Anaesthetic rooms: current practice in one British health region.
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In Britain it is traditional that each operating theatre has an adjacent anaesthetic room (1). The implications for equipping current theatre suites and the design of new theatres are wide-ranging. There are no data available on the attitudes of anaesthetists in this country towards the necessity for anaesthetic rooms and the extent of the anaesthetic equipment found in them. This survey in the North West region suggests that all consultant anaesthetists regard the availability of an anaesthetic room as a necessity, and most consider that the current level of vital-signs monitoring equipment in the anaesthetic room is inadequate. (+info)
Anesthetic equipment, facilities and services available for pediatric anesthesia in Nigeria.
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Evaluation of the national Cleanyourhands campaign to reduce Staphylococcus aureus bacteraemia and Clostridium difficile infection in hospitals in England and Wales by improved hand hygiene: four year, prospective, ecological, interrupted time series study.
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Availability of pediatric services and equipment in emergency departments: United States, 2006.
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OBJECTIVES: This report presents data on the availability of pediatric services, expertise, and supplies for treating pediatric emergencies in U.S. hospitals. METHODS: Data in this report are from the Emergency Pediatric Services and Equipment Supplement (EPSES), a self-administered questionnaire added to the 2006 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS samples nonfederal short-stay and general hospitals in the United States. Sample data were weighted to produce annual estimates of pediatric services, expertise, and equipment availability in hospital emergency departments (EDs). RESULTS: In 2006, only 7.2 percent of hospital EDs had all recommended pediatric emergency supplies, and 45.6 percent had at least 85.0 percent of recommended supplies. EDs in children's hospitals and hospitals with pediatric intensive care units (PICUs) were more likely to meet guidelines for pediatric emergency department services, expertise, and supplies. About 74.0 percent of these facilities had at least 85.0 percent of recommended supplies, compared with 42.4 percent of other facilities. Among children's hospitals and hospitals with PICUs, 66.0 percent had 24 hours a day, 7 days a week access to a board-certified pediatric emergency medicine attending physician; such access was uncommon in other types of hospitals. In general, little change was noted in the availability of emergency pediatric supplies between 2002-2003, when the initial EPSES was conducted, and 2006. (+info)
Chlorhexidine bathing and microbial contamination in patients' bath basins.
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Access to difficult airway equipment and training for rural GP-anaesthetists in Australia: results of a 2012 survey.
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INTRODUCTION: In rural Australia, general practitioners (GPs) form the frontline for provision of medical services. Besides responsibilities for primary care via private practice, rural doctors often provide emergency and inpatient services for rural hospitals. The aim of this study was to determine access to difficult airway equipment and training among the GP-anaesthetist cadre in rural Australia. METHODS: DESIGN: an online survey regarding availability of difficult airway equipment, access to ongoing training and inviting comments on rural anaesthesia in general. SETTING: a questionnaire was distributed to rural doctors in January 2012 via membership databases of the Rural Doctors Association of Australia and state-based Rural Doctor Workforce Agencies. PARTICIPANTS: 293 participants identified as a GP-anaesthetist working in rural Australia (65% response rate). Of these 83% were male, 17% female with the percentage of respondents from each state concordant with the distributions indicated by the 2010 Rural Health Workforce National Minimum Dataset. MAIN OUTCOME MEASURE: closed-ended questions were quantified and open-ended questions analysed to determine issues relevant to GP-anaesthetists. RESULTS: Only 53% of GP-anaesthetists reported access to a difficult airway trolley or box in their facility. Lack of availability of certain airway equipment was reported among GP-anaesthetists, with very few having access to advanced intubation aids such as videolaryngoscopes or fibreoptic devices (flexible fibrescopes and/or malleable fibreoptic stylets). Open-ended questions suggested that GP-anaesthetists desired such aids to manage difficult airways. Only 79% had access to surgical airway or paediatric airway equipment. Of the respondents, 58% reported involvement in prehospital medicine but only 12% had received training in this challenging environment. A formal arrangement for prehospital responses existed for only 7% of respondents. CONCLUSION: Despite the existence of well-publicised algorithms for difficult airway management and the need for specific equipment to manage the difficult airway, Australian GP-anaesthetists report difficulty accessing essential equipment for these infrequent but life-threatening events. This is surprising in the light of recommendations from the Australian and New Zealand College of Anaesthetists. The consequences of difficulty in airway management can be catastrophic. Equipment needs must be balanced against important considerations including ease of use, initial and ongoing training, and cost. Suggestions for affordable equipment and ongoing training for rural GP-anaesthetists are made. The involvement of GP-anaesthetists in prehospital responses occurs in the absence of formal arrangements and with a dearth of training. There is scope to improve rural prehospital responses in Australia, utilising the advanced skills of GP-anaesthetists in resuscitation and airway management. (+info)