SummaryA patient with a twin pregnancy required a Caesarean section for severe pre-eclampsia. Her platelet count was 71 × 10 9 .l À1 . Epidural anaesthesia was performed after platelet transfusion. A spinal epidural haematoma was diagnosed postoperatively. A generalised tonic-clonic seizure sparing the lower limbs enabled early diagnosis to be made. The patient recovered with no permanent neurological damage after laminectomy and clot removal. The risks and benefits of regional techniques require careful consideration, and postoperative monitoring for recovery of neural blockade is essential.
The increasing demand for cataract surgery, combined with limited resources, has created renewed interest in daycase admission. We have audited the results of all daycase and inpatient cataract surgery in a large unit over a six-month period to determine the factors influencing daycase admission and surgical outcome; 34% of cataract patients were admitted as daycases in the study period. Neither distance travelled by the patient nor age appear to influence daycase admission. However, the differing policies of the In the six months of this study 487 patients were admitted as inpatients, of which 462 had the operation performed (66% of all cataract operations) and 25 had surgery cancelled.The daycase and inpatient cataract patients were compared to determine which factors might influence the decision to admit as an inpatient or daycase. Four variables were examined: the distance of the patient's home from the hospital; the patient's age; the type ofanaesthetic used; and the identity ofthe surgical firm admitting the patient.
A departmental survey demonstrated that just over half the consultant anaesthetists were not confident in the use of all local difficult airway trolley equipment. Previous work has shown that web-based learning of airway techniques is as effective as traditional teaching, both in terms of knowledge gains and motor skills performance [1]. A 'Google' search identified many difficult airway websites that purported to be educational. Common problems with these informational websites included a lack of interactivity, an absence of self-assessment, and a lack of relevance to the local equipment. We therefore aimed to develop a learner centred, user friendly intranet website that demonstrated the use of the local difficult airway trolley equipment.
Methods
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