Singap Med J
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In recent years, there has been a paradigm shift from an inpatient to outpatient preanaesthesia evaluation. This has been driven by rising healthcare costs and the increasing popularity of ambulatory and same-day admission surgery. These outpatient preanaesthesia clinics play an important role in enhancing the cost-effectiveness of the perioperative process. This review describes the structure of modern outpatient preanaesthesia evaluation clinics, and the associated benefits, limitations and controversies.
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In the year 2002, the Society for Emergency Medicine in Singapore Chapter of Paramedics organised the first emergency medical services (EMS) day, to educate the public about basic emergency response skills and to increase public awareness of the local EMS System. ⋯ Continuing efforts should be made to increase public awareness of the EMS system as well as to manage public expectations regarding response times and the roles of paramedics. EMS day represents one such opportunity.
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Pulmonary tuberculosis is still a major health problem worldwide, but the principles of diagnosis and treatment are well-established. Endobronchial tuberculosis (EBTB) is known to complicate pulmonary tuberculosis and its importance lies in the potential for bronchostenosis. In the absence of parenchymal disease, EBTB is less well-recognised and can lead to difficulties in diagnosis. ⋯ Although the chest radiograph did not show any lung infiltrate, a bronchoscopy was carried out. The findings, suspicious of malignancy, were actually due to EBTB, which was confirmed on histology by special stains and on culture for Mycobacterium tuberculosis. The patient subsequently developed bronchostenosis, a well-described complication.
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Comparative Study
Emergency physician versus cardiologist-initiated thrombolysis for acute myocardial infarction: a Singapore experience.
To compare the door-to-needle time between thrombolysis administration for patients with ST elevation myocardial infarction (STEMI) in the emergency department (EMD) by emergency physicians and those administered in the coronary care unit (CCU) by cardiologists. ⋯ Emergency physicians can administer thrombolytic treatment appropriately, quickly and safely in patients with STEMI.
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Clinical Trial
Antenatal use of a novel vaginal birth training device by term primiparous women in Singapore.
To study the use, safety and effectiveness of a novel antenatal vaginal birth training device (EPI-NO) in primiparous women. ⋯ EPI-NO appeared to be safe and acceptable to the majority of users. Although birth training with EPI-NO significantly decreases the rate of episiotomies in term primiparous patients, and the degree of perineal tissue injury appeared to be less in the EPI-NO group especially among those with lacerations, the overall perineal trauma rate was slightly but not significantly lower, in view of the higher spontaneous laceration rate in the EPI-NO group.