SummaryThis review begins by outlining the history of probability theory, exposing cultural differences between scientists and lay people in the way risks are viewed. The basic principles of the science of risk perception are described, and the various methods of communicating risk in health care, both verbal and numerical, are then discussed critically. These concepts are then applied to the practice of anaesthesia. Risk perception may affect anaesthetists' choice of career and may be involved in the genesis and evolution of critical incidents; we also discuss possibilities for training in risk perception issues. The place of risk communication in informed consent and its ethical implications are discussed.
To date, we have performed this simple, reliable block for 21 patients undergoing thoracic surgery, who have required minimal postoperative analgesia, and one patient with thoracic trauma, which enabled early rehabilitation. No complications have occurred. We intend to investigate the analgesic potential of this block in a formal trial.
with ICD-9 codes for pneumonia. In the pre-retirement group, 145/152, or 95.4% (95% CI: 90-95%), of patients were given the correct antibiotics. The most common fallouts included administering azithromycin without ceftriaxone (3/152, 2%, 95% CI: 0.7-5%). These patients also had COPD; however, they were diagnosed as having pneumonia, not a COPD flare or bacterial bronchitis. The second source of errors included ICU patients (3/152, 2%, 95% CI:0.7-5%). These patients often received vancomycin and cefepime (2/ 152, 1%, 0.6-3%) rather than cipro/cefepime/vanco to adequately cover for pseudomonas, with 1/152 (0.3%, 95% CI 0.2-2%) receiving vancomycin and piperacillin/tazobactam. Lastly, an ESRD requiring dialysis was incorrectly classified and treated as having CAP (1/152, 0.3%, 95% CI 0.2-2%). After core measures were retired, 114/117 (97.4%), 95% CI 93-99%)patients were given the correct antibiotic. The fallouts included one patient receiving ceftriaxone and sulfamethoxazole/trimethoprim, another cefepime and vancomycin, and the third vancomycin, rocephin, and moxifloxacin.Conclusion: Compliance with Pneumonia Core Measure was not affected by retirement of this core measure. Based on this pilot data, we believe that these treatment strategies are hardwired into ED clinical culture.
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