Anaesthesia and intensive care
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Anaesth Intensive Care · Jul 2010
Unplanned early readmission to the intensive care unit: a case-control study of patient, intensive care and ward-related factors.
The purpose of this study was to identify patient, intensive care and ward-based risk factors for early, unplanned readmission to the intensive care unit. A five-year retrospective case-control study at a tertiary referral teaching hospital of 205 cases readmitted within 72 hours of intensive care unit discharge and 205 controls matched for admission diagnosis and severity of illness was conducted. The rate of unplanned readmissions was 3.1% and cases had significantly higher overall mortality than control patients (odds ratio [OR] 4.7, 95% confidence interval [CI] 2.1 to 10.7). ⋯ Physiological derangement on the ward (OR 26, 95% CI 8.0 to 81, P < 0.001) strongly predicted readmission, although only 20% of patients meeting medical emergency team criteria had a medical emergency team call made. Risk of readmission is associated with both patient and intensive care factors. Physiological derangement on the ward predicts intensive care unit readmission, however, clinical response to this appears suboptimal.
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Anaesth Intensive Care · Jul 2010
Historical ArticleThe self-inflating resuscitator--evolution of an idea.
Based on animal experiments conducted in the sixteenth century by Vesalius, the Royal Humane Society recommended fireside bellows to resuscitate victims of drowning. In the mid-twentieth century, the bellows concept was adapted by Kreiselman and others, though none of these devices gained widespread popularity. ⋯ A similar product was soon developed by Asmund Laerdal of Norway, in collaboration with American anaesthesiologists Drs Elam and Safar. The self-inflating bag is such a simple device, yet it is extremely effective--it has enabled rescuers around the world to support life in virtually any environment, simply by squeezing a bag.
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Anaesth Intensive Care · Jul 2010
Historical ArticleStorage, display and access--innovations at the Harry Daly Museum and the Richard Bailey Library of the Australian Society of Anaesthetists, Sydney.
Open storage with simple access to collection items and books is a well-established form of museum display. It is particularly suited to collections in which many examples of slightly differing artefacts are acquired during the process of research and field work. In the long run, open storage saves curatorial time, relieves storage space problems and increases visitor interest and participation. Simple access procedures are essential when busy professionals require information for their ongoing research or immediate application.
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Anaesth Intensive Care · Jul 2010
Historical ArticleJoseph Clover and the cobra: a tale of snake envenomation and attempted resuscitation with bellows in London, 1852.
The Industrial Revolution saw the creation of many new jobs, but probably none more curious than that of zookeeper. The London Zoological Gardens, established for members in 1828, was opened to the general public in 1847. In 1852 the "Head Keeper in the Serpent Room", Edward Horatio Girling, spent a night farewelling a friend departing for Australia. ⋯ Interestingly, the attempted resuscitation was with bellows, which had been abandoned by the Royal Humane Society twenty years earlier Clover records other cases of resuscitation with bellows at University College Hospital during his time as a resident medical officer there (1848 to 1853). There is a casebook belonging to Joseph Clover in the Geoffrey Kaye Museum, in Melbourne. This story is one of the many interesting stories uncovered during a study of this book and Clover's other personal papers.
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Formal and informal fallacies refer to errors in reasoning or logic, which result from invalid arguments. Formal fallacies refer to arguments that have an invalid structure or 'form', while informal fallacies refer to arguments that have incorrect or irrelevant premises. ⋯ This paper describes several such potential fallacies. It is possible that a greater awareness, recognition and discussion of these logic-based errors will lead to improved patient safety and more informed appraisal of clinical research.