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A quantitative analysis of anaesthetist-patient communication during the pre-operative visit | Previous communication research in general medical practice has shown that effective communication enhances patient compliance, satisfaction and medical outcome. It is expected that communication is equally important in anaesthesia, since patients often suffer from anxiety and lack of knowledge about anaesthetic proced... |
Anesthesiologists and acute perioperative stress: A cohort study | Previous studies have indicated that many anesthesiologists exhibit symptoms of chronic stress. There is a paucity of data, however, regarding the existence of acute stress signs among anesthesiologists. Anesthesiologists from three practice settings (n = 38) were studied while they were anesthetizing 203 patients. Hea... |
Patient-maintained propofol sedation using reaction time monitoring: A volunteer safety study | Previous volunteer studies of an effect-site controlled, patient-maintained sedation system using propofol have demonstrated a risk of over-sedation. We have incorporated a reaction-time monitor into the handset of the patient-maintained sedation system to add an individualised patient-feedback mechanism. This study as... |
Sustained increases in productivity with maintenance of quality in an academic anesthesia practice | Previously, the authors reported trends in anesthesia quality and productivity in a university-based anesthesia practice as it responded to increasing service demands with shortages of qualified staff and decreasing reimbursement. From 1992 to 1997, productivity increased, with a significant decrease in patient injury.... |
Organizational factors affect comparisons of the clinical productivity of academic anesthesiology departments | Productivity measurements based on "per operating room (OR) site" and "per case" are not influenced by staffing ratios and have permitted meaningful comparisons among small samples of both academic and private-practice anesthesiology groups. These comparisons have suggested that a larger sample would allow for clinical... |
An American tale - Professional conflicts in anaesthesia in the United States: Implications for the United Kingdom | Professional conflict between nurse anaesthetists and anaesthesiologists in the United States of America is well known in the UK but has not been explored and documented in detail. We present an account, based on critical analysis of published literature and other documentary evidence, of the historical, professional a... |
The teaching of professionalism during residency: Why it is failing and a suggestion to improve its success | Professionalism is one of the core competencies to be taught and evaluated during residency. A review of the literature suggests that professionalism is not completely understood or practiced. The teaching of professionalism has been incorporated into the educational programs for residents. However, residents learn fro... |
Needs assessment for business strategies of anesthesiology groups practices | Progress has been made in understanding strategic decision making influencing anesthesia groups operating room business practices. However, there has been little analysis of the remaining gaps in our knowledge. We performed a needs assessment to identify unsolved problems in anesthesia business strategy based on Porter... |
Propranolol and cardiac surgery: a problem for the anesthesiologist? | Propranolol therapy has been implicated as a cause of myocardial depression and increased morbidity and mortality in patients undergoing coronary artery surgery. The authors reviewed 169 consecutive patients undergoing cardiac surgery, of whom 143 had been taking propranolol, with regard to preoperative administration ... |
Lifebox pulse oximeter implementation in Malawi: evaluation of educational outcomes and impact on oxygen desaturation episodes during anaesthesia | Pulse oximetry is an essential monitor for safe anaesthesia but is often not available in low-income countries. The aim of this study was to determine whether the introduction of pulse oximetry with training was feasible and could reduce the incidence of oxygen desaturation during anaesthesia in a low-income country. P... |
Global oximetry: An international anaesthesia quality improvement project | Pulse oximetry is mandatory during anaesthesia in many countries, a standard endorsed by the World Health Organization 'Safe Surgery Saves Lives' initiative. The Association of Anaesthetists of Great Britain and Ireland, the World Federation of Societies of Anaesthesiologists and GE Healthcare collaborated in a quality... |
