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 perioperative medicine service. We describe the setup of a complex decision pathway within our district health board and report on the audit data from our first 49 patients. The complex decision pathway encourages surgeons to identify high-risk patients who will benefit from shared decision-making, manages input from multiple specialists as needed with excellent communication between those specialists, and provides a patient-centred approach to decision-making using a structured communication tool.
journal_name
Anaesth Intensive Carejournal_title
Anaesthesia and intensive careauthors
Omundsen HC,Franklin RL,Higson VL,Omundsen MS,Rossaak JIdoi
10.1177/0310057X20960734subject
Has Abstractpub_date
2020-11-01 00:00:00pages
473-476issue
6eissn
0310-057Xissn
1448-0271journal_volume
48pub_type
杂志文章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::Although penetrating abdominal trauma is on the increase in Australia, blunt trauma continues to account for the majority of cases and usually presents a more challenging problem than the former. Diagnosis has been greatly facilitated by the widespread use of peritoneal lavage and computerised tomography. Conservative...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X8501300305
更新日期:1985-08-01 00:00:00
abstract::Venous thromboembolism is an important complication after general and cardiac surgery. Using transthoracic echocardiography, this study assessed the incidence of inferior vena cava (IVC) thrombosis among a total of 395 and 289 cardiac surgical and major surgical patients in the immediate postoperative period after car...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1304100614
更新日期:2013-11-01 00:00:00
abstract::One hundred and fifty-nine adult patients undergoing elective colonoscopy in a major regional hospital were surveyed regarding their perceptions and expectations of sedation/anaesthesia for this procedure. The survey was undertaken on the day of the procedure, but before their assessment by the anaesthetist. Most of o...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1304100315
更新日期:2013-05-01 00:00:00
abstract::A randomized, controlled clinical trial was conducted on 72 patients undergoing elective cardiac surgery to compare patient-controlled analgesia (PCA) to nurse-titrated infusion of morphine. Pain and nausea scores were assessed at 5, 20, 32 and 44 hours after cardiopulmonary bypass. Serum cortisol estimations were per...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1177/0310057X9402200605
更新日期:1994-12-01 00:00:00
abstract::A study was undertaken to determine the time constants of elimination and effect compartment equilibration of suxamethonium and for the slope exponent of the Hill equation. Twelve patients were anaesthetized with thiopentone, fentanyl, and isoflurane in nitrous oxide and oxygen. After allowing conditions to become sta...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9702500312
更新日期:1997-06-01 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::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::The strong ion gap (SIG) is under evaluation as a scanning tool for unmeasured ions. SIG is calculated by subtracting [buffer base], which is ([A-]+[HCO3-), from the apparent strong ion difference, which is ([Na+]+[K+]+[Ca++]+[Mg++]-[Cl-]-[L-lactate]). A- is the negative charge on albumin and phosphate. We compared th...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0703500308
更新日期:2007-06-01 00:00:00
abstract::The aim of the study was to calculate the in vitro inspiratory resistance (R(ETT)) of adult endotracheal tubes (ETT), via the end-inspiratory occlusion method, and to apply this method in vivo in order to estimate R(ETT) value in real time. By plotting R(ETT) over inspiratory flow (V) and calculating Rohrer's coeffici...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1103900311
更新日期:2011-05-01 00:00:00
abstract::Posthypoxic myoclonus is a rare and devastating complication of near-fatal cardiopulmonary arrest. Despite treatment with available anti-myoclonic agents, some patients may recover cognitively but remain completely disabled by severe myoclonus. We report a 16-year-old patient with severe treatment-refractory posthypox...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0903700214
更新日期:2009-03-01 00:00:00
abstract::Effective utilization of an anaesthetic clinic depends on appropriate referral of high-risk surgical patients. The decision-making behaviour of anaesthetists and nurses was examined to identify factors that influence the referral of patients to an outpatient anaesthetic clinic. Eleven consultant anaesthetists, seven a...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9402200510
更新日期:1994-10-01 00:00:00
abstract::Vancomycin is a commonly used antibiotic due to the high burden of methicillin-resistant Staphylococcus aureus infections. This study aimed to describe the pharmacokinetics (PK) of vancomycin in Australian Indigenous patients with severe sepsis, and advise an optimal dosing strategy. A population PK study was c...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1804600405
更新日期:2018-07-01 00:00:00
abstract::Breathing through an endotracheal tube, connector, and ventilator demand valve imposes an added load on the respiratory muscles. As respiratory muscle fatigue is thought to be a frequent cause of ventilator dependence, we sought to examine the efficacy of five different ventilators in reducing this imposed work throug...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9302100116
更新日期:1993-02-01 00:00:00
abstract::A questionnaire investigating substance abuse was sent to 128 anaesthetic departments in Australia and New Zealand of which 100 (78%) replied. Forty-four cases of substance abuse were reported. Abusers were more likely to be male, aged between 25 and 35 years and abusing opioids. Death was the eventual outcome in 24% ...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0503300216
更新日期:2005-04-01 00:00:00
