Objective: To determine if the skills to successfully ventilate using the laryngeal mask (The Laryngeal Mask Company Limited, Henley on Thames, United Kingdom) and Combitube (The Kendall Company, Mansfield, USA) can be retained after seven months. Methods: Nursing, medical and theatre staff from Dunedin Hospital were recruited in a prospective study. Subjects were taught to insert and ventilate an Ambuman manikin using both devices. Subjects were tested on their ability to ventilate the manikin with both devices within one month then following a six‐month period. Results: A total of 101 subjects were recruited with 86 subjects retested at least six months later. Initial testing resulted in subjects successfully ventilating the manikin in 90% (laryngeal mask) and 92% (Combitube) of attempts. At retesting, successful ventilation was achieved in 85% (laryngeal mask) and 77% (Combitube) of attempts. The decline in skills level was significant for the Combitube only (95% CI 4% to 26%). Conclusion: The ability to successfully ventilate is better maintained with the laryngeal mask than the Combitube after seven months.

Aims: To assess patient receipt of written information. To ensure patients understand the written information about a resuscitation policy and to determine whether they disapproved of or had concerns about the policy.Methods: All admissions to four wards of the hospital were approached for an interview. A set questionnaire was asked by one of 2 interviewers.Results: 72% of 572 admissions were interviewed. Refusal accounted for only 2 of the people not interviewed. 11% were unable to advocate for themselves by reason of mental incompetence, inability to communicate or impairment secondary to their illness.Of the 401 interviewed only 49% recalled receiving the patient information booklet. Few patients (17%) recalled reading the information in the patient information booklet. They were all then given the paragraph about the hospital's resuscitation policy. 352 were asked their understanding and only 61% demonstrated that they understood the paragraph. 91% of all 401 patients approved of the hospital having the option of DNR orders. 31% of people however had concerns related to DNR orders. These are discussed.Conclusions: Many acutely unwell patients are unable to advocate for themselves. Written information is a poor method of communicating with patients. There was limited receipt of the information and many misunderstood the paragraph about the hospitals resuscitation policy. There was a wide range of patient thoughts and concerns expressed.. Bioethics

CASE REPORT We report a rare but serious hazard associated with pulmonary artery flotation catheter insertion. The patient was a 75-year-old female anaesthetised for coronary artery bypass graft surgery. She had a readily visible goitre which was thought to have a retrosternal extension. An 8.5 Fr sheath was introduced into the right internal jugular vein at the level of the cricoid cartilage over a guidewire which initially passed posterior to the goitre. A 7.5 Fr pulmonary artery flotation catheter was advanced through the sheath and a right atrial *F.

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