1
|
Alam F, LeBlanc VR, Baxter A, Tarshis J, Piquette D, Gu Y, Filipowska C, Krywenky A, Kester-Greene N, Cardinal P, Andrews M, Chartier F, Burrows C, Houzé-Cerfon CH, Burns JK, Kaustov L, Au S, Lam S, DeSousa S, Boet S. Age and its impact on crisis management performance and learning after simulation-based education by acute care physicians: a multicentre prospective cohort study. Br J Anaesth 2024; 132:383-391. [PMID: 38087740 DOI: 10.1016/j.bja.2023.10.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Physiological changes associated with ageing could negatively impact the crisis resource management skills of acute care physicians. This study was designed to determine whether physician age impacts crisis resource management skills, and crisis resource management skills learning and retention using full-body manikin simulation training in acute care physicians. METHODS Acute care physicians at two Canadian universities participated in three 8-min simulated crisis (pulseless electrical activity) scenarios. An initial crisis scenario (pre-test) was followed by debriefing with a trained facilitator and a second crisis scenario (immediate post-test). Participants returned for a third crisis scenario 3-6 months later (retention post-test). RESULTS For the 48 participants included in the final analysis, age negatively correlated with baseline Global Rating Scale (GRS; r=-0.30, P<0.05) and technical checklist scores (r=-0.44, P<0.01). However, only years in practice and prior simulation experience, but not age, were significant in a subsequent stepwise regression analysis. Learning from simulation-based education was shown with a mean difference in scores from pre-test to immediate post-test of 2.28 for GRS score (P<0.001) and 1.69 for technical checklist correct score (P<0.001); learning was retained for 3-6 months. Only prior simulation experience was significantly correlated with a decreased change in learning (r=-0.30, P<0.05). CONCLUSIONS A reduced amount of prior simulation training and increased years in practice, but not age on its own, were significant predictors of low baseline crisis resource management performance. Simulation-based education leads to crisis resource management learning that is well retained for 3-6 months, regardless of age or years in practice.
Collapse
Affiliation(s)
- Fahad Alam
- Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Anesthesiology & Pain Medicine University of Toronto, Toronto, ON, Canada.
| | - Vicki R LeBlanc
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada; University of Ottawa Simulation & Skills Centre, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Alan Baxter
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Jordan Tarshis
- Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Anesthesiology & Pain Medicine University of Toronto, Toronto, ON, Canada
| | - Dominique Piquette
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Yuqi Gu
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Caroline Filipowska
- Department of Emergency Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Ashley Krywenky
- Department of Emergency Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Nicole Kester-Greene
- Department of Emergency Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Pierre Cardinal
- Department of Critical Care Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Meghan Andrews
- Department of Anesthesiology and Pain Medicine, Montfort Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Francois Chartier
- Le Centre Hospitalier Affilié Universitaire Régional (CHAUR), Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec (CIUSSS MCQ), Trois-Rivière, QC, Canada
| | - Claire Burrows
- Department of Anaesthesia, Western Health, Melbourne, VIC, Australia; Western Health Anaesthesia and Critical Care Simulation, Melbourne, VIC, Australia
| | - Charles-Henri Houzé-Cerfon
- Department of Emergency Medicine, Toulouse University Hospital, Toulouse, France; Toulouse Institute of Simulation Healthcare, Toulouse University Hospital, Toulouse, France
| | - Joseph K Burns
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Lilia Kaustov
- Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Shelly Au
- Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Sandy Lam
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Susan DeSousa
- Sunnybrook Canadian Simulation Centre, Toronto, ON, Canada
| | - Sylvain Boet
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada; Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
2
|
AlDobekhi F. Assessment of Knowledge and Attitude of Anaesthetists in Utilizing Telehealth-Based Pre-anaesthesia Evaluation. Cureus 2024; 16:e51663. [PMID: 38313912 PMCID: PMC10838142 DOI: 10.7759/cureus.51663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/31/2023] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND This study aims to assess anaesthesiologists' understanding and attitudes toward utilizing telehealth for pre-anaesthesia evaluations (PAEs) in instances where a scheduled surgery is deferred to the procedure day due to hospital or patient-related reasons. METHODOLOGY This observational cross-sectional study involved anaesthesiologists with over six months of hospital experience, opting to participate voluntarily. Non-probability sampling was employed for participant selection. The study's objectives were communicated, and consent was obtained. Data were recorded in Microsoft Excel and analyzed using STATA 12.0. RESULTS Of the 237 participating anaesthetists, 155 were aged 21 to 40. Notably, 88.6% (n=210) expressed interest in advanced telemedicine learning, and 77.6% (n=184) were keen on its implementation. Common sources of information included tele-diagnosis (n=194), tele-education, counselling (n=147), and tele-surveillance, with additional input from telesurgery, tele-triage, tele-monitoring, and teleradiology. CONCLUSION The study highlights anaesthetists' strong enthusiasm for adopting advanced telemedicine and teleconferencing. Predominant information sources included tele-diagnosis, tele-education, tele-counselling, and tele-surveillance. The majority endorsed the potential of telemedicine to aid patients, expressing comfort in using it for pre-anaesthesia examinations.