Evaluation of a large-scale donation of Lifebox pulse oximeters to non-physician anaesthetists in Uganda | Pulse oximetry is widely accepted as essential monitoring for safe anaesthesia, yet is frequently unavailable in resource-limited settings. The Lifebox pulse oximeter, and associated management training programme, was delivered to 79 non-physician anaesthetists attending the 2011 Uganda Society of Anaesthesia Annual Co... |
Patients with difficult intubation may need referral to sleep clinics | PURPOSE:: Upper airway abnormalities carry the risk of obstructive sleep apnea (OSA) and difficult tracheal intubations. Both conditions contribute to significant clinical problems and have increased perioperative morbidity and mortality. We hypothesized that patients who presented with difficult intubation would have ... |
Factors influencing the reporting of adverse perioperative outcomes to a quality management program | Quality management programs have used several data reporting sources to identify adverse perioperative outcomes. We compared reporting sources and identified factors that might improve data capture. Adverse perioperative outcomes between January 1, 1992, and December 31, 1994, were reported to the Department of Anesthe... |
Hygienic practices of consultant anaesthetists: A survey in the North-West region of the UK | Questionnaires were distributed to all 213 consultant anaesthetists in the North-West region of the UK with a response rate of 68%. These questionnaires were designed to assess the hygienic precautions taken to reduce the potential for transmission of infectious agents to and from the patients under their care. Face ma... |
Data fabrication and other reasons for non-random sampling in 5087 randomised, controlled trials in anaesthetic and general medical journals | Randomised, controlled trials have been retracted after publication because of data fabrication and inadequate ethical approval. Fabricated data have included baseline variables, for instance, age, height or weight. Statistical tests can determine the probability of the distribution of means, given their standard devia... |
A new anaesthetic record | Record‐keeping is part of the proper practice of anaesthesia and a record should be able to be quickly and easily completed. Two types of information need to be recorded: clinical, for use both immediately or subsequently and epidemiological, for detailed study of a large number of anaesthetics. A design which answers ... |
The mechanical aspects of anesthetic pollution control | Reduction of anesthetic contamination in the operating room requires removal of excess circuit gases (scavenging), elimination of anesthetic equipment leakage, and avoidance of anesthetic technics which allow unopposed spill of gas into the operation room. Scavenging and disposal of excess anesthetic gases can present ... |
Intranasal self-administration of remifentanil as the foray into opioid abuse by an anesthesia resident | Remifentanil is a potent μ-opioid receptor agonist that produces intense analgesia. This anilidopiperidine analog of fentanyl was approved by the United States Food and Drug Administration and became commercially available in the United States in 1997. Because of its unique chemical structure, remifentanil must be reco... |
The prevalence of latex sensitivity among anesthesiology staff | Reports dealing with allergic reactions to latex among health care professionals are increasing steadily. This study is the first epidemiological investigation of latex allergy among anesthesia staff. We tested 101 persons of the staff of the Institute of Anesthesiology, Kantonsspital, Lucerne, Switzerland, using a sta... |
A survey of anaesthetic misadventures | Reports of anaesthetic misadventures were regularly collected in the Anaesthetic Department of a district general hospital, to identify recurring problems. Eighty‐one misadventures, none of which had serious outcome, were reported during a 6‐month period, in which 8312 anaesthetics were administered. Human error was mo... |
An updated view of the national anesthesia personnel shortfall | Reports of anesthesia personnel shortages in 2001 led to the first comprehensive analysis of labor supply and demand for anesthesiologists since 1993. We now update this analysis and forecast, incorporating newly available data about residency composition, American Board of Anesthesiology and Certified Registered Nurse... |
Potential hazard of East‐Radcliffe ventilator: Failure to entrain adequate oxygen | Reports of two hypoxic episodes which occurred during the use of the East Radcliffe PNA 1 ventilator in the ‘complete rebreathing’ mode led to the study of the efficiency of the emergency air entrainment system. The inability of this system to maintain adequate oxygen concentrations during interruption of the fresh gas... |
Empowering Women as Leaders in Pediatric Anesthesiology: Methodology, Lessons, and Early Outcomes of a National Initiative | Research has shown that women have leadership ability equal to or better than that of their male counterparts, yet proportionally fewer women than men achieve leadership positions and promotion in medicine. The Women's Empowerment and Leadership Initiative (WELI) was founded within the Society for Pediatric Anesthesia ... |
