Anaesthesia
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The Human Rights Act 1998 was incorporated into UK statutory law on October 2, 2000. The 18 Articles of the Act are likely to have a significant impact on the practice of medicine in the UK, particularly in reference to consent, disclosure of medical information and patient access to healthcare. This article examines the implications of the new legislation for anaesthetic and intensive care practice.
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An increasing number of patients are taking herbal medicines such as echinacea, garlic, ginkgo biloba, ginseng, St John's Wort, valerian, ephedra, kava, grapefruit juice and ginger. Although these herbal medications are considered 'natural' products that may have some benefits, adverse effects such as increased bleeding tendencies and drug interactions are associated with their use. ⋯ Anaesthetists and surgeons must be familiar with the effects of herbal medicines and should specifically enquire about the use of herbal medicines during pre-operative assessment. Currently available data suggest that all herbal medicines should be ceased 2 weeks before surgery.
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Respiratory monitoring is an important aspect of critical care, especially in neurosurgery and neuro-intensive care. Fixed capnographs are too cumbersome to allow monitoring during patient transport. ⋯ We compared the Criticare POET LT Handheld expired fraction carbon dioxide monitor, in three different settings, to fixed capnographs and arterial blood gas analysis. A methodology for systematic appraisal of end-tidal capnographs is proposed.
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A postal survey was sent to all anaesthetic departments in the UK to identify current practice and gain insight into anaesthetists' attitudes regarding the use of anaesthetic rooms for induction of general anaesthesia. Replies were received from 247 (88%) departments. Of these, 10 (4%) departments routinely anaesthetise all patients in theatre. ⋯ Only 9.7% of all respondents believed that clinical governance would necessitate a change to anaesthetizing all patients in theatre compared to 25% who believed that the increasing costs of monitoring equipment would lead to a change. Overall 79% of respondents prefer to use the anaesthetic room, 16% prefer in-theatre induction and 5% expressed no preference. However, of those who routinely anaesthetise in theatre, 70% thought it to be preferable.