Anaesthesia and intensive care
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Anaesth Intensive Care · Jun 2005
ReviewOutcome-based clinical indicators for intensive care medicine.
The clinical indicator is a tool used to monitor the quality of health care. Its use in the Intensive Care Unit (ICU) is desirable for many reasons: the maintenance of minimum standards, the development of best practice and the delivery of cost-effective health care. ⋯ Monitoring of adverse events, system descriptors, and resource indicators is valuable but they have a limited relationship to the quality of care. ICU mortality prediction models provide a global measure of quality and, despite their inherent deficiencies, remain one of the most robust and useful clinical indicators.
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Anaesth Intensive Care · Jun 2005
ReviewAnaesthesia for neurosurgery in the sitting position: a practical approach.
Neurosurgery in the sitting position offers advantages for certain operations. However, the approach is associated with potential complications, in particular venous air embolism. As the venous pressure at wound level is usually negative, air can be entrained. ⋯ Other particular concerns to the anaesthetist are airway management, avoidance of pressure injuries, and the risk of pneumocephalus, oral trauma, and quadriplegia. Newer anaesthetic agents have made the choice of anaesthetic technique easier. An appreciation of the implications of neurosurgery in the sitting position can make the procedure safer
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Anaesth Intensive Care · Jun 2005
Assessment of internal diameter and cross-sectional area of right internal jugular vein pre-induction and post-intubation.
This prospective observational study compared the internal diameter and cross-sectional area of the right internal jugular vein pre-induction and post-initiation of positive pressure ventilation. Twenty patients undergoing coronary artery bypass surgery were studied. ⋯ There was a statistically significant increase in both measurements post-intubation. This study suggests that it may be easier and safer to perform cannulation of RIJV after institution of intermittent positive pressure ventilation in patients in the modified Trendelenburg position.
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Anaesth Intensive Care · Jun 2005
Biography Historical ArticleHubert Ingham Clements: a pioneer of Australian anaesthesia.
Hubert Ingham Clements was an inventor, designer and engineer who manufactured many pieces of apparatus for use in the scientific and medical practice, particularly in the field of anaesthesia from 1917 when he designed and manufactured suction pumps and anaesthetic machines. His products were ingenious, light and portable where desirable, but sturdy, extraordinarily reliable, of low maintenance and high performance. His contribution to the specialty of anaesthesia is acknowledged.
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Anaesth Intensive Care · Jun 2005
Biography Historical ArticleNorman R. James F.F.A.R.A.C.S., a pioneer of high quality anaesthesia in Australia.
Dr Norman R. James was a multi-talented, highly accomplished clinician, teacher and innovator broadly recognized on three continents. In the United Kingdom, he served in London's Emergency Medical Service during World War II and was dubbed "England's foremost exponent of regional anaesthesia". ⋯ T. "Pepper" Jenkins, the charismatic founder of anesthesiology at the University of Texas Southwestern Medical School, recruited him to Dallas in 1960, where he taught the art and science of anesthesiology at Parkland Memorial Hospital until his retirement in 1974. He died in 1987 and is buried in Winnsboro, Texas. A brief story of his life and career follows.