Anaesthesia and intensive care
-
Anaesth Intensive Care · Sep 2011
The impact of anaesthetic trainees on elective caesarean section procedural times: a prospective observational study.
Operating room efficiency is an important concern in hospitals today both in the public and private sectors. Currently, a paucity of literature exists to evaluate the impact of anaesthetic training on operating room efficiency in the Australian health system. At Monash Medical Centre, Clayton, private consultant operating sessions and public teaching operating sessions use the same operating theatres, nursing and technical staff. ⋯ The participation of anesthetic trainees in caesarean sections results in a modest increase in anaesthetic controlled time of approximately five minutes per case or 16 minutes in an operative session with three cases scheduled. Elimination of anaesthetic 'training' time does not allow scheduling of an extra elective caesarean section. Reduced operating theatre throughput is unlikely to be a consequence of training specialist anaesthetists in this clinical setting.
-
Anaesth Intensive Care · Sep 2011
Case ReportsExtracorporeal membrane oxygenation in a patient with stress-induced cardiomyopathy after caesarean section.
Stress-induced cardiomyopathy is an acute cardiac syndrome mimicking ST-segment elevation myocardial infarction and is characterised by transient left ventricular dysfunction in the absence of obstructive coronary artery disease. Caesarean delivery is associated with intense emotional and physical stress, which may precipitate stress-induced cardiomyopathy mimicking acute myocardial infarction. We report a case of a woman who was supported with extracorporeal membrane oxygenation for acute heart failure and severe pulmonary oedema, which may have resulted from stress-induced cardiomyopathy in the early postpartum period following caesarean delivery.
-
Anaesth Intensive Care · Sep 2011
The effect of a graphical interpretation of a statistic trend indicator (Trigg's Tracking Variable) on the detection of simulated changes.
Anaesthesia involves processing large amounts of information over time. One task of the anaesthetist is to detect substantive changes in physiological variables promptly and reliably. It has been previously demonstrated that a graphical trend display of historical data leads to more rapid detection of such changes. ⋯ Changes were detected 10.9% faster with the trend indicator present (mean 13.1 [SD 3.1] cycles vs 14.6 [SD 3.4] cycles, 95% confidence interval 0.4 to 2.5 cycles, P = 0.013. There was no difference in accuracy of detection (median with trend detection 97% [interquartile range 95 to 100%], without trend detection 100% [98 to 100%]), P = 0.8. We conclude that simple statistical trend detection may speed detection of changes during routine anaesthesia, even when a graphical trend display is present.
-
Anaesth Intensive Care · Sep 2011
Modification of Diamedica drawover anaesthetic equipment to facilitate introduction to an Australian teaching hospital.
We wanted to provide training in the use of drawover techniques and apparatus at an Australian teaching hospital. Equipment based on the Diamedica vaporiser was selected as it is suitable for use with sevoflurane. ⋯ Two systems were purchased, the Diamedica Portable Anaesthesia System and a Glostavent anaesthetic machine. Changes made to the equipment to increase its safety and to comply with Australian standards are described.