Collapse
|
3
|
Zhang F, Liu HM, Wang YF, Tang TY, Li HB, Huang YS, Yan YT, Liu KX. Mediating effect of COVID-19 related negative sentiment on the relationship between COVID-19 infection indicators and burnout among Chinese anaesthesiologists in the post-pandemic era. Br J Anaesth 2023; 131:e160-e162. [PMID: 37741723 DOI: 10.1016/j.bja.2023.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/18/2023] [Accepted: 08/20/2023] [Indexed: 09/25/2023] Open
Affiliation(s)
- Fu Zhang
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Hua-Min Liu
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yi-Fan Wang
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Tian-Ying Tang
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Hai-Bo Li
- Department of Anesthesiology, Chifeng Municipal Hospital, Chifeng, Inner Mongolia, China
| | - Yi-Sheng Huang
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Department of Anesthesiology, Ganzhou People's Hospital, Ganzhou, Jiangxi, China
| | - Yang-Tian Yan
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Ke-Xuan Liu
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| |
Collapse
|
4
|
Nazir N. Evaluation of the Effect of Intubation Box use on Tracheal Intubation Difficulty with King Vision(®) and Truview Videolaryngoscope in Manikin in a Tertiary Care Hospital. Rom J Anaesth Intensive Care 2021; 28:25-8. [PMID: 36846538 DOI: 10.2478/rjaic-2021-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
Background The procedures of introducing an airway by intubation are associated with increased risk of aerosolisation of SARS-CoV-2 virus, posing a high risk to the personnel involved. Newer and novel methods such as the intubation box have been developed to increase the safety of healthcare workers during intubation. Methods design In this study, 33 anaesthesiologist and critical care specialists intubated the trachea of the airway manikin (US Laerdal Medical AS™) 4 times using a King Vision® videolaryngoscope and TRUVIEW PCD™ videolaryngoscope (with and without an intubation box as described by Lai). Intubation time was primary outcome. Secondary outcomes were first-pass intubation success rate, percentage of glottic opening (POGO) score and peak force to maxillary incisors. Results Intubation time and the number of times a click was heard during tracheal intubation were considerably higher in both groups when an intubation box was used (Table 1). When comparing the two laryngoscopes, the King Vision® videolaryngoscope enabled much less time to intubate than did the TRUVIEW laryngoscope, both with and without the intubation box. (P<0.001) In both laryngoscope groups, first-pass successful intubation was higher without the intubation box, although the difference was statistically insignificant. POGO score was not affected by intubation box but a higher score was observed with King Vision® laryngoscope (Tables 1,2). Conclusion This study indicates that use of an intubation box makes intubation difficult and increases the time needed to perform it. King Vision® videolaryngoscope results in lesser intubation time and better glottic view as compared to TRUVIEW laryngoscope.
Collapse
|
5
|
Paal P, Zafren K, Pasquier M. Higher pre-hospital anaesthesia case volumes result in lower mortality rates: implications for mass casualty care. Br J Anaesth 2021; 128:e89-e92. [PMID: 34794765 DOI: 10.1016/j.bja.2021.10.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 01/30/2023] Open
Abstract
Senior physicians with a higher pre-hospital anaesthesia case volume have higher first-pass tracheal intubation success rates, shorter on-site times, and lower patient mortality rates than physicians with lower case volumes. A senior physician's skill set includes the basics of management of airway and breathing (ventilating and oxygenating the patient), circulation, disability (anaesthesia), and environment (especially maintaining core temperature). Technical rescue skills may be required to care for patients requiring pre-hospital airway management especially in hazardous environments, such as road traffic accidents, chemical incidents, terror attacks or warfare, and natural disasters. Additional important tactical skills in mass casualty situations include patient triage, prioritising, allocating resources, and making transport decisions.
