British journal of anaesthesia
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This project was devised to estimate the incidence of major complications of airway management during anaesthesia in the UK and to study these events. ⋯ Although these data suggest the incidence of death and brain damage from airway management during general anaesthesia is low, statistical analysis of the distribution of reports suggests as few as 25% of relevant incidents may have been reported. It therefore provides an indication of the lower limit for incidence of such complications. The review of airway management indicates that in a majority of cases, there is 'room for improvement'.
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Multicenter Study
ICU fire evacuation preparedness in London: a cross-sectional study.
Hospital fires present a sporadic but significant threat to patients and staff. This is especially so within an intensive care unit (ICU) setting, due to the complexity of moving acutely unwell patients reliant on invasive monitoring and organ support. Despite an average of 500 in-hospital fires reported to the UK department of health per annum, causing 65 injuries and 1-2 fatalities, the readiness of ICUs for urgent evacuation has not been assessed. ⋯ Forward planning for an urgent evacuation can be improved.
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Randomized Controlled Trial
Analysing a family-centred preoperative intervention programme: a dismantling approach.
The goal of this project was to identify key effective components of ADVANCE, a family-centred preoperative intervention programme, through the use of a dismantling approach. ADVANCE was previously demonstrated to be more effective than parental presence and just as effective as midazolam in reducing children's preoperative anxiety. The total programme, however, may be difficult to implement in hospitals across the country. ⋯ Shaping and exposure (i.e. practise with the anaesthesia mask) and parental use of distraction in the surgical setting are two beneficial components that could be included in preoperative preparation programmes that will be designed in the future.
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Randomized Controlled Trial Comparative Study
Comparison of transversus abdominis plane block vs spinal morphine for pain relief after Caesarean section.
Transversus abdominis plane (TAP) block is an alternative to spinal morphine for analgesia after Caesarean section but there are few data on its comparative efficacy. We compared the analgesic efficacy of the TAP block with and without spinal morphine after Caesarean section in a prospective, randomized, double-blinded placebo-controlled trial. ⋯ Spinal morphine-but not TAP block-improved analgesia after Caesarean section. The addition of TAP block with bupivacaine 2 mg kg(-1) to spinal morphine did not further improve analgesia.
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Randomized Controlled Trial
Continuous care and empathic anaesthesiologist attitude in the preoperative period: impact on patient anxiety and satisfaction.
Continuous care (one anaesthesiologist per patient) and anaesthesiologist empathy at the preoperative visit could affect patient anxiety and satisfaction. We tested both unproven issues in a population at increased risk of anxiety and dissatisfaction. ⋯ The 'one patient, one anaesthesiologist' model, in addition to ensuring sufficient time for open discussion and questions at the preoperative visit, improved patient satisfaction.