Anaesthesia and intensive care
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Anaesth Intensive Care · Jul 2014
Observational StudyCUSUM method for construction of trainee spinal ultrasound learning curves following standardised teaching.
Spinal ultrasonography is a promising aid for epidural insertion. We aimed to determine the learning curve of spinal ultrasonography tasks and the number of training scans required to reach competency after undergoing standardised step-wise teaching. Trainees were required to complete a minimum of 60 assessed scans on selected non-pregnant models following attendance at two training sessions, with feedback from an expert after each scan. ⋯ The average time taken to complete a scan was 163 seconds. Our study showed that after a standardised educational intervention, anaesthetic trainees are able to identify a lumbar interlaminar space easily and can measure the depth to the posterior complex after a reasonable number of additional practice scans, but experienced difficulty accurately marking the needle insertion point whilst using spinal ultrasonography. We confirmed that it was hard to achieve competency in all aspects of spinal ultrasonography, based on assessment using our predefined competency criteria.
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Anaesth Intensive Care · Jul 2014
Biography Historical ArticleThe Medical Officer's Journal: HMAS Sydney 1913-1922. An Australian Naval record of surgery and anaesthesia at the time of the outbreak of World War I.
The Medical Officer's Journal of HMAS Sydney was a record kept by the ship's Surgeon, Leonard Darby, of the conditions on the ship and the health, diseases, injuries and treatment of the sailor's under his care. Records of anaesthesia and surgery indicate chloroform was mostly administered as was ether occasionally. ⋯ The journal also provides an eyewitness account of the Sydney-Emden battle on 9 November 1914 which occurred off the Cocos Keeling Islands and was a famous first victory for the young Australian Navy, making headlines around the world. The treatment of the many injured, mostly Germans, is described; with the two Australian surgeons and the surviving German surgeon working together.
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Anaesth Intensive Care · Jul 2014
Syringe Drivers: incorrect selection of syringe type from the syringe menu may result in significant errors in drug delivery.
There have been many reported adverse incidents due to syringe driver use, most of which have been attributable to human error. In this paper we present a previously unreported, but potentially widespread practice which may result in significant over or under-delivery of medication. Even with the naked eye it is evident that syringes of equal volume have different dimensions and to quantify this we sectioned a range of syringes and measured the inner and outer dimensions. ⋯ There is a wide variation in syringe metrics and complex syringe menus may increase errors, resulting in significant under or over-delivery of medication. Availability of more than one brand of syringe in a clinical area increases the risk of adverse drug delivery events. Systems need to be implemented to minimise the risk of adverse events.
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Anaesth Intensive Care · Jul 2014
Editorial Biography Historical ArticleJeanette Thirlwell: three decades of service to the Journal.
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Anaesth Intensive Care · Jul 2014
Letter Randomized Controlled TrialIntrauterine instillation of lignocaine gel does not help in reducing pain after endometrial ablation.