Collapse
Affiliation(s)
- Peter Paal
- Department of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Salzburg, Austria.
| | - Ken Zafren
- Department of Emergency Medicine, Alaska Native Medical Center, Anchorage, AK, USA; Department of Emergency Medicine, Stanford University Medical Center, Stanford, CA, USA
| | - Mathieu Pasquier
- Emergency Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
6
|
Chen KJ, Tai YT, Chang EH, Kuo LN, Kuo CN. Effectiveness of collaboration between oncology pharmacists and anaesthesiologists for inpatient cancer pain management: A pilot study in Taiwan. J Int Med Res 2021; 49:3000605211055415. [PMID: 34772313 PMCID: PMC8593302 DOI: 10.1177/03000605211055415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of the collaboration between oncology pharmacists and anaesthesiologists for improving pain control management in cancer patients. METHODS This retrospective case-control pilot study enrolled inpatients with active cancer and a pain score of >3 at least once per day for 3 consecutive days. The study group was selected from June 2018 to January 2019. Patients with the same inclusion criteria were selected between November 2017 and May 2018 to serve as the comparison group. The primary outcome was the percentage of patients that experienced pain relief within 7 days from initial pain attack. RESULTS A total of 71 and 77 patients were enrolled in the study and comparison groups. More patients in the study group experienced pain relief within 7 days from the index date (78.9% [56 of 71 patients] versus 72.7% [56 of 77 patients], respectively). The service increased the rate of intervention from attending physicians within 4 days from index date and quality of opioid management. CONCLUSION The collaboration between oncology pharmacists and anaesthesiologists for cancer pain management may be associated with an increase in the rate of pain relief in cancer patients with poor pain control.
Collapse
Affiliation(s)
- Kuan-Ju Chen
- Department of Pharmacy, 38032Taipei Medical University, Wan Fang Hospital, Taipei Medical University, Taipei.,Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei
| | - Yu-Ting Tai
- Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei
| | - Elizabeth H Chang
- Department of Pharmacy, 38032Taipei Medical University, Wan Fang Hospital, Taipei Medical University, Taipei.,Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei.,Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Li-Na Kuo
- Department of Pharmacy, 38032Taipei Medical University, Wan Fang Hospital, Taipei Medical University, Taipei.,Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei
| | - Chun-Nan Kuo
- Department of Pharmacy, 38032Taipei Medical University, Wan Fang Hospital, Taipei Medical University, Taipei.,Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei
| |
Collapse
|
7
|
Sneyd JR. What we do, what we call ourselves, and how we spell it. Br J Anaesth 2021; 127:505-508. [PMID: 34548151 DOI: 10.1016/j.bja.2021.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- J Robert Sneyd
- Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, UK.
| |
Collapse
|
8
|
Rönnberg L, Nilsson U, Hellzén O, Melin-Johansson C. Beyond the monitors: Anaesthesiologists' experiences of the process of extubation. Scand J Caring Sci 2021; 36:988-996. [PMID: 34021616 DOI: 10.1111/scs.12996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/11/2021] [Accepted: 04/18/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although extubation is a high-risk phase associated with risk of severe complications for patients undergoing general anaesthesia, there is a lack of research about this phenomenon from the perspective of anaesthesiologists' experiences of the process of extubation in the anaesthesia setting. AIM To describe Swedish anaesthesiologists' experiences of the extubation process in the anaesthesia setting. METHODS A qualitative descriptive design study with individual semi-structured interviews was conducted in three hospitals in Sweden with a total of 17 anaesthesiologists. A qualitative manifest content analysis method was used to analyse the data. RESULTS The anaesthesiologists' experiences were described in two categories: To assemble sensibilities, where the anaesthesiologists are receptive to inputs, create tailored plans, are guided by emotions and experiences, and sense the atmosphere in the process of extubation; and To stay focused, where they understand the importance of preparation and being prepared, and of being calm and strategic, and of needing to trust the registered nurse anaesthetist in the process of extubation. CONCLUSIONS Decision-making regarding the process of extubation does not rely solely on monitoring signs; rather, the anaesthesiologists described how, by looking beyond the monitors and by being receptive to inputs from the patient and other professionals, their experience and intuition guides them through the process of extubation.
Collapse
Affiliation(s)
- Linda Rönnberg
- Department of Nursing Sciences, Mid Sweden University, Östersund, Sweden
| | - Ulrica Nilsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Ove Hellzén
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Christina Melin-Johansson
- Department of Health Care Sciences/ Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| |
Collapse
|
9
|
Wilson LA, Poeran J, Liu J, Zhong H, Memtsoudis SG. State of the anaesthesia workforce in the United States: trends and geographic variation in nurse anaesthetist to physician anaesthesiologist ratios. Br J Anaesth 2020; 126:e19-e21. [PMID: 33131760 DOI: 10.1016/j.bja.2020.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- Lauren A Wilson
- Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, NY, USA
| | - Jashvant Poeran
- Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jiabin Liu
- Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA
| | - Haoyan Zhong
- Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, NY, USA
| | - Stavros G Memtsoudis
- Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA; Department of Health Policy and Research, Weill Cornell Medical College, New York, NY, USA.
