It is with great pride that the South African Society of Anaesthesiologists is hosting the 2008 World Congress of Anaesthesia in Cape Town. To coincide with this event the South African Medical Association has devoted this edition of the Continuing Medical Education Journal to anaesthesia.
The articles in this edition have been chosen for their relevance to the generalist doctors in South African rural hospitals. This makes these articles pertinent to a large portion of the doctors providing anaesthesia throughout the world. For the super-specialists attending the conference it is hoped this journal will serve as reminder of the problems faced by generalists and encourage outreach into this dedicated group of practitioners.
In many medical systems, the bulk of work is performed by such generalists. Specialist attention is available by referral only. These specialist services are easily overloaded by inappropriate referrals. Accordingly the articles focus on recognition of the problem patient. Johan Diedericks has given insight into paediatric cardiac murmurs. Gillian Lamacraft has written about the areas of concern identified by the South African National Committee for the Confidential Enquiry into Maternal Deaths. Bruce Biccard has highlighted the cardiovascular assessment of patients, and Anthony Reed and Gareth Davies have provided advice on the management of the patient with head injuries.
Regional anaesthesia can avoid many of the complications that can be experienced with general anaesthesia. Appropriate regional anaesthesia can prove very effective for patients in under-resourced environments. Cindy Hammerschlag has outlined those techniques which can be invaluable in the smaller hospital. The neglect of acute pain management is a world-wide topic. Paul Borgdorff has given insights into improving this area.
The shorter 'more about' section includes a piece from Jenny King on the new 2-year intern programme in South Africa. This is directly relevant only to South Africa, but has been included because the points raised are of interest to all doctors involved in training. Mike James and Ivan Joubert have highlighted changes in current thinking on intravenous fluids. Finally, Arthur Rantloane has put some practical advice together on airway management in under-resourced hospitals.
To all WCA delegates--enjoy your conference and the show that Cape Town has put on for you. Hopefully this edition of the CME journal will be of relevance to you as well as to the regular readers that it serves.
ZANE FARINA, MB ChB, DA (SA), FCA (SA)
Chief Specialist and Head, Pietermaritzburg Metropolitan Department of
Anaesthesia, Critical Care and Pain Management
Zane Farina did his undergraduate training at the University of Cape Town. After a spell as a junior doctor in Pietermaritzburg, he returned to the Cape to specialise. He received his FCA in 1997. After gaining experience as a specialist at Groote Schuur and Red Cross hospitals, and subsequently in the UK, he went into private practice in Pietermaritzburg in late 2001. He was appointed at Grey's Hospital as part of the Department of Health's drive to create an additional tertiary hospital in KwaZulu-Natal. An important focus of his job is to try to develop outreach systems into inland KZN to improve district health services there.