Anaesthesia and intensive care
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Our 850-bed, academic, tertiary care hospital uses a four-bed dedicated 'shock room' situated between the Departments of Emergency Medicine and Intensive Care to stabilise all acutely ill patients from outside or inside the hospital before transfer to the intensive care unit or other department. Admitted patients stay a maximum of four hours in the shock room. ⋯ After diagnosis and initial treatment, 54% of patients were transferred to an intensive care unit or a coronary care unit; 2.5% of patients died in the shock room. The shock room provides a useful area of collaboration between emergency department and intensive care unit staff and enables acutely ill patients to be assessed and treated rapidly to optimise outcomes.
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Anaesth Intensive Care · May 2009
Randomized Controlled Trial Comparative StudySore throat or hoarse voice with bronchial blockers or double-lumen tubes for lung isolation: a randomised, prospective trial.
Double-lumen endotracheal tubes and bronchial blockers allow lung isolation for one-lung ventilation. Few studies, however, directly compare these devices. Further, a new endobronchial blocker (Coopdech) is available in some countries. ⋯ Compared to the double-lumen tubes the bronchial blockers took about two minutes less to position but five minutes longer for lung deflation. Surgical exposure was uniformly good across the four groups. We conclude that clinical use of the Coopdech endobronchial blocker is similar to the Arndt and Univent blockers and that all three are associated with less sore throat or hoarse voice than double-lumen tubes.
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Anaesth Intensive Care · May 2009
Randomized Controlled Trial Comparative StudyEase of Proseal Laryngeal Mask Airway insertion and its fibreoptic view after placement using Gum Elastic Bougie: a comparison with conventional techniques.
The Proseal Laryngeal Mask Airway (PLMA) is routinely inserted by the digital and introducer tool techniques but a newer Gum Elastic Bougie (GEB) guided insertion technique has been described. The aims and objectives were to compare the ease of PLMA insertion and fibreoptic view of PLMA after placement using GEB and conventional techniques. Ninety-six ASA I or II patients of either gender aged 18 to 60 years, scheduled for elective surgery under general anaesthesia in the supine position were included in this study. ⋯ Time taken for successful placement was significantly shorter in the GEB-guided group after two attempts (G 22 +/- 2 seconds, I 31.9 +/- 18.8 seconds, D 29.5 +/- 18.6 seconds, P < 0.05). The fibreoptic view through the airway tube was significantly better in the GEB-guided group (P < 0.01). Incidence of trauma was significantly less in the GEB-guided group (P < 0.05).
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Anaesth Intensive Care · May 2009
Randomized Controlled Trial Comparative StudyRelative efficiency of two warming devices during laparoscopic cholecystectomy.
Intraoperative hypothermia is a known consequence of general anaesthesia. Forced air warming devices are commonly used to prevent hypothermia in anaesthesia, but there are limited data on the use of radiant warming devices. Previous trials comparing the efficacy of forced air and radiant warming devices have reported discordant results. ⋯ Postoperative headache was recorded in four Sun-touch and no Warm-touch patients (P = 0.04). No difference in the efficacy of the Sun-touch warming device compared with the Warm-touch was demonstrated. Operational-mode side-effects may limit the use of the Sun-touch device.