General anaesthesia for caesarean delivery

2016 ◽  
Author(s):  
David M. Levy ◽  
Ieva Saule
Keyword(s):  
United Kingdom ◽  
Laryngeal Mask Airway ◽  
General Anaesthesia ◽  
Caesarean Delivery ◽  
Laryngeal Mask ◽  
World Health ◽  
Induction Agent ◽  
Large Set ◽  
The United Kingdom ◽  
Airway Trauma

General anaesthesia (GA) is most often indicated for category 1 (immediate threat to life of mother or baby) caesarean delivery (CD) or when neuraxial anaesthesia has failed or is contraindicated. Secure intravenous access is essential. Jugular venous cannulation (with ultrasound guidance) is required if peripheral access is inadequate. A World Health Organization surgical safety checklist must be used. The shoulders and upper back should be ramped. Left lateral table tilt or other means of uterine displacement are essential to minimize aortocaval compression, and a head-up position is recommended to improve the efficiency of preoxygenation and reduce the likelihood of gastric contents reaching the oropharynx. Cricoid pressure is controversial. In the United Kingdom, thiopental remains the induction agent of choice, although there is scant evidence upon which to avoid propofol. In pre-eclampsia, it is essential to obtund the pressor response to laryngoscopy with remifentanil or alfentanil. Rocuronium is an acceptable alternative to succinylcholine for neuromuscular blockade. Sugammadex offers the possibility of swifter reversal of rocuronium than spontaneous recovery from succinylcholine. Management of difficult tracheal intubation is focused on ‘oxygenation without aspiration’ and prevention of airway trauma. The Classic™ laryngeal mask airway is the most commonly used rescue airway in the United Kingdom. There is a large set of data from fasted women of low body mass index who have undergone elective CD safely with a Proseal™ or Supreme™ laryngeal mask airway. Sevoflurane is the most popular volatile agent for maintenance of GA. The role of electroencephalography-based depth of anaesthesia monitors at CD remains to be established. Intraoperative end-tidal carbon dioxide tension should be maintained below 4.0 kPa.

Effect of obesity on laryngeal mask airway use in general anaesthesia for Caesarean delivery

2020 ◽  
Vol 30 ◽  
pp. e9
Author(s):  
Ming Jian Lim ◽  
Hon Sen Tan ◽  
Miss. Junyi Zhang ◽  
Chin Wen Tan ◽  
Shi Yang Li ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
General Anaesthesia ◽  
Caesarean Delivery ◽  
Laryngeal Mask

scholarly journals A comparison of coronavirus disease 2019 and seasonal influenza surveillance in five European countries: France, Germany, Italy, Spain and the United Kingdom

2021 ◽  
Author(s):  
Hélène Bricout ◽  
Rigoine de Fougerolles Thierry ◽  
Joan Puig-Barbera ◽  
Georges Kassianos ◽  
Philippe Vanhems ◽  
...  
Keyword(s):  
United Kingdom ◽  
Medical Information ◽  
Public Awareness ◽  
Data Communication ◽  
European Countries ◽  
World Health ◽  
Influenza Surveillance ◽  
Molecular Testing ◽  
Surveillance Systems ◽  
The United Kingdom

Background: In response to the coronavirus disease (COVID-19) outbreak that unfolded across Europe in 2020, the World Health Organisation called for repurposing existing influenza surveillance systems to monitor COVID-19. This analysis aimed to compare descriptively the extent to which influenza surveillance systems were adapted and enhanced, and how COVID-19 surveillance could ultimately benefit or disrupt routine influenza surveillance. Methods: We used a previously developed framework in France, Germany, Italy, Spain and the United Kingdom to describe COVID-19 surveillance and its impact on influenza surveillance. The framework divides surveillance systems into 7 sub-systems and 20 comparable outcomes of interest, and uses 5 evaluation criteria based on WHO guidance. Information on influenza and COVID-19 surveillance systems were collected from publicly available resources shared by European and national public health agencies. Results: Overall, non-medically attended, virological, primary care and mortality surveillance were adapted in most countries to monitor COVID-19, whilst community, outbreak, and hospital surveillance were reinforced in all countries. Data granularity improved, with more detailed demographic and medical information recorded. A shift to systematic notification for cases and deaths enhanced both geographic and population representativeness whilst the sampling strategy benefited from the roll out of widespread molecular testing. Data communication was greatly enhanced, contributing to improved public awareness. Conclusions: Well-established influenza surveillance systems are a key component of pandemic preparedness and their upgrade allowed European countries to respond to the COVID-19 pandemic. However, uncertainties remain on how both influenza and COVID-19 surveillance can be jointly and durably implemented.

Suicide in Scotland in Comparison with England and Wales

1972 ◽  
Vol 121 (560) ◽  
pp. 83-87
Author(s):  
Norman Kreitman
Keyword(s):  
United Kingdom ◽  
World Health Organization ◽  
World Health ◽  
Official Statistics ◽  
England And Wales ◽  
Suicide Rates ◽  
The United Kingdom ◽  
A Value ◽  
Health Organization

Over 70 years ago, Sibbald (1900) commented that the official statistics on suicide showed Scotland to have lower rates than England and Wales. It seems that Scotland has always been regarded as one of the countries with relatively few suicides. A recent World Health Organization publication (1968) commented on the official suicide rates in a sample of 20 different nations; among these Scotland ranked nineteenth in 1952–4. However, this picture appears to have been gradually changing over the last two decades, and the same W.H.O. publication, citing official statistics for the period 1961–3, quotes a value for Scotland which raises it to fifteenth in the list of 20 countries. Moreover, the Scottish rates and those for England and Wales have gradually come closer together over the last 20 years.The aim of this paper is to examine the trends in Scottish statistics for the last two decades and to compare the current suicide rates with those of the rest of the United Kingdom. All the data quoted are based on the publications of the Registrars General for Scotland and for England and Wales.

Sign in / Sign up

Export Citation Format

Share Document