Anaesthesia and intensive care
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Anaesth Intensive Care · Jun 2000
Case ReportsVasopressin effective in reversing catecholamine-resistant vasodilatory shock.
A patient with perforated appendicitis developed progressive vasodilatory shock which was complicated by perioperative acute myocardial infarction. Cardiovascular support included dopamine infusion, and later, intra-aortic balloon counterpulsation balloon pump and noradrenaline and dobutamine infusion. Vasopressin was introduced as a final attempt to reverse the refractory shock and was associated with recovery. The experience with this case suggests that vasopressin may be a valuable adjunct to the treatment of catecholamine-resistant vasodilatory shock.
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Anaesth Intensive Care · Jun 2000
Anaesthesia and fatigue: an analysis of the first 10 years of the Australian Incident Monitoring Study 1987-1997.
The Australian Incident Monitoring Study (AIMS) database of the Australian Patient Safety Foundation (APSF) was reviewed from its inception in April 1987 to October 1997. A total of 5600 AIMS reports were lodged in that period. Reports in which fatigue was listed as a Factor Contributing to Incident were examined. ⋯ Anaesthetists reporting fatigue more often reported incidents during induction. These data suggest that fatigue alleviation strategies and equipment checking routines, improved workplace design (including drug ampoule and syringe labelling protocols) and regulation of working hours will facilitate minimization of fatigue-related incidents. Definitive prospective studies might be most usefully targeted at these and related interventions.
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Anaesth Intensive Care · Jun 2000
Case ReportsOesophageal rupture in a patient with postoperative nausea and vomiting.
Rupture of the oesophagus (Boerhaave's syndrome) is a rare complication of forceful or suppressed vomiting. Postoperative nausea and vomiting is common but does not usually lead to life-threatening complications. ⋯ Delayed diagnosis mandated conservative treatment. The clinical presentation, diagnosis and management of oesophageal rupture is discussed.
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Anaesth Intensive Care · Jun 2000
Letter Case ReportsDiathermy burn to a visitor in the operating theatre.
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Anaesth Intensive Care · Jun 2000
Letter Case ReportsEphedrine may predispose to arrhythmias in obstetric anaesthesia.