Anaesthesia and intensive care
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Anaesth Intensive Care · Jan 2018
Case ReportsCannula cricothyroidotomy and rescue oxygenation with the Rapid-O2™ oxygen insufflation device in the management of a can't intubate/can't oxygenate scenario.
We describe the successful use of cannula cricothyroidotomy and the Rapid-O2™ oxygen insufflation device (Meditech Systems Ltd, Dorset, UK) for rescue of a can't intubate/can't oxygenate (CICO) scenario in a patient with severe airway haemorrhage post-debridement of laryngeal amyloidosis. This case highlights the practical utility of a cannula technique for CICO rescue when appropriate equipment is used and when institutional measures are taken to prepare for this rare anaesthetic crisis.
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Anaesth Intensive Care · Jan 2018
Observational StudyThe impact of alcohol-related admissions on resource use in critically ill patients from 2009 to 2015: an observational study.
Excessive alcohol use is associated with increased health care utilisation and increased mortality. This observational study sought to identify the proportion of patients admitted with a critical illness in which alcohol misuse contributed, and to examine the resource use for this group. We performed an observational retrospective database review of all admissions to the Alice Springs Hospital intensive care unit (ICU) between 1 January 2009 and 31 December 2015. ⋯ Admissions associated with alcohol were significantly more likely to require mechanical ventilation (30% versus 20%, P <0.01), and had a significantly longer ICU length of stay (2.1 versus 1.9 days, P <0.05). The proportion of admissions in which alcohol misuse was implicated is amongst the highest in the published literature. The results of this study should drive further policy change directed at harm minimisation, and warrant more detailed epidemiological work at both a local and national level.
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Failed airway management in the obstetric patient undergoing general anaesthesia is associated with major sequelae for the mother and/or fetus. Effective and adequate pre-oxygenation is an important safety strategy and a recommendation in all current major airway guidelines. ⋯ We review the current literature surrounding high flow nasal oxygen relevant to the pregnant woman. We also propose a basis for potential advantages and complications for its use in this context.