Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2018
Prospective pilot study of cerebral near infrared spectroscopy monitoring during pre-hospital anaesthesia.
Near-infrared spectroscopy (NIRS) provides a non-invasive measure of cerebral tissue oxygenation. The literature on application of this method in pre-hospital setting is limited. The aims of this study were to determine the feasibility of cerebral NIRS during pre-hospital anaesthesia and to quantify the changes in front lobe regional oxygen saturation (rSO2) during the pre-hospital phase. ⋯ NIRS is feasible during pre-hospital anaesthesia and substantial changes were observed in some patients. It provides data beyond the standard monitoring used in the pre-hospital setting.
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Acta Anaesthesiol Scand · Sep 2018
Standardised assessment of competence in Focused Assessment with Sonography for Trauma.
The aim of this study was to develop and gather validity evidence for a standardised test of competence in Focused Assessment with Sonography for Trauma (FAST) and to define the appropriate cut-off point in simulation-based learning of the FAST protocol. ⋯ The FAST simulation-based test provided valid assessment of competence in FAST. The FAST test could be used to guide training and ensure basic competence of physicians using FAST.
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Acta Anaesthesiol Scand · Sep 2018
Change in Mallampati class during labor: Hypertensive versus normotensive parturients.
Mallampati class has been shown to increase during labor. There are no prospective studies evaluating airway changes in hypertensive parturients during labor. The aim of our study was to observe the frequency of change in Mallampati class during labor in hypertensive compared to normotensive parturients. ⋯ Mallampati class showed 2-fold increase in hypertensive compared to normotensive parturients during labor; requiring additional caution during airway management.
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We have surveyed the use of procalcitonin (PCT) in Finland with a specific emphasis on intensive care unit (ICU) patients. ⋯ The use of PCT in Finland varies significantly between hospitals, even though the national guideline proposes its use for septic patients.
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Acta Anaesthesiol Scand · Sep 2018
Analysis of preventable deaths and errors in trauma care in a Scandinavian trauma level-I centre.
The wide disparity in the methodology of preventable death analysis has created a lack of comparability among previous studies. The guidelines for the peer review (PR) procedure suggest the inclusion of risk-adjustment methods to identify patients to review, that is, exclude non-preventable deaths (probability of survival [Ps] < 25%) or focus on preventable deaths (Ps > 50%). We aimed to, through PR process, (1) identify preventable death and errors committed in a level-I trauma centre, and (2) explore the use of different risk-adjustment methods as a complement. ⋯ Preventable deaths were commonly caused by clinical judgment errors in the early phases but death occurred late. Ps calculated with NORMIT was more accurate than TRISS in predicting mortality, but both perform poorly in identifying preventable and non-preventable deaths when applying the cut-offs. PR of all trauma death is still the golden standard in preventability analysis.