DSpace Collection:
https://hdl.handle.net/11055/3
2024-03-28T22:35:19ZAirway management of adult epiglottitis: a systematic review and meta-analysis
https://hdl.handle.net/11055/1205
Title: Airway management of adult epiglottitis: a systematic review and meta-analysis
Authors: Booth AWG; Pungsornruk K; Llewellyn S; Sturgess D; Vidhani K
Abstract: Abstract
Background: Adult epiglottitis is a life-threatening airway emergency where airway protection is the immediate priority. Despite its importance, the optimal approach to airway management remains unclear. We performed a systematic review of the airway management for adult epiglottitis, including meta-analysis of trends over time.
Methods: We systematically searched PubMed, Ovid MEDLINE®, and Embase® for adult epiglottitis studies that described the airway management between 1980 and 2020. The primary outcome was the prevalence of airway intervention. Secondary outcomes were prevalence of tracheal intubation, tracheostomy, and failed intubation. A random-effects model meta-analysis was performed with subgroups defined by decade of study publication. Cases that described the specific method of airway intervention and severity of epiglottitis were included in a separate technique summary.
Results: Fifty-six studies with 10 630 patients were included in the meta-analysis. The overall rate of airway intervention was 15.6% (95% confidence interval [CI] 12.9-18.8%) but the rate decreased from 20% to 10% between 1980 and 2020. The overall rate of tracheal intubation was 10.2% (95% CI 7.1-13.6%) and that of failed intubation was 4.2% (95% CI 1.4-8.0%). The airway technique summary included 128 cases, of which 75 (58.6%) were performed awake and 53 (41.4%) involved general anaesthesia. We identified 32 cases of primary technique failure.
Conclusion: The rate of airway intervention for adult epiglottitis has decreased over four decades to a current level of 10%. Tracheal intubation is a high-risk scenario with a 1 in 25 failure rate. Specific technique selection is most likely influenced by contextual factors including the severity of epiglottitis.
Keywords: adult epiglottitis; airway intervention; epiglottitis; intubation; tracheostomy.2024-01-05T00:00:00ZThe new Diploma of Rural Generalist Anaesthesia: Supporting Australian rural and remote communities
https://hdl.handle.net/11055/1201
Title: The new Diploma of Rural Generalist Anaesthesia: Supporting Australian rural and remote communities
Authors: Gilchrist PT; Beaton NSM; Atkin JN; Roberts LJ
Abstract: Abstract
In 2023, a Diploma of Rural Generalist Anaesthesia (DipRGA) was implemented across Australia. Developed collaboratively by the Australian and New Zealand College of Anaesthetists (ANZCA), the Australian College of Rural and Remote Medicine (ACRRM) and the Royal Australian College of General Practitioners (RACGP), the 12-month qualification is completed during or following ACRRM or RACGP Rural Generalist Fellowship training. Focused on the needs of rural and remote communities for elective and emergency surgery, maternity care, resuscitative care for medical illness or injury, and stabilisation for retrieval, the DipRGA supports rural generalist anaesthetists working within collaborative teams in geographically isolated settings. The goal is a graduate who can anaesthetise American Society of Anesthesiologists physical status class 1, 2 and stable 3 patients for elective surgery, provide obstetric anaesthesia and analgesia, anaesthetise paediatric patients and undertake advanced crisis care within their scope of practice. Crucially, they also recognise both limitations of their skills and local resources available when considering whether to provide care, defer, refer or transfer patients. DipRGA curriculum design commenced by adapting the ANZCA specialist training curriculum with consideration of the training approach of both the ACRRM and the RACGP, particularly the rural and remote context. Curriculum content is addressed in seven entrustable professional activities supported by workplace-based assessments and multisource feedback. Trainees are supervised by rural generalist anaesthetists and specialist anaesthetists, and complete flexible learning activities to accommodate geographical dispersion. Standardised summative assessments include an early test of knowledge and an examination, adapted from the ACRRM structured assessment using multiple patient scenarios.THYRAID: a cognitive aid for the management of neck haematoma following thyroid surgery
https://hdl.handle.net/11055/1200
Title: THYRAID: a cognitive aid for the management of neck haematoma following thyroid surgery
Authors: Phillips A; Graham J; Eyeington C; Mercer I; Taylor CDevelopment of a direct observation of procedural skills tool for gastric ultrasound
https://hdl.handle.net/11055/1199
Title: Development of a direct observation of procedural skills tool for gastric ultrasound
Authors: Sidhu, NS; White,C; Pozaroszczyk, A
Abstract: No abstract available2022-06-01T00:00:00Z