Approximately 4% of patients with coronavirus disease 2019 (COVID-19) will require admission to an intensive care unit (ICU). Governments have cancelled elective procedures, ordered new ventilators and built new hospitals to meet this unprecedented challenge. However, intensive care ultimately relies on human resources. To enhance surge capacity, many junior doctors have been redeployed to ICU despite a relative lack of training and experience. The COVID-19 pandemic poses additional challenges to new ICU recruits, from the practicalities of using personal protective equipment to higher risks of burnout and moral injury. In this article, we describe lessons for junior doctors responsible for managing patients who are critically ill with COVID-19 based on our experiences at an urban teaching hospital.
Aim In 2015 the Intercollegiate Advisory Committee for Sedation in Dentistry published a national standard for the provision of conscious sedation in dentistry. This document highlighted the need for justification of the decision not to fast patients prior to administration of IV sedation. The aim of this case control study was to compare a fasting (F) and non‐fasting (NF) group of patients undergoing oral surgery procedures under IV sedation, and to assess for sedation related complications in both groups. Material and methods A total of 228 patients were analysed, with 114 patients in each group. Results Mean age was 33 years for the F group and 30.2 years for the NF group. The average midazolam dose was 5.11 mg for the F group and 5.72 for the NF group (pa = 0.03). The mean recovery time was: 38.53 min for the F group and 36.57 min for the NF group (pa = 0.14). Extra measures required included: supplemental oxygen for 5 patients in the F group and 6 patients in the NF group, Oral glucose was given during the recovery period to 6 patients in the F group. 1 patient in the F group was unable to be cannulated. Conclusions Practicing minimal to moderate sedation in ASA 1 and 2 non‐fasting patients is safe and in our study appears to give less complications than the fasting patients.
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