| |
Collapse
|
10
|
Du YJ, Zhang XQ, Liu LD, Zhang JY, Han N, Wang GY. Overfatigue amongst Chinese anaesthesiologists from 2017 to 2019. Br J Anaesth 2020; 126:e17-e19. [PMID: 33121745 DOI: 10.1016/j.bja.2020.09.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/17/2020] [Accepted: 09/17/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Ying-J Du
- Department of Anaesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xin-Q Zhang
- School of Humanities and Social Sciences, Peking Union Medical College, Beijing, China
| | - Li-D Liu
- Department of Anaesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jin-Y Zhang
- Department of Anaesthesiology, First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Ning Han
- Department of Anaesthesiology, Roicare Hospital and Clinics, Shenyang, China
| | - Gu-Y Wang
- Department of Anaesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
| |
Collapse
|
11
|
van Klei WA, Hollmann MW, Sneyd JR. The value of anaesthesiologists in the COVID-19 pandemic: a model for our future practice? Br J Anaesth 2020; 125:652-655. [PMID: 32896431 PMCID: PMC7440078 DOI: 10.1016/j.bja.2020.08.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/14/2020] [Accepted: 08/14/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
| | - Markus W Hollmann
- Amsterdam University Medical Center, Academic Medical Center, Amsterdam, The Netherlands
| | - J Robert Sneyd
- Peninsula Medical School, University of Plymouth, Plymouth, UK
| |
Collapse
|
12
|
Lee MCC, Thampi S, Chan HP, Khoo D, Chin BZB, Foo DPX, Lua CB, Lewin B, Jacob R. Psychological distress during the COVID-19 pandemic amongst anaesthesiologists and nurses. Br J Anaesth 2020; 125:e384-e386. [PMID: 32792139 PMCID: PMC7375332 DOI: 10.1016/j.bja.2020.07.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/06/2020] [Accepted: 07/09/2020] [Indexed: 12/21/2022] Open
Affiliation(s)
- Melvin C C Lee
- Department of Anaesthesia, National University Hospital, Singapore.
| | - Swapna Thampi
- Department of Anaesthesia, National University Hospital, Singapore; Department of Cardiothoracic and Vascular Surgery, National University Hospital, Singapore
| | - Hean P Chan
- Department of Anaesthesia, National University Hospital, Singapore
| | - Deborah Khoo
- Department of Anaesthesia, National University Hospital, Singapore
| | | | - Donald P X Foo
- Department of Anaesthesia, National University Hospital, Singapore
| | - Chong B Lua
- Department of Anaesthesia, National University Hospital, Singapore
| | - Barnaby Lewin
- Department of Cardiothoracic and Vascular Surgery, National University Hospital, Singapore
| | - Rajesh Jacob
- Promises Healthcare Pte Ltd, Singapore; Department of Psychiatry, National University Hospital, Singapore
| |
Collapse
|
13
|
Memtsoudis SG, Wilson LA, Liu J, Poeran J. Surgeon- anaesthesiologist team case volume and perioperative outcomes in total joint arthroplasty. Br J Anaesth 2020; 125:e395-6. [PMID: 32536447 DOI: 10.1016/j.bja.2020.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 11/23/2022] Open
|
14
|
Yang M, Dong H, Lu Z. Role of anaesthesiologists during the COVID-19 outbreak in China. Br J Anaesth 2020; 124:666-669. [PMID: 32307116 PMCID: PMC7144667 DOI: 10.1016/j.bja.2020.03.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- Manping Yang
- Department of Anaesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an Shaanxi, China
| | - Hailong Dong
- Department of Anaesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an Shaanxi, China
| | - Zhihong Lu
- Department of Anaesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an Shaanxi, China.