Alternate methods to teach history of anesthesia | Residency programs in anesthesiology in the United States struggle to balance the conflicting needs of formal didactic sessions, clinical teaching, and clinical service obligations. As a consequence of the explosion in knowledge about basic and applied sciences related to our specialty, residents and fellows are expect... |
Individualized quality data feedback improves anesthesiology residents’ documentation of depth of neuromuscular blockade before extubation | Reversal of neuromuscular blockade is an important anesthesia quality measure, and anesthesiologists should strive to improve both documentation and practice of this measure. We hypothesized that the use of an electronic quality database to give individualized resident anesthesiologist feedback would increase the perce... |
Royal College of Anaesthetists Tutors: A survey of their duties and resources | Royal College of Anaesthetists Tutors have a key role in the delivery of postgraduate anaesthetic training in the UK. We report the results of a postal questionnaire sent to all College Tutors in April 2000. An 89% response rate (253 of 283 Tutors) was received. Respondents were responsible for a median 11 trainees. Fo... |
Using screen-based simulation of inhaled anaesthetic delivery to improve patient care | Screen-based simulation can improve patient care by giving novices and experienced clinicians insight into drug behaviour. Gas Man® is a screen-based simulation program that depicts pictorially and graphically the anaesthetic gas and vapour tension from the vaporizer to the site of action, namely the brain and spinal c... |
The relative reliability of actively participating and passively observing raters in a simulation-based assessment for selection to specialty training in anaesthesia | Selection to specialty training is a high-stakes assessment demanding valuable consultant time. In one initial entry level and two higher level anaesthesia selection centres, we investigated the feasibility of using staff participating in simulation scenarios, rather than observing consultants, to rate candidate perfor... |
Self-citations in six anaesthesia journals and their significance in determining the impact factor | Self-citation of a journal may affect its impact factor. We investigated self-citations in the 1995 and 1996 issues of six anaesthesia journals by calculating the self-citing and self-cited rates for each journal. Self-citing rate relates a journal's self-citations to its total number of references. We defined self-cit... |
Body posture during simulated tracheal intubation | Seventeen experienced anaesthetists and 15 novices were filmed intubating the trachea of a training manikin. Measurements were made of the distance from manikin's chin to subject's nose and of the angles at the elbow, the shoulder and of the forearm with the horizontal. Trained subjects stood further back (trained: med... |
Preoperative fasting time: Is the traditional policy changing? Results of a national survey | Several papers in the 1980s questioned the wisdom of withholding clear liquids for more than 3 h before elective surgery. Furthermore, recent papers have suggested relaxing the current NPO after midnight (Latin: Nulla per os; or 'nothing by mouth') practice in children and adults. To see whether the policy and practice... |
Force and torque vary between laryngoscopists and laryngoscope blades | Several studies have examined the effects of patient characteristics on force of laryngoscopy, but little attention has been paid to the importance of technique and equipment. This study investigated whether force, torque, head extension, and view varied significantly between laryngoscopists and compared force and torq... |
An observational study of distractions in the operating theatre | Several studies have reported on the negative impact of interruptions and distractions on anaesthetic, surgical and team performance in the operating theatre. This study aimed to gain a deeper understanding of these events and why they remain part of everyday clinical practice. We used a mixed methods observational stu... |
Simulation in obstetric anesthesia | Simulation can be used to teach technical skills, to evaluate clinician performance, to help assess the safety of the environment of care, and to improve teamwork. Each of these has been successfully demonstrated in obstetric anesthesia simulation. Task simulators for epidural placement, failed intubation, and blood lo... |
