Anaesthesia and intensive care
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Anaesth Intensive Care · Apr 1994
Intensive care costing methodology: cost benefit analysis of mask continuous positive airway pressure for severe cardiogenic pulmonary oedema.
Costing data for intensive care admissions is important, not only for unit funding, but also for cost outcome analysis of new therapies. This paper presents an intensive care episode costing methodology using the example of a cost-benefit analysis of mask CPAP for severe cardiogenic pulmonary oedema (CPO). This analysis examines the intervention of admitting all patients with severe CPO to the intensive care unit for mask CPAP, compared with the previous practice of admitting only patients failing conventional non-CPAP treatment and requiring mechanical ventilation. ⋯ The major contributors to cost in both groups were nursing and medical salaries, and hospital overheads. The cost of previous estimated yearly caseload of 35 ventilated patients ($176,925) was greater than the cost associated with an increased caseload of 100 mask CPAP patients ($115,600). We conclude that, despite an increase in admissions, mask CPAP for severe CPO is cost-effective.
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Anaesth Intensive Care · Apr 1994
Informed consent--recall of risk information following epidural analgesia in labour.
Recall of information pertaining to informed consent for epidural insertion in 40 primiparous labouring women was assessed. The recall of informed consent was compared between those patients who had attended antenatal epidural education classes, and those who had not. ⋯ Recall of information was significantly better in patients who had attended antenatal epidural education classes. We recommend that informed consent for epidural analgesia in labour be obtained antenatally whenever possible, and that details of the consent be recorded in the patient's notes.
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Results were kept on 43 spinal anaesthetics performed for caesarean section in the Solomon Islands, a developing tropical country in the Pacific Ocean. A 25-gauge Quincke needle was used and either 2.5 ml of heavy bupivacaine 0.5% or 2.0-2.5 ml of plain bupivacaine 0.5% were injected. ⋯ Five patients had to be given a general anaesthetic. We recommend this technique to other doctors working in the Pacific Islands.