RESUMO
There is concern that the European Working Time Directive 2009 has led to reduced time available for training, and this study examined if this has been the case. For two identical six-month periods in 1999 (pre-Directive) and 2009 (post-Directive), weekly data were collected on the total number of sessions attended by trainees, the number of supervised sessions and the leave days taken. A total of 5925 theatre sessions were analysed (2353 in 1999 and 3572 in 2009). For ST1-2 trainees, there was a 37% increase in theatre sessions attended (p=0.02), with a 77% increase in the number of these sessions supervised by a consultant (p=0.02). For ST3-7 trainees, there was a reduction in the number of theatre sessions attended of 27% (p=0.03), but this was not accompanied by a significant increase in the number of consultant-supervised sessions (11% increase; p=0.18). The aggregate median increase in weekly consultant-supervised theatre sessions per trainee increased for ST1-2 trainees (70% increase; p=0.0016) but not for ST3-7 trainees (11% increase; p=0.31). For neither trainee group did training time decline. Our data contradict the hypothesis that the European Working Time Directive has reduced access to training, or suggest that if it has, other factors (such as improved trainee rostering) have overridden its effect.
Assuntos
Anestesiologia/educação , Capacitação em Serviço/organização & administração , Admissão e Escalonamento de Pessoal/organização & administração , Coleta de Dados , Europa (Continente) , Humanos , Unidades de Terapia Intensiva/organização & administração , Internet , Obstetrícia/organização & administração , Salas Cirúrgicas , Médicos , Estudos Prospectivos , Recursos Humanos , Carga de TrabalhoAssuntos
Patógenos Transmitidos pelo Sangue/isolamento & purificação , Consentimento Livre e Esclarecido/ética , Testes Sorológicos/ética , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Unidades de Terapia Intensiva/ética , Competência Mental , Ferimentos Penetrantes Produzidos por Agulha/terapiaRESUMO
OBJECTIVE: Paediatric foreign bodies may present with vague and nonspecific symptoms. It is important to have a high index of suspicion when managing such cases. METHOD: We report the case of a nine-month-old infant who presented with a wheeze, cough and fever following ingestion of a needle. RESULTS: This patient developed pericardial tamponade as a consequence of the needle ingestion, and required a thoracotomy for retrieval. We discuss the pathophysiology involved and the surgery required. CONCLUSION: Pericardial tamponade is a rare but potentially fatal manifestation of an ingested foreign body.