Anaesthesia
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Randomized Controlled Trial Comparative Study
A prospective randomised study of a rigid video-stylet vs. conventional lightwand intubation in cervical spine-immobilised patients.
Compared with a lightwand which is used blind, Optiscope™ , a rigid video-stylet, can provide direct imaging of airway structures, potentially offering improved conditions in cervical spine-immobilised patients. We randomly assigned 168 patients who required cervical immobilisation during tracheal intubation to use of the Optiscope or the lightwand. ⋯ The incidence of postoperative airway complications was similar in the two groups. The devices were equivalent with respect to initial intubation success rate but the Optiscope yielded slightly longer intubating times.
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Implementation of a quality improvement bundle for peri-operative management of emergency laparotomy (ELPQuIC) improved mortality in a previous study. We used data from one site that participated in that study to examine whether it was associated with the cost of care. We collected data from 396 patients: 144 before, 144 during and 108 after implementation of the bundle. ⋯ The costs per patient and per survivor did not differ between the time periods, p = 0.87 and p = 0.17, respectively. Costs were similar for patients aged < 80 years vs. ≥ 80 years. Implementation of a quality improvement bundle for emergency laparotomy has the capacity to save lives without increasing hospital costs.