Evaluation of an ACLS training program for nurse anesthetist aims at role and satisfaction

Background : Anesthesiology patients have a high risk of cardiac arrest and staff must be prepared for CPR.  CPR must be performed quickly and correctly to benefit patients.  Not only do nurses anesthetists need adequate skills and knowledge of CPR but also need an understanding of and satisfaction with their work.   Objective : Compare knowledge with responsibility of CPR before and after an educational campaign among nurses anesthetists.Sample : 27 nurses anesthetists working in OR at Srinagarind Hospital, Khon Kaen.Methods : Descriptive study which assessed nurses anesthetists knowledge and responsibilities before, immediately and three months after training.  Following training nurses were given assigned roles and responsibilities, narrated documents, a video and practical experience before being retested after three months. Results : The study revealed there was a difference in satisfaction levels before and after training.  Satisfaction was divided into six parts. Participation in Hospital Accreditation was a difference in satisfaction levels before and after training. In peer support, personal CPR skills, and practice of CPR, study of practical hindrances and roles and responsibilities, satisfaction over the other five sections did not change over the testing period.Conclusions : Nurses anesthetists must have more information and knowledge about their roles and responsibilities regarding CPR.  Knowledge from the training when coupled with practical experience can last for at least three months.  Keyword : cardiopulmonary resuscitation, role, satisfaction, nurse anesthetist

Surveillance of and Risk Fztors for Difficult Intubation At Srinagarind Hosipital

Objective:  To identify the incidence of, and risk factors for, difficult intubation during anesthesia at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand.Design:  Descriptive, prospective study.Methods:  Our study was part of a multi-center study conducted in 2003 by the Thai Royal College of Anesthesiologists aimed at surveillance of anesthetic-related complications in Thailand.  We collected the data from all of the cases receiving anesthesia service at Srinagarind Hospital between January 1 and December 31, 2003, to document cases of difficult intubation during anesthesia and to determine the cause(s), that the quality of service might be improved.  Patient data, corrective method, contributing factors, factors minimizing incidence and suggested corrective strategies were recorded on the ‘Difficult Intubation Record Form’.Results:  A total of 10 607 patients were included.  The incidence of difficult intubations during anesthesia was 20 (18.86 per 10 000; 95%CI 11.52, 29.11).  Corrective methods included:  stylet use, straight laryngoscope blade and intubation laryngeal mask airway.  Only minor physiological disturbances occurred in most patients.  The common contributing factors were:  insufficient knowledge, inexperience and insufficient equipment.  Suggested corrective strategies could include:  additional training, quality assurance activity, and purchase of equipment.Conclusion:  The incidence of difficult intubation was 18.86 per 10 000.  None of the patients experienced any major complications, perhaps because of standard anesthesia care.  The causes and corrective strategies comprised: patient character, personnel-associated, knowledge and equipment.  Additional equipment and training as well as quality assurance activity would probably help to reduce the incidence of difficult intubation.