Abstract:
:The aim of this study was to determine the extent of unnecessary investigation performed as part of the preoperative preparation of elective surgical patients in a teaching hospital and to audit the effect of guidelines and education designed to reduce unnecessary investigation. Guidelines were developed for preoperative anaesthetic investigation for elective surgical procedures in patients over one year of age according to internationally accepted criteria, with some adjustment for local differences in patient morbidity. Forrms outlining these criteria were placed in all operating theatres and anaesthetists were asked to determine whether tests performed were indicated or not, according to these criteria, over a two-week period, in each patient undergoing elective surgery. Tests indicated for surgical reasons were excluded. These same guidelines were then issued to all surgical departments along with explanatory lectures. The audit was repeated six months later and results compared. The incidence of over-investigation decreased from 13.8% to 11.6% (P = 0.03) without a significant increase in under-investigation (0.7 v 1.0%; P = 0.2). This study highlights the incidence of unwarranted screening tests in patients presenting for elective surgery and the role of protocols and ongoing education in reducing this incidence.
journal_name
Anaesth Intensive Carejournal_title
Anaesthesia and intensive careauthors
Greer AE,Irwin MGdoi
10.1177/0310057X0203000310keywords:
subject
Has Abstractpub_date
2002-06-01 00:00:00pages
326-30issue
3eissn
0310-057Xissn
1448-0271pii
2001159journal_volume
30pub_type
杂志文章abstract::Fluid administration has been reported to be associated with an increased risk of acute kidney injury (AKI). We assessed whether, after correction for fluid balance, amount and chloride content of fluids administered have an independent association with AKI. We performed an observational study in patients after major ...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1804600112
更新日期:2018-01-01 00:00:00
abstract::The costs of washed autologous red cell concentrate obtained by intraoperative red cell salvage were compared to the costs of allogeneic packed red cell transfusion during 110 consecutive abdominal aortic aneurysm repairs. The mean volume of scavenged blood during elective procedures was 1350 ml (range 350 to 6675 ml,...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章
doi:10.1177/0310057X0002800606
更新日期:2000-12-01 00:00:00
abstract::The mechanism of cerebral homeostasis is reviewed, paying particular attention to the way blood-brain barrier, cerebrospinal fluid and cerebral blood flow contribute to the maintenance of normal intracranial pressure. The pathophysiology of raised intracranial pressure is outlined delineating the different types of ce...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章,评审
doi:10.1177/0310057X8100900405
更新日期:1981-11-01 00:00:00
abstract::Colloid infusions can cause metabolic acidosis. Mechanisms and relative severity with different colloids are incompletely understood. We compared haemodilution acid-base effects of 4% albumin, 3.5% polygeline, 4% succinylated gelatin (all weak acid colloids, strong ion difference 12 mEq/l, 17.6 mEq/l and 34 mEq/l resp...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0903700304
更新日期:2009-05-01 00:00:00
abstract::Standard clinical practice recommends minimal doses of vasoactive drugs during weaning of patients from mechanical ventilation. However there are currently no clinical data to inform clinicians about whether the use of noradrenaline during weaning predisposes to weaning failure. The objective of this study was to eval...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0803600310
更新日期:2008-05-01 00:00:00
abstract::The first 2000 incidents reported to the Australian Incident Monitoring study (AIMS) were examined to identify those incidents which occurred preoperatively (defined as occurring prior to the commencement of general or regional anaesthesia). The 35 incidents, representing 1.7% of the total, which occurred in this time...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9302100516
更新日期:1993-10-01 00:00:00
abstract::Continuous peripheral nerve blockade is a common technique in the analgesic management for many procedures. Leakage of local anaesthetic from around the nerve catheter insertion site can increase the chance of catheter dislodgement, risks infective complications, and could divert anaesthetic away from the nerve causin...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章,随机对照试验
doi:10.1177/0310057X1804600507
更新日期:2018-09-01 00:00:00
