Browsing by Subject "Intubation"

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    Anesthesia care task sharing a clinical audit for the anesthesia care provided by anesthesia technologists in Wad Medani,Central Sudan
    (2025) Mohamed, Alaa; Alphonsus, Christella; Mahjoub, Sami
    Introduction: The bachelor's degree in anaesthesia sciences program was implemented in Sudan in 1998 to alleviate the shortage of anaesthesiologists while minimizing the anaesthesia related complications of anaesthesia technicians' practice. In the absence of a defined scope of practice and a lack of financial and legal protection, practitioners are leaving their anaesthesia technology careers in Sudan in search of more secure careers, which has resulted in a noticeable gap in anaesthesia practice in Wad Medani, Gezira State. This study was conducted to determine the proportion of anaesthesia care tasks that were carried out by the anaesthesia technologists at four public referral hospitals in Wad Medani, Sudan. Methods: The study was a three-month cross-sectional observational clinical audit of anaesthetic services at four Gezira State Ministry of Health tertiary referral hospitals and included a number of 1559 patients. Data was gathered to describe the perioperative anaesthetic care tasks provided to surgical patients undergoing emergency or elective procedures through a questionnaire that was designed based on the definition of the American Society of Anaesthesiologists of the anaesthesia care tasks. The study began on November 3rd, 2022, and lasted three months, ending on February 2nd, 2023. Results: The analysed data showed an average of 18 cases per day. Out of the total 1559 surgical anaesthesia cases in Wad Medani, 718 (46%) of cases were carried out by anaesthesia technologists without the presence of supervising anaesthesiologists. A percentage of 65.2 of these cases were spinal anaesthesia while general anaesthesia and sedation comprised 25.6% and 9.2% respectively. In the presence of supervising anaesthesiologist, anaesthesia technologists performed over 80% of the anaesthesia care tasks. Conclusions: Anaesthesia technologists make a substantial contribution to Anaesthesia services in Wad Medani. Our results demonstrated that a considerable proportion of Anaesthesia procedures are carried out without any kind of anaesthesiologists supervision. Guidelines and protocols should be developed and implemented to govern anaesthesia practice given the resource constraints in this setting. Regular training on safe anaesthesia practice should be applied. Further research is needed on to assess the provision of anaesthesia care and the extent of surgical delay in regions of displacement.
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    Open Access
    Newborns should be receiving premedication before elective intubation
    (2014) Raban, Moegammad Shukri; Joolay, Yaseen; Horn, Alan Richard; Harrison, Michael Charles
    BACKGROUND: Intubation is a common neonatal procedure. Premedication is accepted as a standard of care, but its use is not universal and wide variations exist in practice. OBJECTIVE: To evaluate current practices for premedication use prior to elective neonatal intubation in South Africa (SA). METHOD: We invited 481 clinicians to participate in a cross-sectional web-based survey. RESULTS: We received responses from 28.3% of the clinicians surveyed; 54.1% were from the private sector and 45.9% from the state sector. Most respondents worked in medium-sized neonatal units with six to ten beds. Most paediatricians (76.0%) worked in the private sector, and 78.6% of neonatologists in the state sector. Premedication was practised by 71.9% of the respondents, but only 38.5% of neonatal units had a written policy. Sedatives were used for premedication by 63.2% of the respondents. Midazolam (41.5%), morphine (34.0%) and ketamine (20.8%) were most commonly used. Muscle relaxants and atropine were not routinely administered. Suxamethonium was the muscle relaxant of choice. Varied combinations of agents or single agents were used. Midazolam used alone was the preferred option. CONCLUSION: This first survey of premedication for neonatal intubation in SA revealed variations in practice, with a minority of clinicians following a written policy. The findings can be used to benchmark practice and inform the design of local collaborative trials aimed at determining optimal premedication prior to neonatal intubation. The survey demonstrates clinicians' reluctance to participate in surveys, suggesting a need for a national collaborative network to obtain representative data.