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Emergency anaesthesia

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https://www.readbyqxmd.com/read/29044462/urgency-of-caesarean-section-grading-alarm-chain-and-intrauterine-resuscitation-a-survey-of-scandinavian-practice
#1
K Wildgaard, M Ismaiel, F Hetmann
BACKGROUND: About 40,000 women have caesarean section in Scandinavia each year. Organizational factors for emergency caesarean section (CS), classification, anaesthetic practice, alarm chain, intrauterine resuscitation has all been investigated in the United Kingdom, but no information from the Scandinavian countries exists. METHODS: Using publicly available data from the National Board of Health, obstetric anaesthetic departments were identified. The heads of the departments provided e-mail contact details of two anaesthesiologists regularly practicing obstetric anaesthesia who were then surveyed...
October 18, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29037252/experiences-of-midwives-on-pharmacological-and-non-pharmacological-labour-pain-management-in-ghana
#2
Lydia Aziato, Abigail A Kyei, Godsway Deku
BACKGROUND: Due to the debilitating effects of severe labour pains, labour pain management continues to be an important subject that requires much attention. Thus, this study sought to gain a detailed insight into the experiences of midwives on pharmacological and non-pharmacological labour pain management strategies in a resource limited clinical context. METHODS: A descriptive exploratory qualitative design was adopted for this study which allowed in-depth follow-up of the midwives' comments resulting in a full understanding of emerging findings...
October 16, 2017: Reproductive Health
https://www.readbyqxmd.com/read/29034967/evaluation-of-a-method-for-isocapnic-hyperventilation-a-clinical-pilot-trial
#3
K Hallén, P Jildenstål, O Stenqvist, S-E Ricksten, S Lindgren
BACKGROUND: Isocapnic hyperventilation (IHV) is a method that shortens time to extubation after inhalation anaesthesia using hyperventilation (HV) without lowering airway CO2 . In a clinical trial on patients undergoing long-duration sevoflurane anaesthesia for major ear-nose-throat (ENT) surgery, we evaluated the utility of a technique for CO2 delivery (DCO2 ) to the inspiratory limb of a closed breathing circuit, during HV, to achieve isocapnia. METHODS: Fifteen adult ASA 1-3 patients were included...
October 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29030677/safe-surgery-for-all-early-lessons-from-implementing-a-national-government-driven-surgical-plan-in-ethiopia
#4
Daniel Burssa, Atlibachew Teshome, Katherine Iverson, Olivia Ahearn, Tigistu Ashengo, David Barash, Erin Barringer, Isabelle Citron, Kaya Garringer, Victoria McKitrick, John Meara, Abraham Mengistu, Swagoto Mukhopadhyay, Cheri Reynolds, Mark Shrime, Asha Varghese, Samson Esseye, Abebe Bekele
Recognizing the unmet need for surgical care in Ethiopia, the Federal Ministry of Health (FMOH) has pioneered innovative methodologies for surgical system development with Saving Lives through Safe Surgery (SaLTS). SaLTS is a national flagship initiative designed to improve access to safe, essential and emergency surgical and anaesthesia care across all levels of the healthcare system. Sustained commitment from the FMOH and their recruitment of implementing partners has led to notable accomplishments across the breadth of the surgical system, including but not limited to: (1) Leadership, management and governance-a nationally scaled surgical leadership and mentorship programme, (2) Infrastructure-operating room construction and oxygen delivery plan, (3) Supplies and logistics-a national essential surgical procedure and equipment list, (4) Human resource development-a Surgical Workforce Expansion Plan and Anaesthesia National Roadmap, (5) Advocacy and partnership-strong FMOH partnership with international organizations, including GE Foundation's SafeSurgery2020 initiative, (6) Innovation-facility-driven identification of problems and solutions, (7) Quality of surgical and anaesthesia care service delivery-a national peri-operative guideline and WHO Surgical Safety Checklist implementation, and (8) Monitoring and evaluation-a comprehensive plan for short-term and long-term assessment of surgical quality and capacity...
