Browsing by Subject "anaesthesia"

Now showing 1 - 5 of 5
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    Local anaesthetics
    (2018) Purcell-Jones, Jessica
    This video is an introduction to local anaesthetics, how they work, and what to think about when deciding dosage and administration.
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    Mechanisms of activation of glycogenolysis during development of malignant hyperthermia in swine
    (1971) Conradie, Paulina Jacoba; Berman, M
    The syndrome of Malignant Hyperpyrexia in man follows administration of certain general anaesthetic agents, and, although rare, is fatal in 70% of cases (EDITORIAL, 1968). Following exposure to the anaesthetic, there is, in most instances of susceptible individuals, a rapid rise in body temperature, usually within a period of 10 minutes, often accompanied by muscular rigidity of the limbs~ Sometimes hyperthermia has.been delayed for hours and muscular rigidity not pronounced. The temperature reached maybe 43°C (115°F) or even somewhat above this. Halothane, CF3CHBrCl, a ha../o/~nated hydrocarbon, is thought to be responsible for most cases(WILSON, NICHOLS, DENT and ALLEN, 1966). Succinyl choline lfH2COOCH2CH2*(cH3 )~ 201_~H2COOCH2CH2~(cH3 )3 a skeletal muscle relaxant employed during anaesthesia, has also been implicated (BRITT and KALOW, 1970; HARRISON, 1971).
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    Paediatric anaesthetics
    (2019) Purcell-Jones, Jessica
    This video is an introduction to the various differences that can be observed when administering anaesthetics to a child as compared to an adult.
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    SASS: South African Simulation Survey a review of simulation-based education
    (2019) Swart, Robert Nicholas; Duys, Rowan
    Background: Simulation-based education (SBE) has been shown to be an effective and reproducible learning tool. SBE is used widely internationally. The current state of SBE in South Africa is unknown. To the best of our knowledge this is the first survey that describes the use and attitudes towards SBE within South Africa. Methods: An online survey tool was distributed by email to: i) the South African Society of Anaesthesiologists (SASA) members; and ii) known simulation education providers in South Africa. The respondents were grouped into anaesthesia and non-anaesthesia participants. Descriptive statistics were used to analyse the data. Ethics approval was obtained: HREC REF 157/2017. Results: The majority of the respondents provide SBE and integrate it into formal teaching programmes. There is a will amongst respondents to grow SBE in South Africa, with it being recognised as a valuable educational tool. The user groups mainly targeted by SBE, were undergraduate students, medical interns, registrars and nurses. Learning objectives targeted include practical skills, medical knowledge, critical thinking and integrated management. Amongst anaesthesia respondents: the tool most commonly used to assess the quality of learner performance during SBE, for summative assessment, was ‘expert opinion’ (33%); the most frequent methods of evaluating SBE quality were participant feedback (42%) and peer evaluation (22%); the impact of SBE was most frequently assessed by informal discussion (42%) and learner feedback (39%). In anaesthesia SBE largely takes place within dedicated simulation facilities on site (47%). Most respondents report access to a range of SBE equipment. The main reported barriers to SBE were: finance, lack of trained educators, lack of equipment and lack of protected time. A limited number of respondents report engaging in SBE research. There is a willingness in both anaesthesia and non-anaesthesia groups (96% and 89% respectively) to collaborate with other centres. Conclusion: To the best of our knowledge this publication provides us with the first cross sectional survey of SBE in anaesthesia and a selection of non-anaesthetic respondents within South Africa. The majority of respondents indicate that SBE is a valuable education tool. A number of barriers have been identified that limit the growth of SBE within South Africa. It is hoped that with a commitment to ongoing SBE research and evaluation, SBE can be grown in South Africa.
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    The impact of point-of-care transthoracic echocardiography on management of patients presenting for emergency surgery in a resource-limited setting
    (2022) Munsie, Robert David; Gibbs, Matthew
    Objective: In this study of patients presenting for non-cardiac, emergency surgery in a resource limited setting, we aimed to evaluate the impact of routine preoperative transthoracic echocardiography on perioperative management. Design: A prospective before- and after-study of adult patients presenting for emergency, non-cardiac, non-obstetric surgery. Setting: The study was performed at an academic hospital in Cape Town, South Africa. Participants: Consenting patients over 18 years of age presenting for emergency surgery enrolled via convenience sampling during working hours over a 10 day period. Interventions: Basic and advanced Focused Assessment Transthoracic Echocardiography (FATE) was performed to evaluate ventricular function, valvular pathology and fluid status. After completing an assessment and treatment plan, the FATE findings were disclosed to the treating anesthetist. A post FATE plan was subsequently completed. Measurements and Main Results: A total of 67 patients were scanned with a change in management detected in 55% of cases. Thirty-nine percent of these alterations were in response to fluid management strategies with 31% of patients scanned being assessed as hypovolemic. There was a statistically significant link between patient volume status and change in perioperative management (p=0.0003). The presence or absence of valvular pathology also led to a significant association with change in management (p=0.020), most commonly in relation to the decision to proceed with surgery or the use of additional monitoring. Conclusion: This observational study of adult patients presenting for emergency surgery in an upper middle-income country demonstrates that routine preoperative transthoracic echocardiography has an impact on perioperative anesthetic management.