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Ability of anaesthetists to identify the position of the right internal jugular vein using anatomical landmarks: A double-blind study. 麻醉师利用解剖标志识别右颈内静脉位置的能力:双盲研究。
IF 1.1 4区 医学 Q3 ANESTHESIOLOGY Pub Date : 2024-05-01 Epub Date: 2024-02-06 DOI: 10.1177/0310057X231212504
Apurv Sehgal, Bethany Walker, Fideron Sl Tsang, Sameen Anodiyil, David W Hewson
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引用次数: 0
A case series of the Royal Perth Hospital cannula-first approach in the 'can't intubate, can't oxygenate' scenario. 珀斯皇家医院在 "无法插管、无法吸氧 "的情况下采用插管先行法的病例系列。
IF 1.1 4区 医学 Q3 ANESTHESIOLOGY Pub Date : 2024-05-01 Epub Date: 2024-03-28 DOI: 10.1177/0310057X231214548
Andrew Mb Heard, David A Lacquiere, Helen L Gordon, Scott G Douglas, Hans J Avis

At the Royal Perth Hospital, we have been developing and teaching a can't intubate, can't oxygenate (CICO) rescue algorithm for over 19 years, based on live animal simulation. The algorithm involves a 'cannula-first' approach, with jet oxygenation and progression to scalpel techniques if required in a stepwise fashion. There is little reported experience of this approach to the CICO scenario in humans. We present eight cases in which a cannula-first Royal Perth Hospital approach was successfully implemented during an airway crisis. We recommend that institutions teach and practice this approach; we believe it is effective, safe and minimally invasive when undertaken by clinicians who have been trained in it and have immediate access to the requisite equipment. The equipment is low cost, comprising a 14G Insyte cannula, saline, 5 ml syringe and a Rapid-O2. Training can be provided using low-fidelity manikins or part-task trainers.

在皇家珀斯医院,19 年来我们一直在开发和教授基于活体动物模拟的 "无法插管、无法吸氧(CICO)"抢救算法。该算法包括 "插管先行 "方法、喷射吸氧以及在必要时逐步使用手术刀技术。这种方法在人类 CICO 情景中的应用鲜有报道。我们介绍了皇家珀斯医院在气道危机中成功实施插管先行法的八个病例。我们建议各医疗机构教授并实践这种方法;我们相信,如果临床医生接受过相关培训并能立即使用必要的设备,这种方法是有效、安全和微创的。这些设备的成本很低,包括一个 14G Insyte 插管、生理盐水、5 毫升注射器和一个 Rapid-O2。可使用低保真人体模型或部分任务训练器进行培训。
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引用次数: 0
Time to re-evaluate the routine use of sterile gowns in neuraxial anaesthesia. 是时候重新评估无菌衣在轴向麻醉中的常规使用了。
IF 1.1 4区 医学 Q3 ANESTHESIOLOGY Pub Date : 2024-05-01 Epub Date: 2023-11-25 DOI: 10.1177/0310057X231210314
Bradley H Tuohey, Cliff L Shelton, Stefan Dieleman, Forbes McGain
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引用次数: 0
I-Excel: A preparation course for specialist international medical graduate candidates for the Australian and New Zealand College of Anaesthetists final fellowship examination. I-Excel:澳大利亚和新西兰麻醉师学院国际医学专科毕业生最终奖学金考试预备课程。
IF 1.1 4区 医学 Q3 ANESTHESIOLOGY Pub Date : 2024-05-01 Epub Date: 2024-02-06 DOI: 10.1177/0310057X231214550
Nicholas M Woodland, Lahiru Amaratunge, Narguess Jahangiri
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引用次数: 0
‘On the inhalation of the vapour of Æther, with cases’: The first paper on anaesthesia read before a medical society in Australia 关于吸入乙醚蒸汽,附病例":澳大利亚医学会宣读的第一篇麻醉论文
IF 1.5 4区 医学 Q3 ANESTHESIOLOGY Pub Date : 2024-04-19 DOI: 10.1177/0310057x231214552
Rajesh P Haridas
On 7 September 1847, in Melbourne in the Port Phillip District of the Colony of New South Wales, David John Thomas (1813–1871) presented a paper, ‘On the inhalation of the vapour of Æther, with cases’, at an ordinary monthly meeting of the Port Phillip Medical Association. This is the earliest known presentation of a paper on etherisation in Australia. The partial publication of the manuscript in October 1847 in the Australian Medical Journal may have led to it being returned to Thomas in Melbourne. The handwritten manuscript is now preserved in the Medical History Museum, University of Melbourne, Melbourne, Victoria. A transcript of the complete manuscript is now recorded with relevant historical notes.