Simulation-based training in anaesthesiology: A systematic review and meta-analysis | Simulation has long been integrated in anaesthesiology training, yet a comprehensive review of its effectiveness is presently lacking. Using meta-analysis and critical narrative analysis, we synthesized the evidence for the effectiveness of simulation-based anaesthesiology training. We searched MEDLINE, ERIC, and SCOPU... |
Objective structured clinical examination-based assessment of regional anesthesia skills: The israeli national board examination in anesthesiology experience | Simulation techniques are increasingly being used in anesthesia training programs and to a lesser extent in evaluation of residents. We describe 7 years of experience with Objective Structured Clinical Examination-based regional anesthesia assessment in the Israeli National Board Examinations in Anesthesiology. We beli... |
Simulation education in anesthesia training: A case report of successful resuscitation of bupivacaine-induced cardiac arrest linked to recent simulation training | Simulation training is rapidly becoming an integral element of the education curriculum of anesthesia residency programs. We report a case of successful resuscitation of bupivacaine-induced cardiac arrest treated with IV lipid emulsion by providers who had recently participated in simulation training involving a scenar... |
Anaesthetic log books | Since 1989, the Royal College of Anaesthetists has encouraged trainees to keep log books, although there is little information about the benefits of this practice as a part of anaesthetic training. A postal survey of all grades of trainee anaesthetist in the North West Region of England was conducted to obtain informat... |
The use of single-use devices in anaesthesia: Balancing the risks to patient safety | Single-use devices are designed, manufactured and sold to be used once and then discarded. This paper addresses growing concerns about the quality of some devices. Single-use devices, manufactured at a lower cost to justify their disposal, are perceived to have a lesser efficacy, which may threaten patient safety throu... |
The Engström Elsa anaesthetic machine An electronic system for anaesthesia | Six Engström Elsa anaesthetic machines have been in regular use for 18–24 months. The machine incorporates a number of new concepts for anaesthetic delivery and monitoring. At flows below 1000 ml/minute, each machine delivered 20% more than the indicated value; at higher flows, the indicated value was within 10% of the... |
Using Lean Six Sigma Methodology to Improve Quality of the Anesthesia Supply Chain in a Pediatric Hospital | Six Sigma and Lean methodologies are effective quality improvement tools in many health care settings. We applied the DMAIC methodology (define, measure, analyze, improve, control) to address deficiencies in our pediatric anesthesia supply chain. We defined supply chain problems by mapping existing processes and solici... |
Evoked potential monitoring identifies possible neurological injury during positioning for craniotomy | Somatosensory-evoked potential (SSEP) monitoring is commonly used to detect changes in nerve conduction and prevent impending nerve injury. We present a case series of two patients who had SSEP monitoring for their surgical craniotomy procedure, and who, upon positioning supine with their head tilted 30°- 45°, develope... |
A randomised placebo-controlled trial examining the effect on hand supination after the addition of a suprascapular nerve block to infraclavicular brachial plexus blockade | Some surgeons believe that infraclavicular brachial plexus blocks tends to result in supination of the hand/forearm, which may make surgical access to the dorsum of the hand more difficult. We hypothesised that this supination may be reduced by the addition of a suprascapular nerve block. In a double-blind, randomised,... |
Personality testing and profiling for anaesthetic job recruitment: Attitudes of anaesthetic specialists/consultants in New Zealand and Scotland | Specialist/consultant anaesthetists based in New Zealand and Scotland were sent a reply paid postal questionnaire asking about their attitudes to personality testing and personality types in the recruitment process for registrars and specialists. The questionnaire consisted of nine Likert-style questions and 14 visual ... |
High thoracic/cervical epidural blood patch for spontaneous cerebrospinal fluid leak: A new challenge for anesthesiologists | Spontaneous cerebral spinal fluid leakage is increasingly recognized as a cause of headache due to low intracranial pressure. The site of leakage can be identified with radionuclide cisternography, and anesthesiologists are increasingly requested to provide epidural blood patch for their management. This series of case... |
Stanley Rowbotham: Twentieth century pioneer anaesthetist | Stanley Rowbotham was born in 1890 and spent the first years after qualification in 1915 with the Royal Army Medical Corps (RAMC). His career in anaesthesia began after the Armistice, when he was posted with Ivan Magill to Harold Gillies's plastic surgery unit at Sidcup. Together. they laid the foundations of tracheal ... |
