A F Merry

..346 s; p < 0.001) and during anaesthesia (20 vs. 104 s; p < 0.001). Comments facilitated development of the system and the evaluation endorsed proceeding to a clinical trial...

..Pushing the limits of ethics in research threatens to undermine not only the reputation of those conducting the research but also the standing of science itself...

..To evaluate the possibility that anaesthetists are administering potentially pathogenic micro-organisms to their patients...

..The PDU is well placed to support quality improvement in perfusion by providing such data...

..Patients receiving BITA grafts were case-matched with patients receiving SITA grafts for confounding factors and comparison was made between perioperative outcomes in the two groups...

..They are designed particularly for regions that have yet to formulate or adopt their own standards so as to promote optimum patient outcomes in every anesthetizing location in the world...

..We compared this combination with each of the constituent drugs for the relief of pain after extraction of third molar teeth...

..045, Chi-squared test). Despite the difficulties of demonstrating significant benefit from safety initiatives in medicine, these data suggest that targeted system redesign can be effective inreducing error...

..Use of this checklist has been shown to reduce harm. Incident reporting will be invaluable in monitoring its effectiveness and identifying areas for refinement...

..Balanced anticoagulation using combinations of drugs that act at different stages in the coagulation system may improve the management of coagulation in cardiac surgery, but careful investigation of this concept is needed...

..In the longer-term, comprehensive simulations of cardiac surgical procedures involving all participants in meaningful simulated roles may be possible...

..It is, nevertheless, important that all involved are cognizant of the practical and ethical issues at stake...

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..To clinically evaluate a new patented multimodal system (SAFERSleep) designed to reduce errors in the recording and administration of drugs in anaesthesia...

..Any medicine or fluid that cannot be identified (e.g., in an unlabelled syringe or other container) should be considered unsafe and discarded. Reducing adverse medication events will require the engagement of individual anaesthetists...

..46, so in future studies 21 subjects would provide 80% statistical power to show a reduction in error rate of 30% from baseline with p<or=0.05. Our research design will facilitate the evaluation of safety initiatives in anaesthesia...

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..It follows that the very extensive experience of some of the older practitioners may have been more valuable in decision making than many of the very reasonable and logical advances that have influenced modern practice...

..We also assessed flow with angiography at 3 months using a modified Thombolysis in Myocardial Infarction (TIMI) grade in the grafted coronary arteries...

..A larger study is needed to investigate the impact of improved graft patency on other clinical outcomes after cardiac surgery...

..This provides objective evidence supporting the requirement for trained assistance to the anaesthetist, and furthermore, demonstrates that a simulation-based model can provide rigorous evidence on safety interventions in anaesthesia...

..In this study, we evaluated the psychometric characteristics, logistics of application, and impact on the quality of supervision of the Mini-CEX in anaesthesia training...

..However, its value depends on how supervisors use it with their trainees. This study analyses experience with the mini-CEX after its introduction into anaesthesia departments in our institution...

..The absence of standards undermines confidence in the results of any simulation-based endeavour and increases the risk of negative learning. We propose a practical framework for setting standards for simulators for anaesthesia...

..In addition, 47 transient physiological effects were reported, of which five required intervention. We conclude that drug administration error during anaesthesia is considerably more frequent than previously reported...

..Prefilled syringes for the new system increased costs by euro 23.00 per anaesthetic (p = 0.041), but this increase is likely to be offset by the potential of the new system to decrease costly iatrogenic harm by preventing drug error...

..By using sound principles of systems design and human factors psychology, we have designed and deployed a system with the aim of improving patient safety by facilitating correct drug administration and accurate anesthesia record making...

..These data support the inclusion of tenoxicam 20 mg IV in the management of pain at rest for patients undergoing thoracotomy, but do not show additional benefit for a higher dose...

..However, these data suggest more effort is required to promote compliance with appropriate guidelines...

..We therefore sought to determine whether the behaviour of anaesthetists differed in assessing anaesthetic records re-synthesized from either handwritten or automated records...

..73), and neither was an air towel alone (2.5, 15, 80; P=0.176) nor the hospital's standard procedure (0, 1, 500; P=0.035). If hand preparation is needed, an adequate and validated method should be used, together with thorough hand drying...

..Expertise stems from deliberate practice and a desire constantly to improve performance with a career-long commitment to education...

..To review the cost of healthcare utilisation by patients suffering from intractable angina, unsuitable for coronary revascularisation, before and after treatment with spinal cord stimulation...

..However, two further RCTs have failed to demonstrate benefit. Lignocaine cannot be recommended for neuro-protection in cardiac surgery at this time, but a role in clinical neuro-protection in this or other contexts is not ruled out...

..In the present study, we aimed to test the benefit of a 12-hour infusion in a broader group of cardiac surgery patients, including those undergoing coronary artery bypass graft surgery...

..We placed anaesthesia teams into a stressful environment in order to explore interactions between members of different professional groups and to investigate their perspectives on the impact of these interactions on team performance...

..Human observers are the current 'gold standard' for capturing task data, but they are expensive and have cognitive limitations...

..The patient was weaned from opioids and after six months had needed no further hospital admissions. We recommend consideration of spinal cord stimulation in patients with features of angina pectoris following heart transplantation...

..We have found no common terminology amongst authors for describing or classifying simulators, and propose a framework for describing (or classifying) them that is simple, clear and applicable to any simulator...

..005). A similar pattern was observed for the maintenance dose. The duration of action of rocuronium is influenced by time of day and this effect is of potential clinical significance and practical relevance to research...

..We aimed to investigate (1) the rate of stroke, new ischemic change on MRI, and cognitive impairment after cardiac valve surgery; and (2) the controversial relationship between perioperative cerebral ischemia and cognitive decline...

..28 vs 1.63, P = 0.01), and placed lumens were used more intensively (P < 0.001). Data appear to justify the routine selection of a triple-lumen CVC in adult patients, but not of a quad-lumen CVC...

..In the end, outcomes that the patients themselves desire are the most meaningful endpoint of the pursuit of safer cardiac surgery...

..006-0.028%). No major adverse outcomes from these errors were reported with the new system while 11 (0.002%) were reported with conventional methods (p = 0.055). We conclude that targeted system re-design can reduce medical error...

..The aim of this study was to determine the safety and performance of a new method of non-blood-contacting counterpulsation using an inflatable cuff around the ascending aorta (extra-aortic balloon [EAB])...

..To replicate electromagnetic interference (EMI) with a common drug infusion device resulting from the use of radio frequency identification (RFID) technology in a simulated operating theatre environment...