October 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29028915/point-of-care-paediatric-gastric-sonography-can-antral-cut-off-values-be-used-to-diagnose-an-empty-stomach
#5
J J Moser, A M Walker, A O Spencer
Background: Gastric sonography is emerging as a valuable clinical point-of-care tool to assess aspiration risk. A recent study proposed that a single cut-off cross-sectional area (CSA) in the supine position could diagnose an empty stomach in the parturient. This study establishes the sensitivity and specificity of a single CSA cut-off measurement in both supine and right lateral decubitus (RLD) positions in the diagnosis of an empty antrum in paediatric patients. Methods: Following induction of anaesthesia, antral sonography was performed in supine and RLD positions in 100 fasted paediatric patients prior to upper endoscopic evaluation...
September 27, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28985089/examining-participant-perceptions-of-an-interprofessional-simulation-based-trauma-team-training-for-medical-and-nursing-students
#6
Rune Bruhn Jakobsen, Sarah Frandsen Gran, Bergsvein Grimsmo, Kari Arntzen, Erik Fosse, Jan C Frich, Per Hjortdahl
High quality care relies on interprofessional teamwork. We developed a short simulation-based course for final year medical, nursing and nursing anaesthesia students, using scenarios from emergency medicine. The aim of this paper is to describe the adaptation of an interprofessional simulation course in an undergraduate setting and to report participants' experiences with the course and students' learning outcomes. We evaluated the course collecting responses from students through questionnaires with both closed-ended and open-ended questions, supplemented by the facilitators' assessment of students' performance...
October 6, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28981584/variations-in-assessment-and-certification-in-postgraduate-anaesthesia-training-a-european-survey
#7
G Jonker, L A Manders, A P Marty, C J Kalkman, Th J Ten Cate, E F van Gessel, R G Hoff
Background: Postgraduate specialty training has traditionally been based on a time- and rotation-based model, but competency-based models are emerging. Because anaesthesia training evolves differently across Europe, variations in assessment and certification processes are expected, but the extent of similarities and differences is unknown. The aim of this study was to compare anaesthesia training programmes in Europe, focusing on assessment and certification processes. Methods: We performed an online survey among national representatives of the Union of European Medical Specialists/European Board of Anaesthesiology...
July 14, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28980388/incidence-and-risk-factors-for-parastomal-bulging-in-patients-with-ileostomy-or-colostomy-a-register-based-study-using-data-from-the-danish-stoma-database-capital-region
#8
Rune M Andersen, Tobias W Klausen, Anne K Danielsen, Anders Vinther, Ismail Gögenur, Thordis Thomsen
AIM: To investigate incidence and risk factors for parastomal bulging, a clinically important complication, in patients with an ileostomy or colostomy. METHOD: The Danish Stoma Database Capital Region prospectively collects data on patients with a stoma up to a year after surgery. Stoma care nurses clinically assessed the main outcome, parastomal bulging. We linked data from the Stoma Database to data from the Danish Anaesthesia Database. Cumulative incidence of parastomal bulging over the first year was calculated with death and stoma reversal as competing risks...
October 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28976895/discontinuation-of-oral-antiplatelet-agents-before-dental-extraction-necessity-or-myth
#9
Atanaska S Dinkova, Dimitar T Atanasov, Ludmila G Vladimirova-Kitova
BACKGROUND: The risk of excessive bleeding often prompts physicians to interrupt the antiplatelet agents as acetylsalicilyc acid and clopidogrel before dental extractions which puts patients at risk of adverse thrombotic events. AIM: To assess the bleeding risk during dental extractions in patients with continued antiplatelet therapy. MATERIALS AND METHODS: The study included 130 patients (64 men and 66 women) aged between 18 and 99 years old...
