Obstetric anaesthesia: the source of the crisis

The Saving Mothers Reports have consistently shown that, out of all the provinces of South Africa, the Free State has one of the highest rates of maternal deaths arising from anaesthesia.The province's Department of Health requested the University of the Free State's Department of Anaesthesiology to investigate the problem. We examined possible factors, including training and experience of doctors administering anaesthesia, availability of suitable anaesthetic drugs and equipment, and use of regional anaesthesia. All the level 1 and 2 hospitals in which caesarean sections (CSs) were being performed were investigated. The foremost problems identified were lack of training and experience in administering obstetric anaesthesia, and lack of senior anaesthetic assistanceSouth African Medical Journal Vol. 98 (2) 2008: pp. 123-12

Errors in drug administration by anaesthetists in public hospitals in the Free State

Objective. To investigate errors in administering drugs by anaesthetists working in public hospitals in the Free State province. Methods. Anonymous questionnaires were distributed to doctors performing anaesthesia in public hospitals in the Free State, i.e. 188 doctors at 22 public sector hospitals. Outcomes included demographic information on respondents, information regarding the administration of anaesthetics, reporting of errors, and the occurrence of errors during anaesthesia. Results. The response rate was 46.3%; 48.8% were medical officers, and 39.3% of participants were involved in at least one event of erroneous drug administration. Registrars and specialists reported the most errors. Most events were of no clinical significance, caused no permanent harm to patients, and most commonly involved fentanyl and suxamethonium. Of the respondents, 23.8% indicated that they were aware of a South African standard for colour-coding syringe labels, and 92.9% indicated that they would report anaesthetic errors if a single reporting agency for such events existed. Conclusions. More than a third of participating anaesthetists were involved in a drug error at some stage in their practice. Preventive systems and precautionary measures should be put in place to reduce drug administration errors

The effect of different anaesthetic mask shapes on the anatomical dead space using infant, child and adult part-task trainers

Dead space is the portion of tidal volume that does not participate in alveolar gas exchange. The purpose of this study was to compare the dead space contribution of differently shaped masks, of the same size, by measuring the volume of each mask. The study was conducted in the Clinical Simulation Unit of the School of Medicine, University of the Free State (UFS) using formed masks with inflatable polyvinylchloride (PVC) cuffs and rounded masks with non-inflatable PVC cuffs. The masks were placed on the faces of the infant, child and adult part-task trainers as well as on a flat surface. The cuffs of the formed masks were inflated to 5 cm water and 70 cm water. Masks were filled with water and the volume was measured.The volumes (ml) of the masks on the flat surface were significantly larger than those measured on the part-task trainers’ faces. The volume of the rounded masks was greater than the volume of the formed masks. The amount of cuff inflation pressure (5 cm water vs. 70 cm water) did not lead to a significant change in mask volume: 102.3 ml (standard deviation [SD] 75.9) vs. 110.2 ml (SD 82.3), averaged for all sizes.Formed masks contribute less to anatomical dead space than rounded masks and are thus possibly the better choice. Cuff inflation pressure has insignificant influence on dead space volume.Keywords: anaesthesia, anatomical dead space, inhalation, masks, pulmonary ventilation, respirator

Errors in drug administration by anaesthetists in public hospitals in the Free State

Objective. To investigate errors in administering drugs by anaesthetists working in public hospitals in the Free State province. Methods. Anonymous questionnaires were distributed to doctors performing anaesthesia in public hospitals in the Free State Province, i.e. 188 doctors at 22 public sector hospitals. Outcomes included demographic information on respondents, information regarding the administration of anaesthetics, reporting of errors, and the occurrence of errors during anaesthesia. Results. The response rate was 46.3%; 48.8% were medical officers, and 39.3% of participants were involved in at least one event of erroneous drug administration. Registrars and specialists reported the most errors. Most events were of no clinical significance, caused no permanent harm to patients, and most commonly involved fentanyl and suxamethonium. Of the respondents, 23.8% indicated that they were aware of a South African standard for colour coding syringe labels, and 92.9% indicated that they would report anaesthetic errors if a single reporting agency for such events existed. Conclusions. More than a third of participating anaesthetists were involved in a drug error at some stage in their practise. Preventative systems and precautionary measures should be put in place to reduce drug administration errors

Staging of breast cancer with PET/CT

No abstact available