| |
Collapse
|
15
|
Memtsoudis SG, Wilson LA, Bekeris J, Liu J, Poultsides L, Fiasconaro M, Poeran J. Anaesthesia provider volume and perioperative outcomes in total joint arthroplasty surgery. Br J Anaesth 2019; 123:679-687. [PMID: 31561883 DOI: 10.1016/j.bja.2019.08.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 07/12/2019] [Accepted: 08/13/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND While increased surgical-provider volume has been associated with improved outcomes, research regarding volume-outcome relationships within high-volume institutions and the role of anaesthesiologists is limited. Further, the effect of anaesthesia-care-team composition remains understudied. This analysis aimed to identify the impact of anaesthesiologist and surgeon volume on adverse events after total joint arthroplasties. METHODS We retrospectively identified 40 437 patients who underwent total joint arthroplasties at a high-volume institution from 2005 to 2014. The main effects of interest were anaesthesiologist and surgeon volume and experience along with anaesthesia-care-team composition. Multivariable logistic regression models were used to evaluate three outcomes: any complication, cardiopulmonary complication, and length of stay (>5 days). Odds ratios (ORs) and 99.75% confidence intervals (CIs) were reported. RESULTS Across all three models, anaesthesiologist volume and experience, and anaesthesia-care-team composition were not significant predictors. Surgeon annual case volume >50 was associated with significantly reduced odds of any complication (annual case volume: 50-149; OR: 0.80; CI: 0.66-0.98) and prolonged length of stay (OR: 0.69; CI: 0.60-0.80). Surgeon experience >20 yr was associated with significantly reduced odds of prolonged length of stay (OR: 0.85; CI: 0.75-0.95). CONCLUSIONS Anaesthesiologist volume and experience, and anaesthesia-care-team composition did not impact the odds of an adverse outcome, although a higher surgeon volume was associated with decreased odds of complications and prolonged length of stay. Further study is necessary to determine if these findings can be extrapolated to less specialised, lower volume surgical settings.
Collapse
Affiliation(s)
- Stavros G Memtsoudis
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA; Department of Health Policy and Research, Weill Cornell Medicine, New York, NY, USA.
| | - Lauren A Wilson
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA
| | - Janis Bekeris
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Jiabin Liu
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA
| | - Lazaros Poultsides
- Department of Orthopedic Surgery, Division of Adult Reconstruction, New York University Langone Orthopedic Hospital, New York, NY, USA
| | - Megan Fiasconaro
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA
| | - Jashvant Poeran
- Institute for Healthcare Delivery Science, Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
16
|
Yılmaz İnal F, Yılmaz Y, Daşkaya H, Toptaş M, Koçoğlu H, Uysal H, Akkoç İ. Evaluation of the attitudes of surgeons about regional anesthesia: a survey study. Local Reg Anesth 2019; 12:89-95. [PMID: 31571980 PMCID: PMC6756757 DOI: 10.2147/lra.s211469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/29/2019] [Indexed: 11/23/2022] Open
Abstract
Background The intraoperative attending anaesthesiologist ultimately makes decisions about the anaesthesiology technique to be performed, but the attitudes of surgeons and preferences of patients on this subject may affect their choice. In this questionnaire-based study, we aimed to evaluate the attitudes and behaviors of surgeons about the use of regional anaesthesia (RA) in surgical operations. Methods Surgeons from different surgical branches with residencies at 4 different hospitals were asked to complete questionnaires that included reasons for preferring (12 reasons) and not preferring (13 reasons) the use of RA techniques for surgeries, using a 5-point Likert scale. Results A total of 156 surgeons from 4 hospitals, out of 167 surgeons who were approached to participate in the study, completed the questionnaire. The most commonly observed reason for a preference towards regional anaesthesia among the surgeons was the risk of general anaesthesia for patients with an American Society of Anesthesiologists (ASA) risk class of III and above. The second most commonly observed reason was for protection from the complications of general anaesthesia, and the third most commonly observed reason was the lower risk of thromboembolisms with regional anaesthesia. The most commonly observed reasons for not choosing regional anaesthesia were found to be incompatibility of the patients and patients’ fears of feeling pain during surgery. Conclusion We conclude that programmes for informing surgeons and educating patients about the advantages of RA may increase the preference ratio among surgeons and decrease patients’ refusals to choose this procedure.
Collapse
Affiliation(s)
- Ferda Yılmaz İnal
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Istanbul Medeniyet University, Istanbul, Turkey
| | - Yadigar Yılmaz
- Department of Anesthesiology and Reanimation, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
| | - Hayrettin Daşkaya
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Bezmialem Vakıf University, Istanbul, Turkey
| | - Mehmet Toptaş
- Department of Anesthesiology and Reanimation, Haseki Education and Research Hospital, Istanbul, Turkey
| | - Hasan Koçoğlu
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Istanbul Medeniyet University, Istanbul, Turkey
| | - Harun Uysal
- Department of Anesthesiology and Reanimation, Haseki Education and Research Hospital, Istanbul, Turkey
| | - İbrahim Akkoç
- Department of Anesthesiology and Reanimation, Haseki Education and Research Hospital, Istanbul, Turkey
| |
Collapse
|
17
|
Vigil-Fowler M, Hillman S, Desai S. Who Controls the Power over Pain? A Comparative History of Nurse Anaesthesia. Can Bull Med Hist 2019; 36:308-345. [PMID: 31525306 DOI: 10.3138/cbmh.284-092018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
From the advent of the use of anaesthesia during surgery through the Second World War, confusion and competition over who should administer the technology - doctors or nurses - dominated gendered discussions of professional boundaries. Using information about practice in the United States, the United Kingdom, and France in this period, we find vastly different outcomes for nurse-administered anaesthesia. Differences in perceptions regarding the gendered nature of this technology and its related level of prestige largely determined who could practice it. When administering anaesthesia carried low prestige and was viewed as non-technical, it fell under the purview of women's work in medicine, that is, nursing. When the same technology gained prestige and became perceived as a technical, medical skill, doctors associated it with their masculine professional identity and worked to exclude nurses from administering anaesthesia.
