British journal of anaesthesia
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Distractions are cited as contributory to healthcare-associated errors in a large proportion of incidents including those involving anaesthetists. The anaesthetist is relatively understudied, despite the closer coupling between action and outcome than in surgery. ⋯ Distracting events involving the anaesthetist are common, but approximately two-thirds of these events have no externally visible effect. Another anaesthetist was the most common recipient of a distracting event initiated by the anaesthetist. Anaesthetists need to address themselves as causes of distractions and the potential impact on patient safety.
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Review Meta Analysis
Measurement of quality of recovery using the QoR-40: a quantitative systematic review.
Several rating scales have been developed to measure quality of recovery after surgery and anaesthesia, but the most extensively used is the QoR-40, a 40-item questionnaire that provides a global score and subscores across five dimensions: patient support, comfort, emotions, physical independence, and pain. It has been evaluated in a variety of settings, but its overall psychometric properties (validity, reliability, ease of use, and interpretation) and clinical utility are uncertain. ⋯ The QoR-40 is a widely used and extensively validated measure of quality of recovery. The QoR-40 is a suitable measure of postoperative quality of recovery in a range of clinical and research situations.
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Randomized Controlled Trial
Single-cuff forearm tourniquet in intravenous regional anaesthesia results in less pain and fewer sedation requirements than upper arm tourniquet.
A limitation of Bier's block or i.v. regional anaesthesia (IVRA) is tourniquet pain. We hypothesized that tourniquet placement on the forearm vs upper arm during IVRA for distal upper extremity surgery may result in less tourniquet pain, lower the need for analgesic interventions, and decrease post-anaesthesia care unit (PACU) admission. ⋯ Our results indicate that the placement of the tourniquet on the forearm resulted in less discomfort, fewer sedation interventions, and greater likelihood of bypassing the PACU when compared with upper arm tourniquet.
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Randomized Controlled Trial
Anticipation of the difficult airway: preoperative airway assessment, an educational and quality improvement tool.
Assessment of the potentially difficult airway (DA) is a critical aspect of resident education. We investigated the impact of a new assessment form on airway prediction and management by anaesthesia residents. We hypothesized that residents would demonstrate improvement in evaluation of DAs over the study duration. ⋯ The use of a comprehensive airway assessment did not improve resident ability to predict a DA in an academic, tertiary-based hospital, anaesthesiology residency training programme.