ABSTRACT
AIM AND OBJECTIVES: This study aimed to determine the psychological effects of the COVID-19 pandemic on healthcare professionals working in primary care settings in the first year of the pandemic. BACKGROUND: The healthcare industry has faced an unprecedented burden in the COVID-19 pandemic. Primary care professionals experienced the high level of psychological problems. DESIGN AND METHODS: A total of 793 healthcare professionals from different regions of Turkey participated in this cross-sectional study. The STROBE (Strengthening the reporting of observational studies in epidemiology) checklist was used in the study. Data were collected online. RESULTS: It has been found that more than half of healthcare professionals experienced severe depression, three-quarters experienced anxiety, and almost half experienced stress. It was also found that about half of the participants experienced a high degree of acute and chronic fatigue, and one-fifth experienced low inter-shift recovery. CONCLUSION: The effects of the COVID-19 pandemic on the mental health of primary care professionals, especially nurses and midwives, are alarming. The problems that arise from the flawed healthcare delivery models and gender inequality, which worsen the usual psychological effects of the pandemic on primary care professionals, should be addressed urgently. RELEVANCE TO CLINICAL PRACTICE: Psychological support and rehabilitative services should be expanded to eliminate the short- and long-term psychological effects of the pandemic on healthcare professionals.
ABSTRACT
BACKGROUND: Supraglottic airway devices such as the LMA-Supreme (LMA-S) and I-gel, which have an additional lumen for the insertion of a gastric tube, can be useful in the management of the difficult airway. OBJECTIVE: To test the performance of these two devices in the difficult paediatric airway. DESIGN: Randomised double-blind study. SETTING: Anaesthesia department, university hospital. PATIENTS: Sixty American Society of Anesthesiologists (ASA) I-II children undergoing elective surgery. INTERVENTION: After obtaining ethical approval and written informed consent from the parents, we compared the size 2 LMA-S with the I-gel in a simulated airway scenario made more difficult by using a cervical collar to limit mouth opening and neck movement. MAIN OUTCOME MEASURES: The primary aim was to compare the oropharyngeal leak pressure of the LMA-S and the I-gel. The secondary aims were to compare success rate, insertion time, time to pass a gastric tube and fibreoptic view of the larynx. RESULTS: Oropharyngeal leak pressure (meanâ±âSD) for the LMA-S was significantly higher than with the I-gel (20.9â±â3.2 versus 18.9â±â3.2 cmH2O, Pâ=â0.019). First attempt success rate for the LMA-S was 100 and 90% for the I-gel (Pâ>â0.05). Insertion time of the LMA-S was shorter than I-gel (11.2â±â1.8 versus 13.5â±â2.4 s, Pâ=â0.001). Gastric tube placement was possible in all patients. The mean insertion time of the gastric tube was shorter with the LMA-S than with the I-gel (10.3â±â3.6 versus 12.7â±â3.2 s, Pâ=â0.009). Fibreoptic laryngeal views were similar in both groups. CONCLUSION: In the simulated difficult airway in children, both airway devices provided effective ventilation. Paediatric size 2 LMA-S sustained a higher airway pressure before leaking and was quicker to insert than the I-gel equivalent. These differences may not be clinically significant.
Subject(s)
Elective Surgical Procedures/methods , Intubation, Intratracheal/methods , Laryngeal Masks , Child , Child, Preschool , Double-Blind Method , Elective Surgical Procedures/instrumentation , Equipment Design , Female , Fiber Optic Technology , Humans , Male , Oropharynx/physiology , Pressure , Time FactorsABSTRACT
When ultrasound (US) is used in peripheric nerve blocks, successful nerve blocks can be performed even if nerve stimulation is not possible. In this case report, we present a 37-year-old male patient, ASA physical status I, undergoing debridement and grafting for incomplete arm whose upper extremity (forearm) was amputated due to electric shock; motor response to nerve stimulation was not possible. With the help of US, lateral sagittal infraclavicular block was performed with 20 ml local anesthetic mixture (10 ml of 0.5% levobupivacaine and 10 ml 2% lidocaine with 5 mcg/ml epinephrine). After 20 minutes, the patient was ready for surgery and the operation was performed successfully.
