Development of objective performance metrics for ultrasound-guided internal jugular vein cannulation on behalf of the College of Anaesthesiologists of Ireland and observation of scores amongst novice and experienced operators.

Background: Ultrasound-guided, internal jugular venous (IJV) cannulation is a core technical skill for anaesthesiologists and intensivists.

Objectives: At a modified Delphi panel meeting, to define and reach consensus on a set of objective ultrasound-guided IJV cannulation performance metrics on behalf of the College of Anaesthesiologists of Ireland (CAI). To use these metrics to objectively score video recordings of novice and experienced anaesthesiologists.

Effect of a proficiency-based progression simulation programme on clinical communication for the deteriorating patient: a randomised controlled trial.

Objective: This study aimed to determine the effectiveness of a proficiency-based progression (PBP) training approach to clinical communication in the context of a clinically deteriorating patient.

Design: This is a randomised controlled trial with three parallel arms.

Setting: This study was conducted in a university in Ireland.

Prospective Validation of a Checklist to Predict Short-term Death in Older Patients After Emergency Department Admission in Australia and Ireland.

Background: Emergency departments (EDs) are pressured environment where patients with supportive and palliative care needs may not be identified. We aimed to test the predictive ability of the CriSTAL (Criteria for Screening and Triaging to Appropriate aLternative care) checklist to flag patients at risk of death within 3 months who may benefit from timely end-of-life discussions.

Methods: Prospective cohorts of >65-year-old patients admitted for at least one night via EDs in five Australian hospitals and one Irish hospital.

Subarachnoid and parenchymal haemorrhages as a complication of severe diabetic ketoacidosis in a preadolescent with new onset type 1 diabetes.

Diabetic ketoacidosis (DKA) is one of the most common causes of morbidity and mortality in new onset type 1 diabetes mellitus (T1DM). Children have a higher rate of neurological complications from DKA when compared to adults. The differential for sudden focal neurological deterioration in the setting of DKA is cerebral oedema followed by ischaemic and haemorrhagic stroke.

Efficacy of a tool to predict short-term mortality in older people presenting at emergency departments: Protocol for a multi-centre cohort study.

Background: Prognostic uncertainty inhibits clinicians from initiating timely end-of-life discussions and advance care planning. This study evaluates the efficacy of the CriSTAL (Criteria for Screening and Triaging to Appropriate aLternative care) checklist in emergency departments.

Methods: Prospective cohort study of patients aged ≥65 years with any diagnosis admitted via emergency departments in ten hospitals in Australia, Denmark and Ireland.

The effect of adult Early Warning Systems education on nurses' knowledge, confidence and clinical performance: A systematic review.

Aims: This review aims to determine the effect of adult Early Warning Systems education on nurses' knowledge, confidence and clinical performance.

Background: Early Warning Systems support timely identification of clinical deterioration and prevention of avoidable deaths. Several educational programmes have been designed to help nurses recognize and manage deteriorating patients.

Cumulative radiation exposure from diagnostic imaging in intensive care unit patients.

Aim: To quantify cumulative effective dose of intensive care unit (ICU) patients attributable to diagnostic imaging.

Methods: This was a prospective, interdisciplinary study conducted in the ICU of a large tertiary referral and level 1 trauma center. Demographic and clinical data including age, gender, date of ICU admission, primary reason for ICU admission, APACHE II score, length of stay, number of days intubated, date of death or discharge, and re-admission data was collected on all patients admitted over a 1-year period.

Defining a competency map for a practical skill.

Background: In recent years there has been a move towards a competency-based model for assessing the performance of practical procedures in clinical medicine rather than the traditional assumption that competency is achieved with increasing experience. For such an assessment to be valid, the necessary competencies comprising that skill must be identified. Our aim was to map the individual competencies necessary to perform a given procedural skill using spinal anaesthesia as the example, and to explore the relationship of individual competencies with each other.

Long versus short axis ultrasound guided approach for internal jugular vein cannulation: a prospective randomised controlled trial.

Aim: The aim of this study was to compare the short and long axis approaches to ultrasound guided right internal jugular vein cannulation with respect to indicators of success.

Methods: Patients undergoing cardiac surgery requiring central venous cannulation (99 patients) were randomised to undergo either long or short axis ultrasound guided cannulation of the right internal jugular vein by a skilled anaesthetist. First pass success, number of needle passes, procedural taken and complications were documented for each procedure.

Teaching and learning spinal anaesthesia: anaesthetists' attitudes.

Background: To identify the determinants of learning for one medical procedural skill, spinal anaesthesia, by eliciting the opinions of anaesthetists in Ireland and Hungary. This objective is one component of a research project, Medical Competence Assessment Procedure (MedCAP) funded by the EU Leonardo da Vinci Lifelong Learning Programme.

Methods: An electronic survey was circulated to anaesthetists in Hungary and Ireland.