1847 年 9 月 7 日,大卫-约翰-托马斯(1813-1871 年)在新南威尔士殖民地菲利普港区墨尔本的菲利普港医学协会月度例会上发表了一篇题为 "关于吸入乙醚蒸汽及病例 "的论文。这是澳大利亚已知最早的一篇关于乙醚化的论文。1847 年 10 月,该手稿在《澳大利亚医学杂志》(Australian Medical Journal)上部分发表,这可能导致手稿被送回墨尔本的托马斯手中。手稿现保存在维多利亚墨尔本的墨尔本大学医学史博物馆。现在记录了完整手稿的誊本以及相关的历史注释。
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引用次数: 0
Thanks to Reviewers 感谢审稿人
IF 1.5 4区 医学 Q3 ANESTHESIOLOGY Pub Date : 2024-04-15 DOI: 10.1177/0310057x241233456
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引用次数: 0
Simulated impact of lift car sizes on transport of critical care patients: Informing the design of the New Dunedin Hospital 模拟电梯轿厢尺寸对运送危重病人的影响:为新达尼丁医院的设计提供依据
IF 1.5 4区 医学 Q3 ANESTHESIOLOGY Pub Date : 2024-04-15 DOI: 10.1177/0310057x241226720
Sheila G Barnett, Katherine M Stephens
The New Dunedin Hospital (NDH) is New Zealand’s largest health infrastructure build. Here we describe the use of a simple simulation-based hospital design exercise to inform the appropriate lift car size for critical care intrahospital transfers in the NDH. The intensive care unit (ICU) user group tested a series of entries and exits of simulated complex patient transfers in mocked-up lift cars of three different dimensions. Time taken to enter and exit the lift were recorded, reflecting the relative difficulty of transfer. Qualitative assessments were made of ease and perceived safety of transfer. These simulations demonstrated that recommended standard patient lift cars, often proposed for critical care transfers, could not physically accommodate all complex ICU transfers. A size of 1800 mm wide (W) × 3000 mm deep (D) had the physical capacity to permit all simulated ICU transfers, but with staff and patient risk. As lift car size increased to 2200 mm W × 3300 mm D, the simulation demonstrated reduced transfer times, smoother entry and exit, improved access to the head end of the bed, and reduced risk of disconnection or dislodgement of lines and airway support. The resultant clinical recommendations for the dimensions of a critical care lift car surpass current international health architecture guidelines and may help to inform future updates. The NDH project benefited from an objective assessment of risk, in language familiar to clinicians and healthcare architects. The outcome was an upsizing of the two ICU-capable lifts.
新达尼丁医院(NDH)是新西兰最大的医疗基础设施。在此,我们介绍了如何通过简单的模拟医院设计来确定 NDH 重症监护院内转运所需的电梯轿厢尺寸。重症监护室(ICU)用户组在三种不同尺寸的模拟移位机车中测试了一系列复杂病人转运的模拟出入口。记录了进入和离开移位机所需的时间,以反映移位的相对难度。对转运的难易程度和安全感进行了定性评估。这些模拟结果表明,通常建议用于重症监护转运的标准病人移位机车无法满足所有复杂的重症监护室转运需求。1800 毫米宽(W)×3000 毫米深(D)的尺寸在物理上能够容纳所有模拟 ICU 转运,但会给工作人员和病人带来风险。当移位机轿厢尺寸增加到 2200 毫米宽 × 3300 毫米深时,模拟结果表明移位时间缩短、进出更顺畅、床头通道更通畅、管路和气道支持断开或脱落的风险降低。由此产生的关于重症监护移位机尺寸的临床建议超过了当前的国际健康建筑指南,可能有助于为未来的更新提供参考。用临床医生和医疗建筑师熟悉的语言对风险进行客观评估,使 NDH 项目受益匪浅。其结果是扩大了两台可用于重症监护室的升降机的尺寸。
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引用次数: 0
Australian and New Zealand Anaesthetic Allergy Group/Australian and New Zealand College of Anaesthetists perioperative anaphylaxis management guideline 2022 澳大利亚和新西兰麻醉过敏小组/澳大利亚和新西兰麻醉师学院围手术期过敏性休克管理指南 2022
IF 1.5 4区 医学 Q3 ANESTHESIOLOGY Pub Date : 2024-04-08 DOI: 10.1177/0310057x231215823
Robyn Tran, Karen Pedersen, Helen Kolawole, Peter Roessler, Richard Scolaro
Perioperative anaphylaxis is a potentially life-threatening emergency that requires prompt recognition and institution of life-saving therapy. The Australian and New Zealand College of Anaesthetists and Australian and New Zealand Anaesthetic Allergy Group have partnered to develop the anaphylaxis management guideline along with crisis management cards that are recommended for use in suspected anaphylaxis in the perioperative setting. This is the third version of these guidelines with the second version having been published in 2016. This article contains the revised Australian and New Zealand Anaesthetic Allergy Group/Australian and New Zealand College of Anaesthetists perioperative anaphylaxis management guideline, with a brief review of the current evidence for the management of anaphylaxis in the perioperative environment.
