Validity evidence of non-technical skills assessment instruments in simulated anaesthesia crisis management
We sought to evaluate the validity of two non-technical skills evaluation instruments, the Anaesthetists ’ Non-Technical Skills (ANTS) behavioural marker system and the Ottawa Global Rating Scale (GRS), to apply them to anaesthesia training. The content validity, response process, internal structure, relations with other variables and consequences were described for validity evidence. Simulated crisi s management sessions were initiated during which two trained raters evaluated the performance of postgraduate first-, second- and third-year (PGY-1, PGY-2 and PGY-3) anaesthesia residents. The study included 70 participants...
Source: Anaesthesia and Intensive Care - July 4, 2017 Category: Anesthesiology Source Type: research
Does anyone ever expect to die?
Patients who come to the intensive care unit are amongst the sickest patients in our hospitals. Patients can be admitted to the intensive care unit unexpectedly (following accidents or sudden onset of illness) or as unplanned but not necessarily truly ‘unexpected’ admissions. These patients often have significant underlying chronic health issues, including metastatic cancer, advanced cardiac, respiratory, renal, or hepatic failure, or frailty, with a high likelihood of death in the ensuing months. Using the Australian and New Zealand Intensiv e Care Society Clinical Trials Group Point Prevalence Program, a prospective ...
Source: Anaesthesia and Intensive Care - July 4, 2017 Category: Anesthesiology Source Type: research
The effect of a perioperative ketamine infusion on the incidence of chronic postsurgical pain —a pilot study
Chronic postsurgical pain (CPSP) is a common and debilitating complication of major surgery. We undertook a pilot study at three hospitals to assess the feasibility of a proposed large multicentre placebo-controlled randomised trial of intravenous perioperative ketamine to reduce the incidence of CPSP. Ketamine, 0.5 mg/kg pre-incision, 0.25 mg/kg/hour intraoperatively and 0.1 mg/kg/hour for 24 hours, or placebo, was administered to 80 patients, recruited over a 15-month period, undergoing abdominal or thoracic surgery under general anaesthesia. The primary endpoint was CPSP in the area of the surgery reported at six-month ...
Source: Anaesthesia and Intensive Care - July 4, 2017 Category: Anesthesiology Source Type: research
Randomised comparison of three types of continuous anterior abdominal wall block after midline laparotomy for gynaecological oncology surgery
Effective analgesia after midline laparotomy surgery is essential for enhanced recovery programs. We compared three types of continuous abdominal wall block for analgesia after midline laparotomy for gynaecological oncology surgery. We conducted a single-centre, double-blind randomised controlled trial. Ninety-four patients were randomised into three groups to receive two days of programmed intermittent boluses of ropivacaine (18 ml 0.5% ropivacaine every four hours) via either a transversus abdominis plane (TAP) catheter, posterior rectus sheath (PRS) catheter, or a subcutaneous (SC) catheter. All groups received patient-...
Source: Anaesthesia and Intensive Care - July 4, 2017 Category: Anesthesiology Source Type: research
Primary prevention in the intensive care unit: a prospective single-centre study of the risk factors for invasive pneumococcal disease
Invasive pneumococcal disease is a significant health burden in Australia, with immunisation recommended for children and at-risk adults. Health benefits of immunisation are clear, but less effective when immunisation rates are low, as in Western Australia. We hypothesised that patients admitted unplanned to the intensive care unit (ICU) would have high eligibility for pneumococcal immunisation, but low rates of recorded vaccine administration. We performed a prospective observational study of 119 emergency admissions to Royal Perth ICU, a 20-bed mixed ICU at a tertiary teaching hospital in Western Australia. Each admissio...
Source: Anaesthesia and Intensive Care - July 4, 2017 Category: Anesthesiology Source Type: research
Awareness during general anaesthesia in the first 4,000 incidents reported to webAIRS
The aim of this study was to analyse the incidents related to awareness during general anaesthesia in the first 4,000 cases reported to webAIRS —an anaesthetic incident reporting system established in Australia and New Zealand in 2009. Included incidents were those in which the reporter selected “neurological” as the main category and “awareness/dreaming/nightmares” as a subcategory, those where the narrative report included the w ord “awareness” and those identified by the authors as possibly relevant to awareness. Sixty-one awareness-related incidents were analysed: 16 were classified as “awareness”, 31...
Source: Anaesthesia and Intensive Care - July 4, 2017 Category: Anesthesiology Source Type: research
Pain after surgery —acute becomes chronic: might there be a silver ROCKet?
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - July 4, 2017 Category: Anesthesiology Source Type: research
Changing of the guard
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - July 4, 2017 Category: Anesthesiology Source Type: research
Noel Morris Cass, 1927-2017
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - July 4, 2017 Category: Anesthesiology Source Type: research
The introduction of intravenous crystalloids
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - July 4, 2017 Category: Anesthesiology Source Type: research
Epidural saline in post –dural puncture headache: how much?
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
In Reply
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
The influence of survey timing on anaesthesia trainees ’ reported sources of stress
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
In reply
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
Safety of nicotine replacement therapy in critically ill patients
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
