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- Volume 17, Issue 5, 2011
Southern African Journal of Anaesthesia and Analgesia - Volume 17, Issue 5, 2011
Volumes & issues
Volume 17, Issue 5, 2011
Author Neal O'DonnellSource: Southern African Journal of Anaesthesia and Analgesia 17, pp 319 –320 (2011)More Less
It is said that in any organisation one is as strong as one's weakest link. In the practice of anaesthesia in South Africa, this weakest link is often our recovery rooms, for a number of reasons.
I recently received a letter from a nursing colleague, challenging the modified Aldrete criteria as the gold standard for deciding when in fact our adult patients are "ward ready".
Source: Southern African Journal of Anaesthesia and Analgesia 17, pp 323 –327 (2011)More Less
Background: Comprehensive information is needed on the epidemiology and burden of chronic pain in the population for the development of appropriate health interventions. This study aimed to determine the prevalence, severity, risk indicators and responses of chronic pain among adults in Ngangelizwe, Mthatha, South Africa.
Method: A cross-sectional survey utilising structured interviews of a sample of adult residents was used. Interviews elicited information on socio-demographic characteristics, general health status, and the prevalence, duration, frequency, severity, activity limitation and impact of chronic pain.
Results: More than 95% (n = 473) of the sampled adults participated in the study. Of these, 182 [38.5%, 95% confidence interval (CI): 36.3-42.5%] reported chronic pain in at least one anatomical site. The most common pain sites were the back and head. The median pain score was 5 on a scale of 0 to 10 [interquartile range (IQR) = 4-7] and the median number of sites of pain was 1 (IQR = 1-2). Female gender [odds ratio (OR) = 2.6, 95% CI: 1.7-3.9] and being older than 50 years of age (OR = 3.5, 95% CI: 2.6-4.1) were identified as risk indicators for chronic pain in the sample. Over 65% of respondents reported that they self-treated; 92.1% had consulted with a doctor or nurse, 13.6% consulted a traditional healer, and 34.5% consulted a pharmacist because of their pain. Despite this, over 50% reported that relief of their pain was transient.
Conclusion: Chronic pain is a common general complaint in this community, but there is a need for focused attention on women and the elderly.
A pilot study to determine the profile of recovery room nurses in Johannesburg hospitals : original researchSource: Southern African Journal of Anaesthesia and Analgesia 17, pp 323 –327 (2011)More Less
Background: Apart from anecdotal evidence, very little is known of the recovery room nurses in South Africa.
Method: An exploratory, prospective, descriptive pilot study was carried out in the recovery rooms of six Johannesburg hospitals, three academic and three private hospitals, one from each of the major private hospital groups. An appointment was scheduled and data were collected from either the theatre nursing manager, sister in charge of the recovery room or the nursing manager. The data collected reflected a brief profile of the selected recovery rooms and the demographic and education profile of nurses working there in August 2011.
Results: Nurse:patient ratios were difficult to determine. Agency staff was used by one recovery room. The other recovery rooms used their permanent staff to work overtime. All the hospitals used anaesthetic nurses to double up when necessary. Only one of the recovery rooms had a supernumerary anaesthetist available during the day. A total of 49 nurses were working in the six recovery rooms during August 2011. The majority, 95.9% (n = 47), of the recovery room nurses were females and 4.1% (n = 2) were males. The average age of the recovery nurses was 44 years (25-63 years), with a median of 41 years. The experience of the recovery room nurses ranged from one month to 35 years with an average of 8.6 years. The majority of nurses, 57.1% (n = 28), were professional nurses, and 42.9% (n = 21) were enrolled nurses. Of the 28 professional nurses, 32.0% (n = 9) had no postgraduate training. The remaining 19 nurses had the following postgraduate qualifications: management and operating room technique 17.9% (n = 5), critical care 14.3% (n = 4), and education 10.7% (n = 3). The six-month anaesthetic nurse qualification, that is not an official South African Nursing Council-endorsed postgraduate qualification, was held by 35.7% (n = 10) of the professional nurses and 4.8% (n = 1) of the enrolled nurses. All the recovery rooms had an in-service education programme.
Conclusion: There is a need to determine the profile of recovery room nurses in South Africa and to establish an appropriately trained and competent recovery room nursing workforce.
Author E. WelchSource: Southern African Journal of Anaesthesia and Analgesia 17, pp 339 –342 (2011)More Less
Genetic variations have always been implicated in interindividual reactions to various pharmaceutical agents. Some common genetically determined anaesthetic conditions, such as malignant hyperthermia, "scoline apnoea", "halothane hepatitis" and porphyria, are fairly well described, and the genetic differences in enzyme, receptor and ion channel systems are slowly being elucidated. These genomic differences allow some explanation as to why drugs that work well in certain patients produce no or unwanted effects in others.
Author M. BosenbergSource: Southern African Journal of Anaesthesia and Analgesia 17, pp 345 –348 (2011)More Less
Little consideration has been given to the environmental impact of gaseous anaesthetic use. All currently used volatile anaesthetics are halogenated and chemically similar to chlorofluorocarbons (CFCs), giving them the potential to impact the environment negatively via both ozone depletion and global warming. Overall contribution to climate change is dependent on both these environmental effects, as well as the quantities released into the atmosphere. This review of the current data provides an insight into the overall ecotoxicity of volatile agents and gives alternatives which may be employed to limit environmental load. Results from the studies reveal that global warming potential and ozone depletion potential are significant for all volatiles, especially when combined with nitrous oxide use. However, because atmospheric levels are estimated to be small when compared to gaseous emissions from industrial and agricultural sources, the actual percentage contribution to climate change is small. Despite these findings, the cumulative effects of small contributors to climate change should not be underestimated, especially with increasing numbers of future anaesthetics and a decreasing CFC load. The carbon footprint of an individual anaesthetist is significantly increased by the daily use of volatile anaesthetic agents and recognised alternatives may be utilised to minimise this.
Author Lee Clover-AnnSource: Southern African Journal of Anaesthesia and Analgesia 17 (2011)More Less