Collapse
Affiliation(s)
| | - Susanne Hillman
- Susanne Hillman - Department of History, San Diego State University
| | - Sukumar Desai
- Sukumar Desai - Department of Anaesthesia, Harvard Medical School, Brigham and Women's Hospital, and Massachusetts General Hospital Originally submitted 4 September 2018; accepted 24 April 2019
| |
Collapse
|
18
|
Abstract
OBJECTIVES The primary objective was to estimate the incidence of patients in the Central Denmark Region triaged to bypass the local emergency department without being part of a predefined fast-track protocol. The secondary objective was to describe these triage decisions in more detail with regard to the most common diagnoses, incidence of direct referral sorted by the prehospital critical care team (PHCCT) and the destination hospital. DESIGN Retrospective descriptive study. SETTING AND PARTICIPANTS The emergency medical service in the Central Denmark Region primarily consists of emergency medical technician (EMT)-staffed ambulances and anaesthesiologist-EMT-staffed PHCCTs. Patients treated by the nine ground-based PHCCTs in the region constituted the study population. The inclusion criteria were all patients treated by the PHCCTs during 2013 and 2014. The exclusion criteria were interhospital transfers, and patients with ST-segment elevation myocardial infarction, stroke or were in active labour. ENDPOINTS Incidence of prehospital critical care anaesthesiologist-initiated direct referral, prehospital tentative diagnoses and transport destination. RESULTS During the study period, the PHCCTs treated 39 396 patients and diverted 989 (2.5%) patients not covered by a predefined fast-track protocol to a specialised hospital department. 'Resuscitated from cardiac arrest' (n=143), 'treatment and observations following road traffic accident' (n=105) and 'observation and treatment for an unspecified disease/condition' (n=78) were the most common prehospital tentative diagnoses, accounting for 33.0% of all diverted patients. In total, 943 (95.3%) of the PHCCT-diverted patients were diverted to a department at Aarhus University Hospital. CONCLUSION Our results demonstrate that in 1 out of 40 patient contacts, the anaesthesiologist-staffed PHCCTs in the Central Denmark Region divert critically ill and injured patients directly to a specialised hospital department, bypassing local emergency departments and potentially reducing time to definitive care for these patients. There may be a potential for increased referral of patients with no predefined fast-track directly to specialised departments in the Central Denmark Region.
Collapse
Affiliation(s)
- Morten Langfeldt Friberg
- Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
- The Pre-hospital Critical Care Service in Aarhus, Department of Pre-hospital Critical Care Service, Pre-hospital Medical Services, Central Denmark Region, Aarhus, Denmark
| | - Leif Rognås
- The Pre-hospital Critical Care Service in Aarhus, Department of Pre-hospital Critical Care Service, Pre-hospital Medical Services, Central Denmark Region, Aarhus, Denmark
| |
Collapse
|
19
|
Abstract
BACKGROUND Previous studies have shown that the public perception of anaesthesiologists' duties regarding perioperative management lacks a good understanding. The aim of this study was to assess the public perception of the anaesthesiologist's role before, during and after surgery, in Romania. METHOD The prospective cross-sectional study was undertaken between January 2015 and August 2016. A questionnaire that comprised 23 questions was uploaded on Google at https://docs.google.com/forms/d/1KxC8jSYydhEu3pn0Hr0LHEsuCEQLSEHQqUo_HzrHuw8/viewform. The link was forwarded on-line randomly (mail, social media). The questions were structured based on current literature. Inclusion criteria were people aged >15 years and not directly related to any medical activity. The answers were anonymously registered, in real time, in an Excel format, used later to process the statistics. RESULTS 1153 people completed the questionnaire, 61% female and 39% male, 80.8% being from the urban area and 19.2% from the countryside. 62.7% were hospitalized in the past, and 49.8% had undergone at least one surgery. From the questioned group 65.2% had graduated university, and 64.3% were aged between 20 and 40 years. A majority of 1089 respondents (94.6%) knew that the anaesthesiologist was responsible for providing anaesthesia in the operating room. 26.6% considered that the surgeon and the anaesthesiologist played different roles in OR, but 54.4% understood that there is a collaboration between them during surgery. Only 36.2% were aware that the anaesthesiologist replaces blood losses and provides patients hemodynamic stability and proper oxygenation during surgery. 54.6% believe that the surgeon decides upon the postoperative pain management and only 32% know the anaesthesiologist is the physician in charge of intensive care patients. 79.5% of respondents are willing to receive from their anaesthesiologist detailed information, regarding anaesthesia and postoperative care, before surgery, and consider that more publicity should be made regarding this profession. CONCLUSION The public perception of the anaesthesiologist's role in Romania is inaccurate in spite of the fact that a large group in our study comprised highly educated people living in urban areas. We consider that further strengthening of the anaesthesiologist/patient relationship and an increased media exposure of our specialty would help to improve its social perception.