abstract::Chlormethiazole ethanedisulphonate (Hemineurin) was administered to provide light sedation in patients undergoing surgery with neural blockade. A two stage intravenous infusion system was used and consisted of a loading dose 1520 mg over 30 minutes followed by a maintenance rate of 10 mg/min for the desired period. Pa...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X8000800405
更新日期:1980-11-01 00:00:00
abstract::The synthetic glucocorticoid dexamethasone is administered to many patients receiving a general anaesthetic to reduce the risk of postoperative nausea and vomiting. Dexamethasone is known to suppress the hypothalamic-pituitary-adrenal axis; however, the duration of this suppression following the standard anti-emetic i...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章,随机对照试验
doi:10.1177/0310057X1304100504
更新日期:2013-09-01 00:00:00
abstract::We present a technique of retrosternal block for symptomatic treatment for dyspnoea of various aetiologies. In our experience with 20 patients, a retrosternal block using lignocaine improved symptoms within minutes. The block was easy to perform and was helpful when the patients' symptoms were not relieved by conventi...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0503300420
更新日期:2005-08-01 00:00:00
abstract::The ability of cricoid pressure to prevent inflation of the stomach during mask ventilation of a patient was studied. Fifty patients were randomly allocated to either have or not have cricoid pressure applied during a three-minute period of standardised mask ventilation. Patients who had had cricoid pressure applied h...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1177/0310057X8801600202
更新日期:1988-05-01 00:00:00
abstract::An unplanned intensive care unit admission within 24 hours of a procedure with an anaesthetist in attendance (UIA) is a recommended clinical indicator It is designed to identify preventable iatrogenic complications. Often understood as a specific anaesthetic outcome, its value has been repeatedly questioned. Iatrogeni...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0803600209
更新日期:2008-03-01 00:00:00
abstract::Thyroid storm is a rare but life-threatening condition manifesting with several clinical presentations. Atypical thyroid storm should be part of the differential diagnosis in patients with multiple organ dysfunction of unknown aetiology. In this case report, delayed recognition of thyroid storm in a young female who p...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0903700609
更新日期:2009-11-01 00:00:00
abstract::An 18-year-old man with metastatic femoral osteosarcoma had inadequate pain control with gabapentin, naproxen and intravenous fentanyl. A tunnelled femoral nerve catheter was used to administer a continuous infusion of 0.2% ropivacaine and 4 microg/ml clonidine (10 ml/hour) until his death 88 days later During dischar...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1003800324
更新日期:2010-05-01 00:00:00
abstract::Current donor management practices target macrohaemodynamic parameters, but it is unclear if this leads to improvements in microvascular perfusion and tissue oxygenation; the latter may have more impact on organ status. In a recent preclinical study we determined that brain death impaired tissue perfusion and oxygen u...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1804600611
更新日期:2018-11-01 00:00:00
abstract::Platypnoea-orthodeoxia syndrome has the pathognomonic clinical findings of dyspnoea and arterial hypoxaemia relieved by recumbency. We report on a patient who presented with platypnoea-orthodeoxia syndrome post laparoscopic surgery. Platypnoea-orthodeoxia syndrome is an important diagnosis to consider when investigati...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1404200317
更新日期:2014-05-01 00:00:00
abstract::The manner in which elements of clinical history, physical examination and investigations influence subjectively assessed illness severity and outcome prediction is poorly understood. This study investigates the relationship between clinician and objectively assessed illness severity and the factors influencing clinic...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章,多中心研究
doi:10.1177/0310057X0503300117
更新日期:2005-02-01 00:00:00
abstract::Patients presenting for elective surgery in the Bay of Plenty area in New Zealand are increasingly elderly with significant medical comorbidities. For these patients the risk-benefit balance of undergoing surgery can be complex. We recognised the need for a robust shared decision-making pathway within our perioperativ...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X20960734
更新日期:2020-11-01 00:00:00
abstract::Acute right heart failure in a young person is an unusual presentation and drug overdose is a rare cause. A case is described where the patient presented with striking clinical signs of acute pulmonary hypertension and right heart failure, which were confirmed by transthoracic echocardiography. The precipitating event...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0403200417
