POCUS as part of the medical curriculum – is this the year?
Echocardiography allows real-time examination of cardiac function and structure. The information obtained includes diagnosing patient pathology, guiding clinical management, and monitoring treatment results. A detailed diagnostic echocardiography examination on a stable patient is usually performed during working hours by an echosonographer in the echocardiography suite. Given the available resources, it is however impractical to expect cardiologists to provide a reliable point-of-care (POC) transthoracic echocardiography (TTE) service at all hours.
The transthoracic echocardiographic skills of registrars in a department of anaesthesiology
Ultrasound plays an important role in improving procedural safety and diagnostic accuracy. It has become widely accepted as a diagnostic and procedural tool, but the application thereof was previously limited to specialist radiographers. With the advances in technology, portable ultrasound machines have become more affordable and more widely available to other medical disciplines. Over the last two decades, advances in technology have led to ultrasonography being incorporated more frequently into clinical practice. The bedside application of ultrasound has since become referred to as point-of-care ultrasonography (POCUS). Emergency medicine, cardiac anaesthesia and critical care were among the first disciplines to incorporate this skill into their daily practice.
Comparing paediatric caudal injection simulation on a 3D-printed, gelatine-cast part-task trainer and the Life/form® Pediatric Caudal Injection Simulator, to real anatomy, by specialist opinion
Many medical and surgical specialities have employed three-dimensional (3D) printing technology in training, research, development, preoperative planning and implant construction.1-3 Although this technology is commonly used in other specialities, there is a significant paucity in literature on 3D printing application in anaesthesiology.4 In line with this, West et al.5 rendered a 3D model of an adult lumbar spine using a real patient CT scan and commercial software. The 3D-printed model was used to develop an ultrasound part-task trainer (PTT) for spinal injection training. The conclusion was that 3D printing is a promising method for producing affordable PTTs with designs that can easily be shared between institutions. However, most of the available literature seems to be centred on models that simulate adult anatomy.
A survey of the perceptions and knowledge of anaesthesia and anaesthetists among Grade 12 learners in four Johannesburg districts
Anaesthesia as a speciality is one of the youngest branches of medicine and has made impressive advances in the medical field. William Morton conducted the first anaesthetic in 1846 using ether. Since the introduction of modern anaesthesia in 1846, there have been vast improvements in drug safety profiles and patient monitoring systems, which have translated into an advancement in surgery as well. Complex surgery can be undertaken safely and in a humane manner due to the safety profile of modern anaesthesia. Anaesthetists have transcended the borders of theatre and are now actively involved in hospital resuscitation teams, trauma units, pain clinics and intensive care units (ICU).
Total intravenous anaesthesia: a survey of practices and training at an anaesthesiology department
As the practice of general anaesthesia has developed over time, modifications to how it is administered have paralleled pharmacological and technological advances. The most widely practised method to achieve general anaesthesia involves a combination of intravenous anaesthetic agents for induction and a volatile agent for maintenance. Volatile agent-based anaesthesia has dominated the practice of general anaesthesia for many years. With the discovery of propofol in the 1970s, there was a renewed interest in the use of intravenous anaesthesia. This was further aided by an improved understanding of the pharmacokinetic and pharmacodynamic principles of drugs, the development of drugs with a rapid onset and offset as well as improved drug delivery systems.
Visual estimation of blood loss on swabs by surgeons and anaesthetists in KwaZulu-Natal: an online survey study
South Africa has one of the highest injury-related mortality rates internationally, a homicide-related mortality rate eight times the global rate, and a road traffic mortality rate twice the global rate. In this context, the decision whether to transfuse becomes an important one. Between 5 000 and 6 000 blood products are ordered monthly from the South African National Blood Service at the Chris Hani Baragwanath Academic Hospital and up to 30% of these orders are either cancelled or wasted. The Western Province Blood Transfusion Service (WPBTS) must collect approximately 700 units of whole blood every day to meet the needs of the Western Cape according to the WPBTS Annual Report 2017/2018. While it seems intuitive to use blood products to replace that which is lost, this decision is not as simple.
The management of postoperative pain after musculoskeletal surgery – a narrative review
The healthcare environment functions on cost-effective care, and the rapidly rising cost of medical services is fast becoming a major consideration in patient management. The implementation of a standardised multimodal analgesia plan can streamline planned patient care since all role players know what to expect after a surgical procedure. This review will focus on strategies for use in the management of postoperative pain following musculoskeletal surgery.
Southern African Journal of Anaesthesia and Analgesia - January/February 2023 Vol 29 No 1