Identity categories and the dilemma of calling police about family violence.

The under-reporting of family violence is a global problem. Multiple barriers to help-seeking have been identified, including some associated with social identities like race, age and gender. This discursive psychology study examines identity and help-seeking in social interaction.

Perioperative pathways for children with neurodevelopmental conditions and behaviours that challenge: An evaluation of parent experiences for service improvement.

Aim: To elicit experiences of parents of children with neurodevelopmental conditions using a new perioperative pathway.

Method: Parents of children accessing an adapted perioperative clinical pathway in a tertiary children's hospital between July 2019 and December 2020 were invited to participate. A mixed method study was conducted comprising a short survey questionnaire followed by telephonic interviews.

Exploring anaesthetists' views on the carbon footprint of anaesthesia and identifying opportunities and challenges for reducing its impact on the environment.

A shift in practice by anaesthetists away from anaesthetic gases with high global warming potential towards lower emission techniques (e.g. total intravenous anaesthesia) could result in significant carbon savings for the health system.

Utilization of Circulating Tumor DNA in the Surveillance Setting.

Introduction: National guidelines give recommendations regarding cancer surveillance follow-up. In many early staged cancers radiographic imaging and labs are not routinely recommended unless patients are symptomatic. This can cause a gap in care because commonly when patients present symptomatically, they have progressed and transitioned to later-stage cancer.

A Conversation Analytic Study of Calls to Medical Reception for Doctor's Appointments.

A call to medical reception is regularly an entry point into primary health care services. Telephone-mediated interactions between patients and receptionists have been found to temper demand for doctor's appointments and influence patient satisfaction ratings; yet little is known about what exactly happens to produce those effects. The present study asks how medical receptionists respond to telephone-mediated appointment requests.

My quitting stories: A qualitative study exploring Aboriginal women's experiences of smoking cessation and preventing relapse in the context of pregnancy.

Background: Most women who give up smoking during pregnancy relapse to smoking postnatally. Evidence on strategies that are helpful in maintaining smoking cessation during and beyond pregnancy is limited.

Aim: This paper aims to explore Aboriginal women's experiences of quitting smoking, relapsing, and preventing relapse, focusing on the strategies they applied for attaining and maintaining abstinence and the support they received.

Association between three prehospital thoracic decompression techniques by physicians and complications: a retrospective, multicentre study in adults.

Introduction: We sought to compare the complication rates of prehospital needle decompression, finger thoracostomy and three tube thoracostomy systems (Argyle, Frontline kits and endotracheal tubes) and to determine if finger thoracostomy is associated with shorter prehospital scene times compared with tube thoracostomy.

Methods: In this retrospective cohort study we abstracted data on adult trauma patients transported by three helicopter emergency medical services to five Major Trauma Service hospitals who underwent a prehospital thoracic decompression procedure over a 75-month period. Comparisons of complication rates for needle, finger and tube thoracostomy and between tube techniques were conducted.

Developing an Extubation strategy for the difficult pediatric airway-Who, when, why, where, and how?

Comprehensive airway management of the pediatric patient with a difficult airway requires a plan for the transition back to a patent and protected airway. Multiple techniques are available to manage the periextubation period. Equally important is performing a comprehensive risk assessment and developing a strategy that optimizes the likelihood of safe extubation.

Lighting a candle, or cursing the darkness? Delivering a climate friendly anaesthetic.

With up to 7% of national emissions coming from health care in industrial nations, and volatile anaesthetics and nitrous oxide being particularly effective greenhouse gases, anaesthetists can potentially reduce their medical carbon footprint substantially. Operating theatres create 25% of hospital waste, and there are many other avenues for 'greening' in the perioperative environment, including recycling and avoiding unnecessary operations. However, it is vital to understand how to produce a real change in practice that continues into the future and is normalised.

A Novel 3-Dimensional Printing Fabrication Approach for the Production of Pediatric Airway Models.

Background: Pediatric airway models currently available for use in education or simulation do not replicate anatomy or tissue responses to procedures. Emphasis on mass production with sturdy but homogeneous materials and low-fidelity casting techniques diminishes these models' abilities to realistically represent the unique characteristics of the pediatric airway, particularly in the infant and younger age ranges. Newer fabrication technologies, including 3-dimensional (3D) printing and castable tissue-like silicones, open new approaches to the simulation of pediatric airways with greater anatomical fidelity and utility for procedure training.

First experience with the abdominal aortic and junctional tourniquet in prehospital traumatic cardiac arrest.

Introduction: The Abdominal Aortic and Junctional Tourniquet (AAJT) increased systemic vascular resistance, mean arterial pressure, carotid blood flow and rate of return of spontaneous circulation (ROSC) in animals with hypovolaemic traumatic cardiac arrest (TCA). The objective of this study was to report the first experience of the use of the AAJT as part of a pre-hospital TCA algorithm.

