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Latest Documents

Posted in: ATOTW > General Topics 2020 Language: english

COVID-19 has become a pandemic. Anaesthesiologists play significant role in patient care, infection control in the perioperative period and airway management. Caring for patients with COVID-19 requires multi-disciplinary effort. Disease transmission can be minimised when perioperative care is thoroughly planned.

Posted in: ATOTW > Intensive Care Medicine 2020 Language: english

Cocaine toxicity has a myriad of end organ complications, both in acute ingestion and chronic abuse. An appreciation for nuances of this presentation is required to provide excellent critical care.

Posted in: UIA > Anaesthesia 2020 Language: english

• Implementation of the WHO surgical safety checklist in a West African teaching hospital: a quality improvement initiative • Postoperative pain management in Timor-Leste • Comprehensive review of laryngospasm • Perioperative myocardial ischaemia in non-cardiac surgery • Saddle Block • Erector spinae plane block • Tranexamic acid • Intrathecal tranexamic acid during spinal anaesthesia for caesarean delivery • Ketamine: Recent evidence and current uses • Complications associated with intraoperative use of irrigation fluid for endoscopic procedures • Case report: Posterior Reversible Encephalopathy Syndrome (PRES) • Letter: OxyContin - a tale of advertisement and addiction • Letter: Sphenopalatine ganglion block - management of PDPH after caesarean section

Posted in: Guidelines & Standards > Safety 2020 Language: english

Infographic produced by Dept of Anesthesia & Intensive Care, Prince of Wales, Hong Kong

Posted in: Guidelines & Standards > Safety 2020 Language: english

Infographic produced by Dept of Anesthesia & Intensive Care, Prince of Wales, Hong Kong

Posted in: ATOTW > Pain 2020 Language: english

Opioids are a cornerstone of anaesthetic practice. This tutorial will discuss a common opioid side effect - Opioid-induced Hyperalgesia (OIH). OIH is a phenomenon for which we have an increasing appreciation. We will discuss its proposed mechanism, clinical relevance and, lastly, evidence on its management strategies.

Posted in: UIA > 2020 Language: english

Background: This study aimed to evaluate the implementation of a surgical safety checklist (SSCL) at an academic hospital in Ghana. Methods: The WHO SSCL was locally adapted and introduced in all surgical cases at Cape Coast Teaching Hospital (CCTH), Ghana. A chart audit of 2.5% of surgical cases over 12 months was conducted. The main outcome measures included: 1. Percentage of cases where the SSCL was present, 2. Percentage complete, 3. Where the SSCL was incomplete, percentage complete at each critical point (before induction of anesthesia, before skin incision, and before leaving the operating theater), 4.Information missing in incomplete charts. Results: One hundred surgical cases were evaluated. The SSCL was present in 93% (95% CI 88%-98%) of cases reviewed, but complete in only 21% (95% CI 10.5%- 29.0%) of all cases, and 3.6% (95% CI -3.3%-13.0%) of C-sections. The last part of the checklist was most likely to be completed. The most common missing information was patient demographics. Conclusion: The SSCL was introduced at CCTH over 1.5 years. While uptake was high, the majority of cases were incomplete. This QI informed a revision of the SSCL and a strategy for periodic evaluation to facilitate its sustainable use. Key Words: patient safety, quality improvement

Posted in: UIA > Obstetric Anaesthesia 2020 Language: english

The National Committee on Confidential Enquiries into Maternal Deaths recently received notification of a death in South Africa caused by inadvertent intrathecal administration of tranexamic acid (TXA). TXA is increasingly used during caesarean delivery following updated recommendations from the World Health Organization in 2017. However, its greater availability has led to an international rise in drug errors during obstetric spinal anaesthesia. This case highlights a growing clinical risk, of which all operating theatre staff should be aware. Review of existing operating theatre drug handling practices is required in order to decrease this risk. Recommendations are made that aim to minimise drug errors associated with the use of this potentially life-saving intervention.

Posted in: UIA > Basic Sciences 2020 Language: english

Tranexamic acid significantly reduces peri-operative blood loss in a wide variety of surgical specialties and improves survival in haemorrhage from trauma and birth. In cardiac patients it carries a risk of seizures, especially with higher doses, and theoretically may predispose to thromboembolic disease but clinically relatively few side effects are observed. It is highly cost-effective and requires minimal training to administer. As such the World Health Organisation now include it on the essential medicines list. Future research to clarify dosing regimens, especially in the cardiac and paediatric populations, as well as usage in other surgical disciplines and intracranial haemorrhage is expected.

Posted in: UIA > Obstetric Anaesthesia 2020 Language: english

The sphenopalatine ganglion is a parasympathetic ganglion and has been blocked for various types of headaches and facial pain. We have reported a patient with severe post-dural puncture headache after cesarean section who showed rapid symptomatic improvement after a single sphenopalatine ganglion block.

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