Anaesthesia and intensive care
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Anaesth Intensive Care · Feb 2025
Experiences of Australian anaesthetists and anaesthetic trainees of working whilst pregnant: Results of a national survey.
Changing medical workforce demographics emphasise the need to understand and effectively manage pregnancy in the workplace. An Australian survey exploring pregnancy experiences of specialists and trainees working in anaesthesia received 242 responses describing 549 pregnancies. One hundred and sixty-two (67%) of these respondents were aged 31-40 years, 185 (76%) were specialists and 159 (66%) reported one or two pregnancies. ⋯ Overall, 171 (71%) of respondents were satisfied with their experience of working in anaesthesia whilst pregnant. Thematic analysis of free text comments identified three major themes: workplace culture, maternal and fetal wellbeing, and career impacts on both pregnancy and family planning. Development of multilevel mechanisms to guide and support pregnant trainees and specialists in anaesthesia is recommended to address these findings.
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Anaesth Intensive Care · Feb 2025
Perioperative anaphylaxis in Malaysia: A nine-year retrospective study.
Diagnosis of perioperative anaphylaxis (POA) and identification of causative agents remain challenging. This study aimed to describe the estimated incidence, characteristics and causative agents of POA in Malaysia. This is a retrospective review of all cases of suspected POA referred to the only anaesthetic allergy centre in Malaysia from March 2014 to December 2022. ⋯ For antibiotics, the commonest causative agents were cefuroxime, ceftriaxone and amoxicillin/clavulanic acid. Using these data, the estimated incidence of Grades 2-4 POA over this period in Malaysia was approximately 1 in 30,000 anaesthetics. However, owing to the voluntary nature of reporting, it is possible that this is an underestimate, particularly in relation to some milder Grade 2 cases which may have gone unrecognised or unreported.
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Anaesth Intensive Care · Feb 2025
The elective use of percutaneous transtracheal oxygen insufflation for laryngeal surgery in a patient with a known difficult airway.
We report the case of successful elective percutaneous transtracheal oxygen insufflation in a patient with high-grade laryngeal stenosis, requiring repeat surgical laryngeal dilation, in the setting of multiple previous failed attempts at intubation and ventilation. This case report highlights the role of this technique as an initial management plan to provide general anaesthesia in a safe and simple way to patients with a known difficult airway. We also describe the use of an intravenous extension kit which allowed end-tidal carbon dioxide to be measured during transtracheal oxygen insufflation.