Chemical dependency treatment outcomes of residents in anesthesiology: Results of a survey | Substance abuse is a potentially lethal occupational hazard confronting anesthesiology residents. We present the results of a survey sent to all United States anesthesiology training programs regarding experience with and outcomes of chemically dependent residents from 1991 to 2001. The response rate was 66%. Eighty pe... |
Random drug testing to reduce the incidence of addiction in anesthesia residents: Preliminary results from one program | Substance abuse occurs in approximately 1%-2% of anesthesia residents and nearly 80% of programs have had one or more resident (s) with such a problem. Education and control efforts have failed to reduce the frequency of substance abuse. Anesthesia providers have a professional obligation to be drug-free for the well b... |
Rapidity and accuracy of tracheal intubation in a mannequin: Comparison of the fibreoptic with the bullard laryngoscope | Successful tracheal intubation with the flexible fibreoptic bronchoscope requires a certain amount of skill which is acquired by practice. It has been suggested that the new Bullard laryngoscope may be mastered more easily. To determine if learning was superior with a flexible fibreoptic or the Bullard device, the ease... |
Checking anaesthetic equipment 2012: Association of anaesthetists of Great Britain and Ireland | Summary A pre-use check to ensure the correct functioning of anaesthetic equipment is essential to patient safety. The anaesthetist has a primary responsibility to understand the function of the anaesthetic equipment and to check it before use. Anaesthetists must not use equipment unless they have been trained to use i... |
Bacterial contamination of surgical scrub suits worn outside the operating theatre: A randomised crossover study | Summary In this study, we aimed to evaluate the bacterial contamination of surgical scrub suits worn outside the operating theatre. We randomised 16 anaesthetists on separate occasions into one of 3 groups: restricted to the operating theatre only; theatre and surgical wards; and theatre and departmental office. For ea... |
The relationship between experience and mental workload in anaesthetic practice: An observational study | Summary Mental workload is seen as a key factor in defining performance and expertise in some complex work environments, but there are no validated instruments for assessing mental workload in anaesthesia. We studied the mental workload of 20 anaesthetists of varying levels of experience, during five routine cases each... |
The value of joint anaesthetic and surgical preoperative assessment | Summary: A combined preoperative ward round where anaesthetist, radiologist and surgeon take part has been described in detail. The preoperative state of health of 208 patients seen and assessed in this way has been analyzed. This has shown that only 50 per cent of the elective surgery waiting-list patients had a strai... |
Anaesthesia ln the western region of Scotland G | Summary: A comparison of consultant anaesthetic staffing in the Western Region with that of Scotland shows that the West has its proportionate shortage of anaesdietists. This shortage is exacerbated by an inadequate supply of trained anaesthetists in the region. Training programmes are successful, but there is an inade... |
A simple photo-electric method for the estimation of blood loss during surgery | Summary: A rugged version of the sensitive machine described by Gardiner and Dudley (1962) has been constructed and has been in use for over two years without incident. It has proved possible for it to be operated by nurses and theatre technicians without supervision and with reproducible results. Failure of the electr... |
A return to trichloroethylene for obstetric anaesthesia | Summary: A study of 405 patients revealed that the substitution of 0.1% trichloroethylene for 0.1% methoxyflurane in a previously established technique of anaesthesia led to no remarkable changes in the incidence of postoperative nausea, vomiting or headache. There was, however, an increase in the incidence of awarenes... |
A system for the assessment of the adequacy of anaesthetic staffing in scottish hospitals | Summary: A technique based upon Scottish inpatient operation statistics was investigated for the assessment of anaesthetic staffing requirements. Each operation category was given a time factor covering all aspects of anaesthesia to give a total time for anaesthetic work. In a preliminary trial of this system it was fo... |
