PubMed Health⌕ Search

Biomedical subjects

A K McIndoe

Publications and source records attributed to A K McIndoe.

11 recordsLinked to original sources
PubMed2000

A detailed analysis of theatre training activity in a UK teaching hospital.

We examined the placement of anaesthetists in our department over a 2 yr period. Data were collected from an in-theatre system to provide details of caseload and supervision for 34,856 operations. There was wide variation between anaesthetic sub-specialties with overall supervision levels of 35% of cases for senior house officers (SHOs) and 32% for specialist registrars (SpRs). The consultant data showed the size and areas of teaching reserve in the department. We then examined individual logbooks in order to validate our data, and departmental rotas to put these data into perspective with previous attempts to quantify trainee supervision. Supervision data derived from the rota allocations showed that 86% of SHO lists and 62% of SpR lists were scheduled to be supervised. This study has described our training activity and facilitated departmental changes, as well as highlighting the need for great care in interpreting trainee supervision data acquired from different sources, particularly when comparisons are being made.

Anesthesiology↗
PubMed1999

Continuous auditory monitoring--how much information do we register?

We have studied response times of 30 anaesthetists to a standardized episode of arterial oxygen desaturation in a simulated patient, randomized to the use of either a fixed or variable pitch pulse oximeter. We wished to determine if a variable auditory signal was important in detecting adverse events. A variable pitch pulse signal had a shorter time to recognition of desaturation (P < 0.0001), with a mean response time of 32 s, compared with 129 s for the fixed pitch signal.

Acoustic Stimulation↗
PubMed1998

Multiple-choice examinations: adopting an evidence-based approach to exam technique.

Negatively marked multiple-choice questions (MCQs) are part of the assessment process in both the Primary and Final examinations for the fellowship of the Royal College of Anaesthetists. It is said that candidates who guess will lose marks in the MCQ paper. We studied candidates attending a pre-examination revision course and have shown that an evaluation of examination technique is an important part of an individual's preparation. All candidates benefited substantially from backing their educated guesses while only 3 out of 27 lost marks from backing their wild guesses. Failure to appreciate the relationship between knowledge and technique may significantly affect a candidate's performance in the examination.

Anesthesiology↗
PubMed1997

Drawover vaporizers for sedation in intensive care.

OBJECTIVE: We have undertaken a laboratory study to determine whether a drawover vaporizer in the inspiratory limb of an intensive care ventilator circuit can produce safe and therapeutic concentrations of isoflurane. DESIGN: An Oxford Miniature Vaporizer (OMV) and Ohmeda TEC vaporizer were assessed over the range of inspired isoflurane concentrations, airway pressures and tidal volumes experienced in the ICU. CONCLUSIONS: The experimental findings suggest that the OMV inhaler in plenum mode can be relied upon to produce safe concentrations of isoflurane over a clinically useful range of inspired concentrations. Furthermore, it behaves predictably over the range of airway pressures likely to be encountered in the patient admitted with acute severe asthma. However, we found that the Ohmeda TEC vaporizer did not perform reliably in this setting.

Anesthetics, Inhalation↗
PubMed1996

A comparison of retrospective versus contemporaneous nausea scores with patient-controlled analgesia.

In the search for an effective method of reducing the incidence of postoperative nausea, a standardised system of patient assessment is required. We examined 76 patients who had undergone elective total abdominal hysterectomy and were receiving patient-controlled analgesia with morphine. Nausea scores were obtained using an 11-point rating score. Repeated contemporaneous assessments were compared with a single retrospective score made 5 days after surgery. Retrospective nausea scores were higher than those recorded contemporaneously. Maximum contemporaneous score showed greater agreement with the retrospective score than did the median, mean, or minimum contemporaneous score. Collectively, these results suggest that patients tend to remember their episodes of nausea vividly, even if these episodes were punctuated by relatively nausea-free periods. The variability between the two sets of results suggests that contemporaneous and retrospective nausea scores should not be used interchangeably.

Adult↗
PubMed1995

Peripartum cardiomyopathy presenting as a cardiac arrest at induction of anaesthesia for emergency caesarean section.

Peripartum cardiomyopathy is defined as the onset of acute heart failure without demonstrable cause in the last trimester of pregnancy or within the first 6 months after delivery. It occurs in about 1 in 4000 deliveries and is often unrecognized as symptoms of normal pregnancy commonly mimic those of mild heart failure. We describe a previously asymptomatic patient who presented with a cardiac arrest at induction of general anaesthesia for emergency Caesarean section and subsequently developed acute heart failure. This case is unique both in its mode of presentation and the total absence of antecedent symptoms or signs of cardiac disease.

Adult↗