Biomedical subjects

Polpun Boonmak

Publications and source records attributed to Polpun Boonmak.

3 recordsLinked to original sources

PubMed2005

Surveillance of anesthetic related complications at Srinagarind Hospital, Khon Kaen University, Thailand.

OBJECTIVE: To identify the incidence of common anesthetic complications in 2003 at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand and find the strategies for prevention. MATERIAL AND METHOD: The study was part of a multi-center study conducted by the Thai Royal College of Anesthesiologists to survey anesthetic related complications in Thailand in 2003. The authors collected data from all the cases receiving anesthesia service at Srinagarind Hospital between January 1 and December 31, 2003, to report the incidence of common anesthetic complications and to assess the need to improve the quality of service. This was a prospective, descriptive study. When any anesthetic complications occurred, they were reported by anesthesia personnel and anesthesiologists. The reporting forms comprised four categories of complications, viz.: respiratory, cardiovascular, neurological and others. Each category of complications has a guidebook for reference in order to correctly fill out the form. All the forms were verified by the principal author then included in the present study. RESULTS: A total of 10,607 patients were included and among these 268 incidents were recorded. The common incidents per 10,000 were desaturation (95.22), cardiac arrest (44.31), re-intubation (29.23), equipment failure (19.80) and difficult intubation (18.86). Main contributing factors were insufficient knowledge and inappropriate decisions. Suggested corrective strategies included quality assurance activities, additional training and improved supervision. CONCLUSION: Despite practical prevention guidelines being in place, the most common anesthesia incident at Srinagarind Hospital was respiratory incident. Continuing quality improvement is needed.

Adolescent↗

PubMed2004

An experience with intubating laryngeal mask airway for difficult airway management: report on 38 cases.

A retrospective study was performed on 38 patients (23 males and 15 females) in whom the intubating laryngeal mask airway (ILMA) was used for airway management at Srinagarind and Siriraj Hospital in 2003. The patients 'age and weight ranged between 12 and 75 years and 40 and 94 kg, respectively. Difficult tracheal intubation was suspected before starting general anesthesia in 17 patients, whereas it was found difficult after induction of general anesthesia in 21. The ILMA was successfully placed in all patients with airway patency classified as 'good' and 'acceptable' in 36 patients (94.7%), and 'poor' in two. Oxygen saturation during intubation was maintained above 95 percent in all patients. Tracheal intubation through the ILMA was successful in 34 patients (89.5%), which was described as 'easy' in 27 of 34 patients (79.4%). In the remaining 7, 2-5 attempts were required for successful tracheal intubation. The types of endotracheal tubes used were: 1) the pre-formed silicone tube in 55.9 percent, 2) the pre-formed flexible tube in 41.2 percent; and, 3) the standard polyvinyl tube in 2.9 percent. In the four patients with failed tracheal intubation through the ILMA, three were successfully intubated with conventional laryngoscopy and one with gum elastic bougie. There were no serious complications following the use of the ILMA in these patients. The ILMA proved a safe, very useful and easy to use device with a high success rate for difficult airway management.

Adolescent↗

PubMed2004

Knowledge and skill after brief ACLS training.

OBJECTIVES: To determine the knowledge level and skill base in nurse anesthetists before and after brief ACLS training, and again three months later. METHOD: Thirty nurse anesthetists were tested for knowledge and skill before ACLS training comprising 1-hr lecture and handout, and 1-hr simulation training. Concepts included ABCD, primary and secondary survey, management, medications, and algorithms for common problems. Skill practice comprised airway management, chest compression and practice with equipment. After the training, the nurse anesthetists were immediately tested and again three months later. RESULTS: Age of participants averaged 39.33 + or - 3.14 years and working experience 10.04 +/- 3.23 years. The knowledge and skill scores pre- vs post-training vs three-months-later was 50.32 +/- 15.24 vs 75.40 +/- 10.29 (p < 0.001) vs 60.48 +/- 11.80 (p < 0.001) and 65.00 + 16.07 vs 79.67 +/- 10.80 (p < 0.001) vs 75.67 +/- 14.53 (p < 0.001), respectively. The pre-training vs three-months-post-training skill scores was not statistically different (p = 0.255). CONCLUSION: After the briefACLS training knowledge and skills were significantly improved, but knowledge was not retained at the post-training test levels until the 3-month check, albeit skills had persisted. More frequent ACLS education is necessary.

Adult↗