Collapse
Affiliation(s)
| | - Cristina Rus
- "Octavian Fodor" Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
| | - Iurie Acalovschi
- "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| |
Collapse
|
20
|
Abstract
Background and Aims: The anaesthesiologists’ understanding and knowledge of law has an important bearing on issues, related to anaesthesia practice. Lack of such knowledge could also lead to misperceptions affecting both patient care and professional practices. The aim of the study was to find out exact nature of apprehension of the anaesthesia providers towards the implementation of the law related to anaesthesia practice. Methods: A prospective survey of 875 anaesthesia specialists was conducted during informal meetings personally by the investigator and the responses to a standard set of queries were noted. Also included were the remarks and suggestions related to each query. Three different set of practitioners depending on the place of work (teaching hospital, corporate hospital and small establishments) were queried. Results: The opinions of all three groups of anaesthesiologists did not differ materially. The opinions and views were similar in many aspects and controversy existed in few areas. Major confusion was about how much information should be provided to patients before anaesthesia to obtain informed consent. Opinions were offered for prevention of litigations and how to face litigations but there was the lack of clarity on these issues. Conclusions: The anaesthesiologists are invariably confused about how exactly they should prevent litigations or respond to them. The majority expressed need for intervention by Indian Society of Anaesthesiologists (ISA) to prepare protocols and set up medico-legal cells.
Collapse
Affiliation(s)
- Shakil G Momin
- Perioperative Physician Anaesthesiologist, Kolhapur, Maharashtra, India
| |
Collapse
|
21
|
Erbaş M, Kiraz HA, Şimşek T, Şahin H, Toman H, Hancı V. Turkish Anaesthesiologist's Experiences of Anaesthetic Management of Patients with Obstructive Sleep Apnea (OSA). Turk J Anaesthesiol Reanim 2015; 43:253-62. [PMID: 27366507 DOI: 10.5152/tjar.2015.70893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 12/22/2014] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Obstructive sleep apnea (OSA) is an important health problem that is increasing with the increase in the incidence of obesity. For patients with OSA, it is reported that preoperative OSA diagnosis is made in only 10%-20% of the patients. Therefore, it gains importance that these patients are diagnosed in the preoperative period. The aim of this study is to analyze with a survey the experiences of anaesthesia experts working in Turkey about the diagnosis of patients with OSA, anaesthetic methods and postoperative care. METHODS The study was completed with an online survey form distributed via email. Survey participants were sent an email, and those experts who wished to participate clicked on the link, answered the questions and returned the survey via email. RESULTS A total of 134 anaesthesia experts participated in this study. While 97% of the participating anaesthetists considered diagnosis of patients with OSA to be important, only 53% trusted themselves to recognize this patient group. Of the total number of participants. 43% did not know the STOP-BANG test used in the preoperative period to diagnose patients with OSA. The percentage who thought that patients with OSA would increase the incidence of difficult intubation was 84%. In the intraoperative period, the percentage who chose inhalation anaesthetics was 35%, whereas the rate of those who chose total intravenous anesthesia (TIVA) was 48%. CONCLUSION This study indicates that the medical knowledge of Turkish anaesthetists on the topic of OSA requires updating. In addition, we believe a practical guide to standardize the diagnosis and preoperative/perioperative management of patients with OSA should be prepared for Turkish anaesthetists.
