Anaesthesia and intensive care
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Anaesth Intensive Care · Sep 2021
Randomized Controlled TrialVentilatory performance of AMBU® AuraGain™ and LMA® Supreme™ in laparoscopic surgery: A randomised controlled trial.
The Ambu® AuraGain™ (Ambu A/S, Ballerup, Denmark) is a newer phthalate-free, single-use supraglottic device with the advantage of a facility for tracheal intubation if necessary intraoperatively. We compared the oropharyngeal leak pressures and other performance variables between the AMBU AuraGain and the LMA® Supreme™ (Teleflex Medical, Athlone, Co. Westmeath, Ireland) in patients undergoing laparoscopic cholecystectomy and preperitoneoscopic inguinal herniorrhaphy with carbon dioxide insufflation under controlled ventilation. ⋯ No cases of regurgitation and aspiration occurred, and minor postoperative complications were similar. The AuraGain exhibited higher oropharyngeal leak pressures than the LMA Supreme, but was slightly more difficult to insert. The higher oropharyngeal leak pressures suggest that ventilation might be less affected by high peak inspiratory pressures when using the AuraGain than the LMA Supreme.
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Anaesth Intensive Care · Sep 2021
More than half of front-line healthcare workers unknowingly used an N95/P2 mask without adequate airborne protection: An audit in a tertiary institution.
Front-line staff routinely exposed to aerosol-generating procedures are at a particularly high risk of transmission of severe acute respiratory syndrome coronavirus 2. We aimed to assess the adequacy of respiratory protection provided by available N95/P2 masks to staff routinely exposed to aerosol-generating procedures. We performed a prospective audit of fit-testing results. ⋯ This audit highlights that without fit-testing over 50% of healthcare workers were using an N95/P2 mask that provided insufficient airborne protection. This high unnoticed prevalence of unfit masks among healthcare workers can create a potentially hazardous false sense of security. However, fit-testing of different masks not only improved airborne protection provided to healthcare workers but also increased their confidence around mask protection.
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Anaesth Intensive Care · Sep 2021
Historical ArticleDoron medicum-the gift of medicine: How a rare 17th century medical translation positively impacted the community and predicted current analgesic techniques.
In 1683, a self-proclaimed apothecary physician and London professor of physick by the name of Guilelmus (William) Salmon authored a pharmacopoeia titled Doron medicum, the 'gift of medicine' (Greek/Latin translation). This text formulates an English supplement to the Latin Materia medica (16th century), discussing internal and external compound medicines of the late 17th century. This pharmacopoeia enabled those incapable of reading Latin to provide medical care to a challenging post-plague community. ⋯ A selection of opiate-based analgesic therapies, early critical care strategies and animal preparations are revisited. A small chronicle of William Salmon's life and professional achievements will be reviewed. Debate surrounding the opening of the first London Dispensary will be discussed in relation to William Salmon's contribution, echoing ongoing contemporary challenges in healthcare over 300 years later.