Anaesthesia
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Oxygen pipeline failure is a rare but potentially catastrophic event which can affect the care of patients throughout an entire hospital. Anaesthetists play a critical role in maintaining patient safety, and should be prepared to support an institution-wide emergency response if oxygen failure occurs. We tested the preparedness for this through observation of 20 specialist anaesthetists to a standardised simulator scenario of central oxygen supply failure. ⋯ All anaesthetists demonstrated safe immediate patient care, but we observed a number of deviations from optimal management, including failure to conserve oxygen supplies and, following restoration of gas supplies, failure to test the composition of the gas supplied from the repaired pipelines. This has implications for patient care at both individual and hospital level. Our results indicate a gap in anaesthesia training which should be addressed, in conjunction with planning for effective hospital-wide responses to the event of critical resource failure.
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Idiopathic intracranial hypertension is a rare syndrome characterised by prolonged elevation of intracranial pressure in the absence of hydrocephalus, intracranial mass lesion or infection, and with increased cerebrospinal fluid pressure but a normal composition. We report a case of uncontrolled idiopathic intracranial hypertension successfully managed using an intrathecal catheter for analgesia in labour and delivery as well as temporary control of intracranial pressure.
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Illumination provided by laryngoscope blades varies widely. It is not known what the optimum level of illumination should be during laryngoscopy. So far, no published standards exist for light intensity provided by laryngoscopes. ⋯ The vacuum bulb laryngoscopes provides a significant lower light output than halogen and xenon laryngoscopes. There is a large variation in illumination requirements amongst anaesthetists which may make setting standards difficult. A brighter laryngoscope, as suggested by some manufacturers, may not necessarily be a better one.