September 1, 2017: Folia Medica
https://www.readbyqxmd.com/read/28975884/anaesthesia-in-patients-undergoing-esophago-gastro-duodenoscopy-for-suspected-bleeding
#10
Ida Helsø, Martin Risom, Therese Risom Vestergaard, Nicolai Bang Foss, Steffen Rosenstock, Morten Hylander Møller, Lars Hyldborg Lundstrøm, Nicolai Lohse
INTRODUCTION: Upper gastrointestinal bleeding (UGIB) is a common emergency. Currently, there are no agreed guidelines on the level of anaesthetic support required in patients undergoing acute esophago-gastro-duodendoscopy (EGD). METHODS: An online questionnaire comprising 19 questions was distributed to all members of the Danish Association of Anaesthesiology and Intensive Care (n = 1,418) and the Danish Society of Anaesthesiologists in Training (n = 566). The questions concerned clinical practice for anaesthesia care to patients undergoing EGD for suspected UGIB and availability of local guidelines...
October 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28974066/post-induction-hypotension-and-early-intraoperative-hypotension-associated-with-general-anaesthesia
#11
S Südfeld, S Brechnitz, J Y Wagner, P C Reese, H O Pinnschmidt, D A Reuter, B Saugel
Background: We hypothesized that different phases of intraoperative hypotension should be differentiated because of different underlying causative mechanisms. We defined post-induction hypotension (PIH; i.e. arterial hypotension occurring during the first 20 min after anaesthesia induction) and early intraoperative hypotension (eIOH; i.e. arterial hypotension during the first 30 min of surgery). Methods: In this retrospective study, we included 2037 adult patients who underwent general anaesthesia...
July 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28970636/post-cardiac-transplant-recipient-implications-for-anaesthesia
#12
REVIEW
Minati Choudhury
The annual heart transplant rate is gradually increasing worldwide. A proportion of this patient population present for an elective or emergency surgery which may or may not be related to the transplanted heart. A MEDLINE search for heart transplant, anaesthesia, adult, paediatric and surgery was conducted to review anaesthetic management for heart transplant recipients. Anaesthesia and perioperative management are different in these cases. A thorough understanding of the physiology of denervated heart, post-transplant morbidities and pharmacology of immunosuppressants is essential for best perioperative management and improved post-operative outcome...
September 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28970631/cardiomyopathies-and-anaesthesia
#13
REVIEW
Rajiv Juneja, Prajeesh M Nambiar
Cardiomyopathy is considered as a heart muscle disease of multiple aetiologies, unlike other cardiac diseases related to a definitive pathophysiology. With more and more research and with the advent of genetic analysis pin pointing the disease causing mutations, causative factors have been defined and classifications and definitions have changed over time. Patients with these conditions present to anaesthesiologists in elective and emergency situations, placement of automated internal cardioverter defibrillator (AICD) devices or biventricular pacing but may also be diagnosed at anaesthetic pre-assessment...
September 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28969235/super-refractory-status-epilepticus-a-therapeutic-challenge-in-paediatrics
#14
Shrikiran Aroor, Kanaparthi Shravan, Suneel C Mundkur, C Jayakrishnan, Sai Sripad Rao
A status epilepticus which persists for 24 hours or more after starting treatment with anaesthesia or has recurred inspite of general anaesthesia is known as Super-Refractory Status Epilepticus (SRSE). It includes cases where status epilepticus recurs on reduction or withdrawal of anaesthesia. SRSE, though infrequently seen, constitutes a medical emergency due to the associated high morbidity and mortality. No clear cut guidelines are available till date for the management of SRSE. Most of the published literature was case reports and expert opinion...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28965301/minimal-trauma-ankle-fractures-predominate-during-pregnancy-a-17-year-retrospective-study
#15
Madhuni Herath, Phillip Wong, Anne Trinh, Carolyn A Allan, Euan M Wallace, Peter R Ebeling, Peter J Fuller, Frances Milat
This study assessed all fractures occurring in pregnancy at a tertiary referral centre over a 17-year period. Most fractures were due to minimal trauma, and those involving the ankle were the most common. Women tended to fracture during their second and third trimesters and most required surgical intervention during pregnancy. PURPOSE: To characterise fractures in pregnancy over a 17-year period at a tertiary referral health service. METHODS: Medical records at the Monash Health in Australia were examined from 2000-2016 for fractures in pregnancy using the birthing outcome system database and the tenth revision of the International Statistical Classification of Diseases and Related Health Problems coding...
