The P-POSSUM scoring systems for predicting the mortality of neurosurgical patients undergoing craniotomy: Further validation of usefulness and application across healthcare systems.

Background And Aims: Continuous audit of clinical practice is an essential part of making improvements in medicine and enhancing patient care. Validated tools are needed to gather evidence for comparisons. Recently, Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (POSSUM) and Portsmouth-POSSUM (P-POSSUM) scores were evaluated in Indian patients undergoing elective craniotomy and it was concluded that P-POSSUM was highly accurate in predicting overall mortality.

What should be included in a simulation course for anaesthetists? The Merseyside trainee perspective.

Background And Objectives: This study is the first attempt in the UK to establish the views of senior anaesthetic trainees in relation to acquiring the attributes of an 'ideal' anaesthetist, and how these could be met by a simulation course.

Methods: An electronic questionnaire consisting of open and closed questions was distributed to all 79 post-fellowship anaesthetic trainees in Merseyside, UK. Responses were anonymous and answers to open questions were independently coded into one of three themes: skills, knowledge and attributes/behaviour.

An evaluation of the Charlson co-morbidity score for predicting sepsis after elective major surgery.

Background And Aims: Severe sepsis is a significant cause of morbidity and mortality following major surgery. The Charlson co-morbidity score (CCS) has been shown to be associated with severe sepsis following major surgery for cancer. This prospective observational study investigated the effect of patient factors (CCS, gender, age and malignancy) and intraoperative factors (duration of surgery and allogeneic blood transfusion) on the incidence of sepsis after elective major surgery, and the impact of patient co-morbidities on length of stay in critical care.

Assessing the implementation of guidelines for the management of the potentially injured cervical spine in unconscious trauma patients in England.

Background: There are many complications involved in the immobilization of unconscious patients with potential cervical spine injuries. In February 2005, the Intensive Care Society (ICS), United Kingdom, produced consensus guidelines to evaluate spinal injuries in unconscious victims of blunt multiple injuries to address this important clinical problem.

Methods: A postal questionnaire was sent to lead consultants of intensive care units in England enquiring about the management of the cervical spine in unconscious trauma patients.

Retention and transferability of team resource management skills in anaesthetic emergencies: the long-term impact of a high-fidelity simulation-based course.

Background And Objective: In 2005, we developed and implemented the Emergency Anaesthetic Simulated Experience course at the Cheshire and Merseyside Simulation Centre.Emergency Anaesthetic Simulated Experience aims to teach clinical and team resource management skills to junior trainees in anaesthesia. Here we present 'proof-of-concept' in terms of long-term retention and transferability of acquired skills into subsequent clinical practice.

Evaluation of POSSUM and P-POSSUM scoring systems for predicting the mortality in elective neurosurgical patients.

A simple way of evaluating surgical outcomes is to compare mortality and morbidity. Such comparisons may be misleading without a proper case mix. The POSSUM scoring system was developed to overcome this problem.