more than 4 weeks after a single dose of propofol. The underlying pathophysiology of this condition is poorly understood but a psychological component is possible in this case.
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This case series details experience of critical care admissions with pandemic (H1N1) 2009 influenza from an intensive care unit in the West Midlands. We present four critically ill patients admitted with severe hypoxia. Two of the patients failed a trial of continuous positive airway pressure and all underwent controlled ventilation within 24 h of admission. ⋯ We also discuss service planning and our response to the pandemic. We were well prepared with stocks of personal protective equipment but had to modify plans as the outbreak progressed. Our cases and discussion provide useful information for other intensive care units preparing for the predicted autumn surge of H1N1 cases.
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Comment Letter Case Reports
Endobronchial intubation and scapel-bougie technique.