Anaesthesia and intensive care
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Anaesth Intensive Care · Jan 2021
Case ReportsAllergic contact dermatitis to a dye or alcohol in a chlorhexidine-based skin preparation: A case report.
This case report describes a patient who developed allergic contact dermatitis to a chlorhexidine skin preparation applied for a transversus abdominis plane block, but not to a different chlorhexidine solution applied to the surgical field. The patient had presented for an elective inguinal hernia repair. He had a known history of anaphylaxis to non-steroidal anti-inflammatory medication but was otherwise well. ⋯ The skin preparations differed in the dyes and alcohols that they contained. The dyes or alcohol in the preparation for the transversus abdominis plane block were therefore considered the likely cause of this patient's allergic reaction. Dyes and alcohols should be considered as a cause of skin allergy in the perioperative setting.
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Anaesth Intensive Care · Jan 2021
Meta AnalysisSafety and efficacy of routine diagnostic test reduction interventions in patients admitted to the intensive care unit: A systematic review and meta-analysis.
Reducing unnecessary routine diagnostic testing has been identified as a strategy to curb wasteful healthcare. However, the safety and efficacy of targeted diagnostic testing strategies are uncertain. The aim of this study was to systematically review interventions designed to reduce pathology and chest radiograph testing in patients admitted to the intensive care unit (ICU). ⋯ Of the 18 studies reporting a difference in testing rates, all reported a decrease associated with targeted testing (range 6%-72%), with 14 (82%) studies reporting >20% reduction in one or more tests. Studies of ICU targeted test interventions are generally of low quality. The majority report substantial decreases in testing without evidence of a significant difference in hospital mortality.
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Anaesth Intensive Care · Jan 2021
The effect of alcohol policy on intensive care unit admission patterns in Central Australia: A before-after cross-sectional study.
Alcohol misuse is a disproportionately large contributor to morbidity and mortality in the Northern Territory. A number of alcohol harm minimisation policies have been implemented in recent years. The effect of these on intensive care unit (ICU) admissions has not been fully explored. ⋯ Admissions with a primary diagnosis of trauma were lower (10.5% versus 4.7%, P < 0.01). This study demonstrated a reduction in ICU admissions associated with alcohol misuse following the implementation of new alcohol harm minimisation policies. This apparent reduction in alcohol-related harm is suggestive of the effectiveness of the Northern Territory's integrated alcohol harm reduction framework.