围手术期过敏性休克是一种可能危及生命的紧急情况,需要及时识别并采取救生治疗措施。澳大利亚和新西兰麻醉师学院与澳大利亚和新西兰麻醉过敏小组合作开发了过敏性休克管理指南以及危机管理卡,建议用于围术期环境中的疑似过敏性休克。这是这些指南的第三版,第二版已于 2016 年发布。本文包含澳大利亚和新西兰麻醉过敏小组/澳大利亚和新西兰麻醉师学院围手术期过敏性休克管理指南修订版,并简要回顾了围手术期过敏性休克管理的现有证据。
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引用次数: 0
Comment on: The financial and environmental impact of purchased anaesthetic agents in an Australian tertiary hospital. 评论:在澳大利亚一家三级医院购买麻醉剂的财务和环境影响。
IF 1.5 4区 医学 Q3 ANESTHESIOLOGY Pub Date : 2024-03-01 Epub Date: 2023-12-02 DOI: 10.1177/0310057X231202267
Robert R Tooley, Dale A Currigan, Christopher H Mitchell
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引用次数: 0
Exploring anaesthetists' views on the carbon footprint of anaesthesia and identifying opportunities and challenges for reducing its impact on the environment. 探讨麻醉师对麻醉碳足迹的看法,并确定减少其对环境影响的机会和挑战。
IF 1.5 4区 医学 Q3 ANESTHESIOLOGY Pub Date : 2024-03-01 Epub Date: 2023-11-24 DOI: 10.1177/0310057X231212211
Matilde Breth-Petersen, Alexandra L Barratt, Forbes McGain, Justin J Skowno, George Zhong, Andrew D Weatherall, Katy Jl Bell, Kristen M Pickles

A shift in practice by anaesthetists away from anaesthetic gases with high global warming potential towards lower emission techniques (e.g. total intravenous anaesthesia) could result in significant carbon savings for the health system. The purpose of this qualitative interview study was to understand anaesthetists' perspectives on the carbon footprint of anaesthesia, and views on shifting practice towards more environmentally sustainable options. Anaesthetists were recruited from four hospitals in Western Sydney, Australia. Data were organised according to the capability-opportunity-motivation model of behaviour change. Twenty-eight anaesthetists were interviewed (July-September 2021). Participants' age ranged from 29 to 62 years (mean 43 years), 39% were female, and half had completed their anaesthesia training between 2010 and 2019. Challenges to the wider use of greener anaesthetic agents were identified across all components of the capability-opportunity-motivation model: capability (gaps in clinician skills and experience, uncertainty regarding research evidence); opportunity (norms, time, and resource pressures); and motivation (beliefs, habits, responsibility and guilt). Suggestions for encouraging a shift to more environmentally friendly anaesthesia included access to education and training, implementing guidelines and audit/feedback models, environmental restructuring, improving resource availability, reducing low value care, and building the research evidence base on the safety of alternative agents and their impacts on patient outcomes. We identified opportunities and challenges to reducing the carbon footprint of anaesthesia in Australian hospitals by way of system-level and individual behavioural change. Our findings will be used to inform the development of communication and behavioural interventions aiming to mitigate carbon emissions of healthcare.

麻醉师在实践中从具有高全球变暖潜势的麻醉气体转向低排放技术(例如全静脉麻醉),可为卫生系统节省大量碳。这个定性访谈研究的目的是了解麻醉师对麻醉的碳足迹的看法,以及对将实践转向更环保的可持续选择的看法。麻醉师从澳大利亚西悉尼的四家医院招募。根据行为改变的能力-机会-动机模型组织数据。对28名麻醉师进行了访谈(2021年7月至9月)。参与者的年龄从29岁到62岁不等(平均43岁),39%是女性,一半在2010年至2019年期间完成了麻醉培训。在能力-机会-动机模型的所有组成部分中确定了更广泛使用绿色麻醉剂的挑战:能力(临床医生技能和经验的差距,研究证据的不确定性);机会(规范、时间和资源压力);以及动机(信念、习惯、责任和内疚)。鼓励转向更环保的麻醉的建议包括获得教育和培训,实施指南和审计/反馈模型,环境重组,改善资源可用性,减少低价值护理,以及建立替代药物安全性及其对患者预后影响的研究证据基础。我们确定了通过系统级和个人行为改变的方式减少澳大利亚医院麻醉碳足迹的机会和挑战。我们的研究结果将用于告知旨在减少医疗保健碳排放的沟通和行为干预的发展。
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Anaesthesia and Intensive Care
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