September 30, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28964314/optimal-dose-of-rocuronium-bromide-undergoing-adenotonsillectomy-under-5-sevoflurane-with-fentanyl
#16
Hyub Huh, Jeong Jun Park, Ji Yeong Kim, Tae Hoon Kim, Seung Zhoo Yoon, Hye Won Shin, Hye-Won Lee, Hye-Ja Lim, Jang Eun Cho
OBJECTIVE: Adenotonsillectomy is a short surgical procedure under general anaesthesia in children. An ideal muscle relaxant for adenotonsillectomy would create an intense neuromuscular block while having a quick recovery time without postoperative morbidity. We compared the effect of different doses of rocuronium for the tracheal intubation in children under 5% sevoflurane and fentanyl. MATERIALS AND METHODS: 75 children (aged 3-10 years, ASA I) scheduled for adenotonsillectomy were enrolled...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28948899/comparison-of-emergence-times-and-quality-between-isoflurane-and-sevoflurane-in-rhesus-macaque-macaca-mulatta-undergoing-neurosurgical-procedure
#17
Henri G M J Bertrand, Svenja Springer, Wesley Burnside, Charlotte Sandersen, Paul A Flecknell
Volatile agents for anaesthesia are widely used for anaesthetizing laboratory primates, and isoflurane is one of the most frequently used agents. Sevoflurane has been shown to offer a more rapid recovery than isoflurane in a number of species, but no comparisons have been made in non-human primates. This study compared the recovery characteristics of isoflurane and sevoflurane in rhesus macaques undergoing experimental neurosurgery. Twelve primates (7 males and 5 females) were randomly allocated to the treatment groups...
October 2017: Laboratory Animals
https://www.readbyqxmd.com/read/28947215/emergent-endovascular-treatment-of-thoraco-abdominal-aortic-rupture-in-behcet-s-disease
#18
Enrico Maria Marone, Domenico Antonio Diaco, Chiara Brioschi, Angelo Argenteri
PURPOSE: Endovascular approach with parallel graft technique can be a valid solution in emergency setting for the treatment of thoraco-abdominal aorta involvement in Behcet's disease. CASE REPORT: we describe the clinical case of a 41-year-old man, urgently hospitalized for a rupture of thoraco-abdominal aorta with occlusion of the celiac trunk and involvement of superior mesenteric artery. The patient also presented a massive right hemothorax and a massive left pulmonary thromboembolism...
September 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28944485/effect-of-repeated-exposure-to-aqui-s-%C3%A2-on-the-viability-and-growth-of-neoparamoeba-perurans
#19
R J Chance, Z Allcock, C J Secombes, B Collet, C Collins
There have been recent efforts amongst immunologists to develop approaches for following individual fish during challenges with viral and bacterial pathogens. This study contributes to assessing the feasibility of using such approaches to study amoebic gill disease (AGD). Neoparamoeba perurans, agent of AGD, has been responsible for widespread economic and fish loss in salmonid aquaculture. With the emergence of AGD in Europe, research into infection dynamics and host response has increased. This study investigated the effect of repeat exposure to anaesthesia, a necessary requirement when following disease progression in individual fish, on N...
September 25, 2017: Journal of Fish Diseases
https://www.readbyqxmd.com/read/28928589/laparoscopic-cholecystectomy-under-segmental-thoracic-spinal-anesthesia-a-feasible-economical-alternative
#20
Aditya Kumar Kejriwal, Shaheen Begum, Gopal Krishan, Richa Agrawal
Laparoscopic surgery is normally performed under general anesthesia, but regional techniques like thoracic epidural and lumbar spinal have been emerging and found beneficial. We performed a clinical case study of segmental thoracic spinal anaesthesia in a healthy patient. We selected an ASA grade I patient undergoing elective laparoscopic cholecystectomy and gave spinal anesthetic in T10-11 interspace using 1 ml of bupivacaine 5 mg ml(-1) mixed with 0.5 ml of fentanyl 50 μg ml(-1). Other drugs were only given (systemically) to manage patient anxiety, pain, nausea, hypotension, or pruritus during or after surgery...
July 2017: Anesthesia, Essays and Researches
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