Anaesthesia and intensive care
-
The aim of this study was to explore the degree and determinants of satisfaction of family members of patients being cared for in an Australasian intensive care unit. This was a prospective observational study that took place within a mixed medical/surgical, level three intensive care unit. One hundred and eight family members of patients staying in the intensive care for more than 48 hours were identified. ⋯ Families who had meetings with the social worker or medical staff were less likely to report dissatisfaction (relative risk 0.14; confidence interval 0.03 to 0.59; P=0.08; relative risk 0.23; confidence interval 0.07 to 0.81; P=0.02). Our study found that the majority of families are happy with their care in the intensive care unit. Social work and medical meetings with the family reduce dissatisfaction.
-
Anaesth Intensive Care · Jan 2012
Incidence of difficult intubation in intensive care patients: analysis of contributing factors.
Difficulties in endotracheal intubation increase morbidity and mortality in intensive care patients. We studied the problem in surgical intensive care patients with the aim of risk reduction. Patients intubated in the intensive care unit were evaluated. ⋯ Every intubation in the ICU setting should be considered potentially difficult. The existing algorithm should be modified to incorporate the American Society of Anesthesiologists difficult airway algorithm adapted to the needs of the intensive care unit. A training program for alternative methods of airway management for difficult intubations should be established.
-
Anaesth Intensive Care · Jan 2012
Emergency surgery in the elderly: a retrospective observational study.
We conducted a retrospective observational study in a regional hospital on patients aged 80 years or over undergoing emergency procedures. We included 202 emergency procedures performed on 178 patients over 185 separate admissions. The aim was to obtain a 'snapshot' of the risks of emergency surgery in the elderly and to analyse functional status both as a risk factor and as an outcome in this patient group. ⋯ Increasing age, higher American Society of Anesthesiologists physical status score and poorer pre-admission functional status appeared to be associated with increased complications and mortality. Although two-thirds of both functionally independent and partially dependent patients were discharged at their original level of function, 28% of partially dependent patients required discharge to a high-level care nursing home, whereas only 5% of the initially independent patients had this poor outcome. Improvement in our ability to stratify risk in this enlarging patient group should help improve our clinical decision-making, which may have benefits both for patients and resource allocation.
-
Anaesth Intensive Care · Jan 2012
Editorial CommentRisks of anaesthesia and surgery in elderly patients.