A5003439494- Cardiac, Anesthesia and Surgical Outcomes
- Anesthesia and Pain Management
- Airway Management and Intubation Techniques
- Maternal and fetal healthcare
- Maternal and Perinatal Health Interventions
- Nausea and vomiting management
- Anesthesia and Sedative Agents
- Spine and Intervertebral Disc Pathology
- Pregnancy and preeclampsia studies
- Hemodynamic Monitoring and Therapy
- Cardiac Arrest and Resuscitation
- Medical History and Innovations
- Anesthesia and Neurotoxicity Research
- Spinal Hematomas and Complications
- Assisted Reproductive Technology and Twin Pregnancy
- Trauma and Emergency Care Studies
- COVID-19 Impact on Reproduction
- Pregnancy and Medication Impact
- Cardiovascular Issues in Pregnancy
- Pain Management and Opioid Use
- Pregnancy-related medical research
- Global Maternal and Child Health
- Healthcare Systems and Challenges
- Neonatal Respiratory Health Research
- Blood Coagulation and Thrombosis Mechanisms
Queen Charlotte's and Chelsea Hospital
2014-2025
University College London
2015-2024
Imperial College Healthcare NHS Trust
2001-2024
Hammersmith Hospital
2004-2022
Royal College of Anaesthetists
2015-2021
National Hospital for Neurology and Neurosurgery
2015
Bradford Teaching Hospitals NHS Foundation Trust
2012-2015
Edinburgh Royal Infirmary
2015
Royal United Hospital
2015
Papworth Hospital
2015
Detailed contemporary knowledge of the characteristics surgical population, national anaesthetic workload, techniques and behaviours are essential to monitor productivity, inform policy direct research themes. Every 3-4 years, Royal College Anaesthetists, as part its National Audit Projects (NAP), performs a snapshot activity survey in all UK hospitals delivering anaesthesia, collecting patient-level encounter data from cases under care an anaesthetist. During November 2021, NAP7,...
Summary The 7th National Audit Project (NAP7) of the Royal College Anaesthetists studied peri‐operative cardiac arrest. Additional inclusion criteria for obstetric anaesthesia were: arrest associated with neuraxial block performed by an anaesthetist outside operating theatre (labour epidural analgesia); and remifentanil patient‐controlled analgesia. There were 28 cases in patients, representing 3% all arrests reported to NAP7, giving incidence 7.9 per 100,000 (95%CI 5.4–11.4 100,000)....
We present the main findings of 5th National Audit Project on accidental awareness during general anaesthesia. Incidences were estimated using reports as numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence certain/probable possible cases was ~1:19 600 anaesthetics (95% CI 1:16 700-23 450). However, there considerable variation across subtypes techniques or subspecialties. with neuromuscular blockade ~1:8200 (1:7030-9700), without it...
A woman who experiences pain during caesarean section under neuraxial anaesthesia is at risk of adverse psychological sequelae. Litigation arising from has replaced accidental awareness general as the most common successful medicolegal claim against obstetric anaesthetists. Generic guidelines on exist, but they do not provide specific recommendations for this area anaesthetic practice. This guidance aims to offer pragmatic advice support anaesthetists in caring women section. It emphasises...
Summary The 7th National Audit Project of the Royal College Anaesthetists studied peri‐operative cardiac arrest in UK, a topic importance to patients, anaesthetists and surgeons. Here we report results 12‐month registry, from 16 June 2021 15 2022, focusing on epidemiology clinical features. We reviewed 881 cases arrest, giving an incidence 3 10,000 anaesthetics (95%CI 3.0–3.5 per 10,000). Incidence varied with patient surgical factors. Compared denominator survey activity, patients arrest:...
Complications and critical incidents arising during anaesthesia due to patient, surgical or anaesthetic factors, may cause harm themselves progress more severe events, including cardiac arrest death. As part of the 7th National Audit Project Royal College Anaesthetists, we studied a prospective national cohort unselected patients. Anaesthetists recorded anonymous details all cases undertaken over 4 days at their site through an online survey. Of 416 hospital sites invited participate, 352...
