Impact of Surgical Lighting on Intraoperative Safety in Low-Resource Settings: A Cross-Sectional Survey of Surgical Providers.

Background: Safe surgery requires high-quality, reliable lighting of the surgical field. Little is reported on the quality or potential safety impact of surgical lighting in low-resource settings, where power failures are common and equipment and resources are limited.

Methods: Members of the Lifebox Foundation created a novel, non-mandatory, 18-item survey tool using an iterative process.

Identifying resource needs for sepsis care and guideline implementation in the Democratic Republic of the Congo: a cluster survey of 66 hospitals in four eastern provinces.

The ongoing conflict in the Eastern Republic of the Congo (DRC) has claimed up to 5.4 million lives by 2008. Whereas few deaths were directly due to violence, most victims died from medical conditions such as infectious diseases.

Surgical time out checklist with debriefing and multidisciplinary feedback improves venous thromboembolism prophylaxis in thoracic surgery: a prospective audit.

Objectives: There is a significant global burden of preventable morbidity and mortality after surgery caused by avoidable adverse events. Venous thromboembolism (VTE) prophylaxis, despite evidence for its efficacy, is not reliably and consistently prescribed, and is currently a serious concern for patient safety. The aim of this study was to prospectively audit errors captured by an extended surgical time out checklist and relate them to the introduction of a safety culture.

Paediatric surgery and anaesthesia in south-western Uganda: a cross-sectional survey.

Objective: to study paediatric surgery rates in south-western Uganda, compare them to rates in England, and determine if existing surgical facilities and workforce meet World Health Organization (WHO) standards.

Methods: to obtain information on surgical facilities and workforce, we conducted a cross-sectional survey of all hospitals performing major surgery in 14 districts of south-western Uganda in 2007-2008. Using theatre logbook data, we determined the surgical rates, types of surgery performed and in-theatre surgical outcomes.

An iterative process of global quality improvement: the International Standards for a Safe Practice of Anesthesia 2010.

Purpose: To enhance patient safety through contemporaneous and comprehensive standards for a safe practice of anesthesia that augment, enhance, and support similar standards already published by various countries and that provide a resource for countries that have yet to formulate such standards.

Standards Development: The Safe Anesthesia Working Group of the World Health Organization's "Safe Surgery Saves Lives" global initiative updated the 1992 International Standards for the Safe Practice of Anaesthesia (Standards) through an iterative process of literature review, consultation, debate, drafting, and refinement. These Standards address, in detail, the organization, support, practices, and infrastructure for anesthesia care.

Global operating theatre distribution and pulse oximetry supply: an estimation from reported data.

Background: Surgery is an essential part of health care, but resources to ensure the availability of surgical services are often inadequate. We estimated the global distribution of operating theatres and quantified the availability of pulse oximetry, which is an essential monitoring device during surgery and a potential measure of operating theatre resources.

Methods: We calculated ratios of the number of operating theatres to hospital beds in seven geographical regions worldwide on the basis of profiles from 769 hospitals in 92 countries that participated in WHO's safe surgery saves lives initiative.

A survey of the status of education and research in anaesthesia and intensive care medicine at the University Teaching Hospital in Lusaka, Zambia.

Background: Current knowledge of the situation of anaesthesia in developing countries is limited. A survey of the status of education and research based on hospital records, records of the anaesthesia section, nursing records, personal observations as well as personal communication with staff, patients and hospital managers was carried out in a 1863-bed university teaching hospital located in the capital of a least developed Sub-Saharan African Country.

Methods: Classification and evaluation of the data was based on the three aspects of the role of university teaching hospitals in Western countries: (I) patient care, (II) university teaching and post-graduation training, as well as (III) research activities.

Con: anesthesia for children in the developing world should be delivered by medical anesthetists.

Surgical care for pediatric patients in poor countries is severely limited by the availability of surgeons, healthcare resources and investment in anesthesia services. Where a surgical service exists, a shortage of trained medical anesthetists limits the care that can be delivered. Where no doctors are available to administer anesthesia, some countries have utilized nonmedical anesthesia providers to provide a service.

Influenza, 1918.

The worst recorded influenza outbreak took place in 1918, when my uncle, Dr Jules S Martin, was a young doctor in the Royal Army Medical Corps in Mozambique. This letter from his commanding officer gives an insight into the horror of the experience