更新日期:2004-08-01 00:00:00
abstract::The first human infection with Chromobacterium violaceum was recorded in 1927, but since then there have been about 33 cases reported worldwide, including two from Australia. Chr. violaceum occurs in the tropics and subtropics and is generally considered to be nonpathogenic, but infection can occur in patients who are...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9202000120
更新日期:1992-02-01 00:00:00
abstract::This study was undertaken to identify factors influencing outcome in elderly patients operated for hip fracture. In particular, this study examined factors related to mortality at least 30 months post-fracture. Hospital records and death registrations were analysed for 463 patients aged 60 or more years treated for hi...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0503300608
更新日期:2005-12-01 00:00:00
abstract::Pethidine (meperidine) is a unique member of the opioid family. In addition to its analgesic activity, it also has significant local anaesthetic activity. This property enables it to be used as the sole agent for spinal anaesthesia. We describe the successful use of intrathecal pethidine 1 mg/kg for an elective lower ...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1304100119
更新日期:2013-01-01 00:00:00
abstract::Althesin was used as a induction agent then diluted and administered as a controlled infusion for 60 patients undergoing 66 procedures. Increment doses of fentanyl were given to provide additional analgesia. There was delayed awakening in 7 patients (12.1%), 3 of whom responded rapidly to narcotic reversal with naloxo...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X7900700208
更新日期:1979-05-01 00:00:00
abstract::The efficacy of predeposited autologous blood transfusion (PABT) with and without intra/postoperative blood salvage to reduce or eliminate the need for homologous blood transfusion (HBT) in primary total hip or knee replacement surgery was investigated by retrospective and prospective studies. Depending on the type of...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1177/0310057X9502300411
更新日期:1995-08-01 00:00:00
abstract::The potential transmission of disease by anaesthetic and ventilator breathing circuits has resulted in the widespread use of filters. Convincing scientific evidence of their complete efficacy is lacking particularly in regard to viruses. In the past, practical difficulties precluded the use of new or autoclavable equi...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9602400207
更新日期:1996-04-01 00:00:00
abstract::Two cases are presented which illustrate the disastrous consequences possible when an anaesthetic breathing circuit is obstructed by a foreign body. Despite reports of previous similar cases, work practices and equipment manufacture or design continue to allow for such events to occur. The importance of both pre-anaes...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9902700116
更新日期:1999-02-01 00:00:00
abstract::The cardiovascular, coagulation and haematological effects of prothrombin activator from Tiger Snake (Notechis scutatus) venom were investigated in anaesthetized mechanically ventilated dogs. Infusion caused dose-related systemic hypotension, marked decreases in cardiac output and stroke volume, marked increases in pu...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract::Sevoflurane is a newly available volatile anaesthetic agent which is suitable for inhalational induction of anaesthesia. Due to concerns about obstructing the upper airway as anaesthesia deepens, its use has until now been avoided in patients with upper airway obstruction. We used its smooth induction and recovery pro...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9702500621
更新日期:1997-12-01 00:00:00
abstract::A Perioperative Service has recently been introduced at liverpool hospital, a 460-bed university teaching hospital. This provides a co-ordinated system for managing all elective surgical patients from the time an admission booked until hospital discharge. This paper describes the patient assessment, structure and staf...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9502300511
更新日期:1995-10-01 00:00:00
abstract::Acute airway obstruction is a very rare presentation of achalasia. We report the case of a 78-year-old woman with previously undiagnosed achalasia who presented with acute respiratory distress and stridor due to tracheal compression by mega-oesophagus. Anaesthetists and physicians caring for patients with achalasia mu...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0803600412
更新日期:2008-07-01 00:00:00