To determine maternal and fetal mortality associated with Eisenmenger's syndrome in the UK, a postal questionnaire was sent to 225 NHS obstetric units neonatal intensive care units, requesting information about outcome cases of Syndrome between 1991 1995. Fifteen were identified. The 40% loss 8%. Only 15% infants born at term. Maternal remains as high it has been for past 50 years. Pooling national data on rare medical conditions pregnancy is required aid management individual cases.
Although much effort has gone into promoting early skin‐to‐skin contact and parental involvement at vaginal birth, caesarean birth remains entrenched in surgical resuscitative rituals, which delay contact, impair maternal satisfaction reduce breastfeeding. We describe a ‘natural’ approach that mimics the situation by allowing (i) parents to watch of their child as active participants (ii) slow delivery with physiological autoresuscitation (iii) baby be transferred directly onto mother’s...
Summary Concise guidelines are presented that recommend the method of choice for skin antisepsis before central neuraxial blockade. The Working Party specifically considered concentration antiseptic agent to use and its application. advice is based on previously published guidelines, laboratory clinical studies, case reports, known properties agents.
BackgroundData on UK obstetric anaesthetic practice between 2009 and 2014 were collected by the Obstetric Anaesthetists' Association's National Anaesthetic Database. This database provides information workload, variation in practice, complication rates.MethodsDuring 2009–14, data submitted 190 hospitals. The number of hospitals that each year ranged 114 145. During this 6 yr period, 27 35 items requested, although not all items. dataset was assessed for quality only those with acceptable...
Cardiac arrest in the peri-operative period is rare but associated with significant morbidity and mortality. Current reporting systems do not capture many such events, so there an incomplete understanding of incidence outcomes. As cardiac rare, hospitals may only see a small number cases over long periods, anaesthetists be involved for years. Therefore, large-scale prospective cohort needed to gain deep events leading up arrest, management itself patient Consequently, Royal College...
Summary The 7th National Audit Project of the Royal College Anaesthetists studied peri‐operative cardiac arrest in UK, a topic importance to patients, anaesthetists and surgeons. We report results 12‐month registry phase, from 16 June 2021 15 2022, focusing on management outcomes. Among 881 cases arrest, initial rhythm was non‐shockable 723 (82%) cases, most commonly pulseless electrical activity. There were 665 (75%) patients who survived event 384 (52%) hospital discharge. A favourable...
Summary The Royal College of Anaesthetists' 7th National Audit Project baseline survey assessed knowledge, attitudes, practices and experiences peri‐operative cardiac arrests among UK anaesthetists Anaesthesia Associates. We received 10,746 responses, representing a 71% response rate. In‐date training in adult paediatric advanced life support was reported by 9646 (90%) 7125 (66%) anaesthetists, respectively. There were 8994 (84%) respondents who confident leading arrest, with males more than...
The 5th National Audit Project of the Royal College Anaesthetists and Association Great Britain Ireland into accidental awareness during general anaesthesia yielded data related to psychological aspects from patient, anaesthetist, perspectives; patients' experiences ranged isolated auditory or tactile sensations complete awareness. A striking finding was that 75% were for < 5 min, yet 51% patients (95% CI 43-60%) experienced distress 41% 33-50%) suffered longer-term adverse effect. Distress...
Summary We report the results of Royal College Anaesthetists' 7th National Audit Project organisational baseline survey sent to every NHS anaesthetic department in UK assess preparedness for treating peri‐operative cardiac arrest. received 199 responses from 277 departments, representing a 72% response rate. Adult and paediatric care was provided by 188 (95%) 165 (84%) hospitals, respectively. There no intensive unit on‐site 144 (87%) hospitals caring children, meaning transfer critically...
( Anaesthesia . 2024, 79, 514–523. doi:10.1111/anae.16204) Cardiac arrest (CA) among pregnant women is not common, occurring between 2.78 per 100,000 patients and 1 in 12,000 hospitalizations. Effective management of such situations necessitates modifications to customary resuscitation procedures, like manual left uterine displacement prompt cesarean delivery (CD), improve likelihood maternal survival. In the UK, anesthetic complications as local toxicity high neuraxial blocks, are primary...