Breathing techniques in the management of asthma.

ence may reflect a difference between elective or semi-elective postoperative admissions versus acute medical admissions. Perceived or actual experience in intensive care could be another factor; 48% of respiratory specialist registrars had experience of intensive care medicine at the SHO level compared with 100% of anaesthetic trainees, and all the anaesthetic trainees had experience at the registrar level compared with 52% of the respiratory specialist registrars. Both groups underestimated the duration of critical care experience of each other. Critical care leads considered that the ‘‘quality’’ of referral was better from specialist registrars in anaesthesia than medicine. They strongly supported the need for physicians to receive more training in how to make effective referrals and in achieving a more ‘‘realistic’’ understanding of potential benefit from ICU admission. Our survey confirms the common perception that medical teams have more difficulty than anaesthetic colleagues in gaining acceptance of their patients to intensive care. Furthermore, this may relate to the perception that they are less able to judge need or prognosis because they have less ICU experience. Critical care training is soon to be integrated into acute care common stem, but additional experience for all medical specialties is probably needed together with an expansion of dual accreditation by medical specialists in intensive care medicine.