Collapse
Affiliation(s)
- Mesut Erbaş
- Department of Anaesthesiology and Reanimation, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Hasan Ali Kiraz
- Department of Anaesthesiology and Reanimation, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Tuncer Şimşek
- Department of Anaesthesiology and Reanimation, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Hasan Şahin
- Department of Anaesthesiology and Reanimation, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Hüseyin Toman
- Department of Anaesthesiology and Reanimation, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Volkan Hancı
- Department of Anaesthesiology and Reanimation, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| |
Collapse
|
22
|
Bartkowska-Śniatkowska A, Rosada-Kurasińska J, Ignyś I, Grześkowiak M, Zielińska M, Bienert A. Procedural sedation and analgesia in children undergoing digestive endoscopic procedures - paediatrician or anaesthesiologist? Prz Gastroenterol 2014; 9:77-81. [PMID: 25061486 PMCID: PMC4108748 DOI: 10.5114/pg.2014.42501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 02/25/2012] [Accepted: 03/30/2012] [Indexed: 12/01/2022]
Abstract
Endoscopic procedures of the gastrointestinal tract were successfully introduced into paediatric practice in the 1970s. Recent expansive development has become useful for improvement of both diagnosis and treatment in many children with gastrointestinal diseases. Most of these procedures are performed under procedural sedation (PSA) knowing anatomical, physiological and psychological differences and requiring good experience from the paediatrician and anaesthesiologist. These principles help to provide the procedure safely and minimise adverse events, which are greater the smaller the child is. Procedural sedation and analgesia in healthy children can be performed by a paediatrician, but children with congenital defects and serious coexisting diseases (ASA ≥ III) and also during the usage of anaesthetics (e.g. propofol), should be managed by an anaesthesiologist.
Collapse
Affiliation(s)
- Alicja Bartkowska-Śniatkowska
- Department of Paediatric Anaesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznan, Poland
| | - Jowita Rosada-Kurasińska
- Department of Paediatric Anaesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznan, Poland
| | - Iwona Ignyś
- Department of Paediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Małgorzata Grześkowiak
- Department of Teaching Anaesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznan, Poland
| | - Marzena Zielińska
- Department of Anaesthesiology and Intensive Care, Paediatric Intensive Care Unit, Wroclaw Medical University, Poland
| | - Agnieszka Bienert
- Department of Clinical Pharmacy and Biopharmacy, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
23
|
Huitink JM, Teoh WHL. Current cancer therapies - a guide for perioperative physicians. Best Pract Res Clin Anaesthesiol 2013; 27:481-92. [PMID: 24267553 DOI: 10.1016/j.bpa.2013.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 09/26/2013] [Accepted: 09/30/2013] [Indexed: 12/20/2022]
Abstract
Cancer is expected to be the leading cause of death around the world. New cancer therapies have improved survival but they can also lead to complications and toxicity. In this article, the effects of modern anti-cancer therapies are reviewed. The perioperative effects of chemotherapy, radiotherapy and experimental therapies in relation to anaesthesia are discussed. Common and rare complications are summarised as is advice for optimal treatment of the cancer patient in the perioperative period.
Collapse
Affiliation(s)
- Johannes M Huitink
- Department of Anaesthesiology, VU University Medical Center/VUmc Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
| | | |
Collapse
|
24
|
Abstract
Management of foetal distress is a subject of gynaecological interest, but an anaesthesiologist should know about resuscitation, because he should be able to treat the patient, whenever he is directly involved in managing the parturient patient during labour analgesia and before an emergency operative delivery. Progressive asphyxia is known as foetal distress; the foetus does not breathe directly from the atmosphere, but depends on maternal circulation for its oxygen requirement. The oxygen delivery to the foetus depends on the placental (maternal side), placental transfer and foetal circulation. Oxygen transport to the foetus is reduced physiologically during uterine contractions in labour. Significant impairment of oxygen transport to the foetus, either temporary or permanent may cause foetal distress, resulting in progressive hypoxia and acidosis. Intrauterine foetal resuscitation comprises of applying measures to a mother in active labour, with the intention of improving oxygen delivery to the distressed foetus to the base line, if the placenta is functioning normally. These measures include left lateral recumbent position, high flow oxygen administration, tocolysis to reduce uterine contractions, rapid intravenous fluid administration, vasopressors for correction of maternal hypotension and amnioinfusion for improving uterine blood flow. Intrauterine Foetal Resuscitation measures are easy to perform and do not require extensive resources, but the results are encouraging in improving the foetal well-being. The anaesthesiologist plays a major role in the application of intrauterine foetal resuscitation measures.
Collapse
Affiliation(s)
- S. Velayudhareddy
- Department of Anaesthesiology, Rajeev Gandhi Institute of Medical Sciences, Kadapa, Andhra Pradesh, India
| | - H Kirankumar
- Department of Anaesthesiology, Rajeev Gandhi Institute of Medical Sciences, Kadapa, Andhra Pradesh, India
| |
Collapse
|