Anaesthesia and intensive care
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A total of 222 medicolegal claims involving 160 anaesthetist members of Victoria's largest medical indemnity organization during the period 1980 to 1999 are reported, with 35% of anaesthetists having a claim. There were 49 claims in the first decade and 173 in the second, with 84 related to dental injury being predominant. ⋯ Anaesthetists were joined with surgeons in 17 claims. The average delay between the incident and the resolution of the claim was 11 months for dental claims and 46 months for non-dental ones.
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Anaesth Intensive Care · Feb 2004
Letter Case ReportsBreathing circuit obstruction by a foreign body.
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Anaesth Intensive Care · Feb 2004
Review Case ReportsPleural puncture: an unusual complication of a thoracic epidural.
Thoracic epidural analgesia is a common method of pain relief for major thoracic and abdominal surgery. Numerous complications may occur, including temporary or permanent neurological injury. A rare and potentially life-threatening complication of thoracic epidural analgesia is pleural puncture by the needle or the catheter. Such a case is presented and pleural puncture in association with attempted thoracic epidural catheter placement is discussed.
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Anaesth Intensive Care · Feb 2004
Comparative StudyPost anaesthesia care unit discharge: a clinical scoring system versus traditional time-based criteria.
This prospective cohort analysis compared the efficiency of time-based discharge criteria (Group 1) to a modified clinical scoring system (Group 2), incorporating the assessment of pain and temperature, in the post anaesthesia care unit (PACU). Two consecutive series of patients (n = 292) were assessed following general anaesthesia for various surgical procedures. The time taken for patients to satisfy their respective discharge criteria was recorded as PACU length of stay (LOS). ⋯ Surgical time, as a linear function, intra- and postoperative opioid administration, as well as postoperative antiemetic use were predictors of increased PACU-LOS. Patient age, gender, urgency of surgery, and ASA classification were not predictive of PACU-LOS. Using covariate adjusted estimates, the new PACU discharge criteria, based on the Aldrete's scoring system, was associated with a significantly reduced PACU-LOS in comparison with time-based criteria.