abstract::Iatrogenic meningitis is a rare complication of spinal anaesthesia. It is mandatory to use a technique which minimises the risk of introducing bacteria into the subarachnoid space. Currently available fentanyl ampoules require a careful drawing-up technique, as the outside of the ampoule is not sterile and there is po...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0903700413
更新日期:2009-07-01 00:00:00
abstract::Cardiac output (CO) is a key determinant of major organ blood flow and solute delivery to drug eliminating organs. As such, CO assessment is a key covariate in understanding altered drug handling in the critically ill. Newer minimally-invasive devices are providing unique platforms for such an application, although co...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1204000408
更新日期:2012-07-01 00:00:00
abstract::The value of propranolol in relieving infundibular spasm is illustrated. The pathophysiology of infundibular spasm in Fallot's tetralogy and its management in anaesthesia is reviewed. ...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X7800600207
更新日期:1978-05-01 00:00:00
abstract::In this study we investigated in vitro and in vivo effects of propofol in malignant hyperthermia susceptible (MHS) patients in order to assess the safety of propofol infusion as a non-triggering anaesthetic technique for diagnostic and therapeutic procedures. In vitro, human MHS muscle samples were exposed to propofol...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9202000208
更新日期:1992-05-01 00:00:00
abstract::We tested the hypothesis that haemodynamic changes to intubation and postoperative pharyngolaryngeal morbidity are similar for blind intubating laryngeal mask (ILM)-guided compared with laryngoscope-guided tracheal intubation in adults with normal airways. We also compared intubation success rates and airway complicat...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1177/0310057X0002800305
更新日期:2000-06-01 00:00:00
abstract::No specific prognostic model has been developed for patients readmitted to the intensive care unit (ICU) during the same hospitalisation. This study assesses the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II predicted mortality measured at the time of ICU readmission and whether incorpo...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0803600107
更新日期:2008-01-01 00:00:00
abstract::A six-year-old boy with oesophageal strictures secondary to neonatal repair of oesophageal atresia and requiring six to eight weekly oesophageal dilatations by bouginage developed anticipatory nausea and vomiting. This was effectively managed by a course of preoperative hypnotherapy over four sessions. Resolution of a...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0703500522
更新日期:2007-10-01 00:00:00
abstract::Several studies have been conducted to evaluate the utilisation of the operating room, a fixed resource, in terms of conditions that prevent day-of-surgery cancellation due to deficient operative capacity. In this study, we surveyed the causes and overall rates of elective surgery cancellation and then compared the nu...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0903700203
更新日期:2009-03-01 00:00:00
abstract::Few authors have addressed the topic of graphic data presentation. The purpose of our study was to combine several guidelines in order to evaluate three anaesthesiology journals listed in Index Medicus (Australian, American and Italian) in terms of the appropriateness and the quality of presentation of graphs. Our ana...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9702500612
更新日期:1997-12-01 00:00:00
abstract::Serious complications from tricyclic antidepressant (TCA) overdose are uncommon. We present a case of massive imipramine overdose complicated by ventricular fibrillation and a prolonged period of cardiovascular collapse. A total of 400 mmol of sodium bicarbonate, 5 mg of adrenaline and 80 mg of sotalol were given duri...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9702500516
更新日期:1997-10-01 00:00:00
abstract::Acute lung injury/acute respiratory distress syndrome (ALI / ARDS) is the most serious pulmonary complication after lung resection. This study investigated the incidence and outcome of patients with ALI / ARDS who required mechanical ventilation within one week of undergoing pneumonectomy for primary lung cancer and a...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0903700110
更新日期:2009-01-01 00:00:00
abstract::Positive end-expiratory pressure (PEEP) maintains airway pressure above atmospheric at the end of expiration, and may be used with mechanical ventilation or spontaneous breathing. CPAP, or continuous positive airway pressure, refers to spontaneous ventilation with a positive airway pressure being maintained throughout...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章,评审
doi:10.1177/0310057X8601400304
更新日期:1986-08-01 00:00:00
abstract::Many anaesthetists practising in Australia and New Zealand realise that differences exist in the training of their counterparts in the United States. This review attempts to highlight the differences observed by two anaesthetists who have been involved in both systems. Aspects of the American Board of Anesthesiology e...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X8301100319
更新日期:1983-08-01 00:00:00
abstract::Costing data for intensive care admissions is important, not only for unit funding, but also for cost outcome analysis of new therapies. This paper presents an intensive care episode costing methodology using the example of a cost-benefit analysis of mask CPAP for severe cardiogenic pulmonary oedema (CPO). This analys...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9402200209
更新日期:1994-04-01 00:00:00
abstract::Measurements of atmospheric nitrous oxide concentrations were made in eight hospitals, using 30 anaesthetic machines and locations, during 41 anaesthetic administrations or simulations. All areas were air conditioned, two by laminar flow devices. All anaesthetic machines and ventilators were fitted with commercially a...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X7800600307
更新日期:1978-08-01 00:00:00