Anaesthesia
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Threshold systolic arterial pressure alarms often use pre-operative values as a guide for intra-operative values. Recently, two systems (normalisation and principal component analysis) have been described that use the 'current' systolic arterial pressure and the change in systolic arterial pressure over a preceding time interval to generate an alarm based on units of standard deviation. ⋯ Systolic blood pressure data, collected from 10 patients (a total of 2177 min at 100 Hz), were cleaned and submitted to analysis using threshold alarms, normalisation and principal component analysis. With the threshold alarms set at 100 mmHg (low) and 140 mmHg (high), and a 5-min window, the alarms were activated for 557 min; using statistics-based thresholds the alarms were activated for 169 min (normalisation) and 155 min (principal component analysis), a reduction of approximately 70-72%.
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We describe the initial management and subsequent recovery of a 61 year-old male patient following attempted suicide by oral ingestion of a potentially fatal overdose of quetiapine and sertraline. Intravenous Intralipid was given soon after initiation of basic resuscitation. ⋯ No other clinical signs of drug toxicity were observed. Intralipid may have reversed the deep coma associated with ingestion and prevented other manifestations of drug toxicity occurring, thus expediting this patient's recovery.
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Comparative Study
The TEG vs the ROTEM thromboelastography/thromboelastometry systems.
We have evaluated the TEG thromboelastograph and the ROTEM thromboelastometer, two point-of-care devices that measure blood coagulation. During a one-week period, seven consultant anaesthetists, one consultant haematologist, one associate specialist anaesthetist and two senior trainee anaesthetists were trained by the manufacturers and set up, calibrated and used both systems, after which their views were obtained and specific technical/support information was sought from the manufacturers using a questionnaire. Although the devices shared common features, they differed in complexity and aspects of ease of use, and in their purchase and running costs.
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Randomized Controlled Trial Comparative Study
Ease of intubation with the GlideScope or Airway Scope by novice operators in simulated easy and difficult airways--a manikin study.
The GlideScope and Airway Scope are video laryngoscopes that have been found to be useful in difficult airway situations. With the GlideScope, there are frequently problems associated with insertion of the tracheal tube despite the ability to view the glottis. The Airway Scope's imaging system and disposable PBlade aid alignment of the PBlade with the glottis and guide insertion of the tracheal tube. ⋯ We found that the students required less time for tracheal intubation with the Airway Scope and reported greater ease of intubation with the Airway Scope in both scenarios. A greater number of students chose the Airway Scope as their device of choice. Our results suggest that the Airway Scope's features may improve the ease of tracheal intubation compared with the GlideScope.