Methods: This is a descriptive case series of the use of the AAJT in patients with TCA in a civilian physician-led pre-hospital trauma service in Sydney, Australia between June 2015 to August 2019.

Validation of Brix refractometers and a hydrometer for measuring the quality of caprine colostrum.

On-farm assessment of caprine colostrum quality is important for goat farmers; the ability to quickly recognize whether colostrum is suitable to feed to kids helps achieve successful passive transfer of immunity. The study compared the use of optical and digital Brix refractometers and a hydrometer against the international gold standard radial immunodiffusion (RID), using both fresh and frozen samples. A locally available ELISA methodology was included for comparison.

Synthesizing Multiple Stakeholder Perspectives on Using Virtual Reality to Improve the Periprocedural Experience in Children and Adolescents: Survey Study.

Background: Virtual reality (VR) technology is a powerful tool for augmenting patient experience in pediatric settings. Incorporating the needs and values of stakeholders in the design of VR apps in health care can contribute to better outcomes and meaningful experiences for patients.

Objective: We used a multiperspective approach to investigate how VR apps can be designed to improve the periprocedural experiences of children and adolescents, particularly those with severe anxiety.

Success and complications by team composition for prehospital paediatric intubation: a systematic review and meta-analysis.

Background: Clinical team composition for prehospital paediatric intubation may affect success and complication rates. We performed a systematic review and meta-analysis to determine the success and complication rates by type of clinical team.

Methods: We searched MEDLINE, EMBASE, and CINAHL for interventional and observational studies describing prehospital intubation attempts in children with overall success, first-pass success, and complication rates.

Physician-staffed helicopter emergency medical services augment ground ambulance paediatric airway management in urban areas: a retrospective cohort study.

Objectives: Paediatric intubation is a high-risk procedure for ground emergency medical services (GEMS). Physician-staffed helicopter EMS (PS-HEMS) may bring additional skills, drugs and equipment to the scene including advanced airway management beyond the scope of GEMS even in urban areas with short transport times. This study aimed to evaluate prehospital paediatric intubation performed by a PS-HEMS when dispatched to assist GEMS in a large urban area and examine how often PS-HEMS provided airway intervention that was not or could not be provided by GEMS.

Impact of High-Risk Characteristics in Hypoplastic Left Heart Syndrome.

Background: Management of hypoplastic left heart syndrome (HLHS) presents many challenges. We describe our institutional outcomes for management of patients with HLHS over the past 12 years and highlight our strategy for those with highly restrictive/intact interatrial septum (R/I-IAS).

Methods: Eighty-eight neonates with HLHS underwent surgical treatment, divided equally into Era-I (n = 44, April 2006 to February 2013) and Era-II (n = 44, March 2013 to June 2018).

Near-infrared spectroscopy monitoring in a pre-hospital trauma patient cohort: An analysis of successful signal collection.

Background: Noninvasive monitoring of cerebral physiology could potentially guide pre-hospital management of patients with traumatic injuries. Near-infrared spectroscopy (NIRS) is one such modality but the consistency of monitoring performance remains unclear. This study assessed the proportion of successful signal collection during pre-hospital care.

Learner and educator experiences and priorities in paediatric airway education: A qualitative study.

Paediatric airway management is a challenging area of anaesthesia practice to learn. Techniques and skills required need modification from adult practice and gaining experience through exposure takes considerable time. Preparation to manage airway emergencies can be particularly difficult as these events are rare in paediatric practice.

Comparison of portable blood-warming devices under simulated pre-hospital conditions: a randomised in-vitro blood circuit study.

Pre-hospital transfusion of blood products is a vital component of many advanced pre-hospital systems. Portable fluid warmers may be utilised to help prevent hypothermia, but the limits defined by manufacturers often do not reflect their clinical use. The primary aim of this randomised in-vitro study was to assess the warming performance of four portable blood warming devices (Thermal Angel, Hypotherm X LG, °M Warmer, Buddy Lite) against control at different clinically-relevant flow rates.

Two cases of penetrating left ventricular cardiac trauma: Pre-hospital ultrasound and direct to theatre.

Left ventricular (LV) Cardiac penetrating trauma is a rare and grave injury. In cases of penetrating cardiac trauma, pre-hospital Ultrasound by flight doctors can assist identify specific pathology. This pre-hospital triage has now been linked to a change in both pre-hospital and in-hospital management.

Complete Resolution of Infection with Clarithromycin and Ethambutol: A Case Report and a Review of the Literature.

A 70-year-old, immunocompetent male presented with mildly painful and pruritic erythematous patches and vesicles on the right dorsal aspect of the distal middle finger present for four weeks. Other skin lesions or systemic symptoms were notably absent. The patient failed to respond to valacyclovir, topical triamcinolone acetonide ointment, trimethoprim-sulfamethoxazole, and cephalexin for presumptive diagnoses of recurrent herpetic whitlow, dyshidrotic eczema, and blistering distal dactylitis, respectively.