A blood pressure recorder | Summary: An instrument is described which has the following features: (1) an indirect method of measurement with a brachial cuff the only attachment to the subject; (2) fully automatic measurement and print-out system; (3) minimum discomfort in use; (4) compact, self-contained, and fully flameproof; (5) minimal loss of... |
Hans andersen and james young simpson | Summary: In the summer of 1847 Hans Andersen and J. Y. Simpson met in Edinburgh. Simpson arranged a dinner in his home in honour of Andersen, who has given a description of this dinner in The Fairy Tale of My Life. Simpson entertained his guests by having them inhale ether. From Andersen's writings and correspondence i... |
Endobronchial anaesthesia in young children | Summary: Selective intubation of a main bronchus during thoracotomy in three young children is described. Modified endotracheal tubes were used to intubate the left main bronchus in an infant with a right bronchopleural fistula and the right main bronchus in two children aged 3 years, one of whom had a foreign body in ... |
Some impressions of the teaching and practice of anaesthesia in the United States | Summary: The organization of anaesthetic services in hospitals in the United States is discussed, particularly as it concerns the relationship between departments of anaesthesia and surgery. Arrangements for training are described together with the examination system. Differences in the training and practice of anaesth... |
Some applications of analogue computers to teaching | Summary: The use of analogue computers for teaching purposes has considerable application in relation to anaesthesia. Examples are presented of hydrodynamic and electronic analogues expressing the complex relationships involved in carbon dioxide and oxygen stores, and in the uptake of general anaesthetic agents. © 1968... |
Instrumental methods for the detection of higher oxides of nitrogen in nitrous oxide | Summary: This paper discusses the possible application of instrumental methods used by the British Coal Utilisation Research Association for flue gas analysis to detect the contamination, by higher oxides of nitrogen, of nitrous oxide (N2O) intended for use as an anaesthetic. Two galvanic instruments sensitive to 1 p.p... |
Clinical evaluation of the oesophageal heat exchanger in the prevention of perioperative hypothermia | Summary: We have studied the efficiency of an oesophageal warming device in the prevention of perioperative hypothermia in 22 patients undergoing total hip replacement. Aural canal and skin temperatures (15 sites) were measured before induction of anaesthesia, at the end of surgery and 1 h after recovery and mean body ... |
5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: Patient experiences, human factors, sedation, consent, and medicolegal issues | Summary. The 5th National Audit Project (NAP5) of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland into accidental awareness during general anaesthesia (AAGA) yielded data related to psychological aspects from the patient, and the anaesthetist, perspectives; patients ... |
Supraglottic airways in difficult airway management: Successes, failures, use and misuse | Supraglottic airway devices (SAD) play an important role in the management of patients with difficult airways. Unlike other alternatives to standard tracheal intubation, e.g. videolaryngoscopy or intubation stylets, they enable ventilation even in patients with difficult facemask ventilation and simultaneous use as a c... |
Anesthesiologists, general surgeons, and tobacco interventions in the perioperative period | Surgery presents an opportunity for interventions in cigarette smokers that will facilitate abstinence from tobacco. However, little attention has beenpaid to the role of anesthesiologists and surgeons in addressing tobacco use. To determine the practices and attitudes of these physicians regarding this issue, we sent ... |
American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Opioid Minimization in Opioid-Naïve Patients | Surgical care episodes place opioid-naïve patients at risk for transitioning to new persistent postoperative opioid use. With one of the central principles being the application of multimodal pain interventions to reduce the reliance on opioid-based medications, enhanced recovery pathways provide a framework that decre... |
The effects of surgical case duration and type of surgery on hourly clinical productivity of anesthesiologists | Surgical duration (hours per case; h/case) and type of surgery (ASA base units per case; base/case) determine the hourly clinical productivity (total ASA units per hour of anesthesia care; tASA/h) for anesthesiology groups. In previous studies, h/case negatively influenced tASA/h, but base/case did not differ significa... |
A technical evaluation of wireless connectivity from patient monitors to an anesthesia information management system during intensive care unit surgery | Surgical procedures performed at the bedside in the neonatal intensive care unit (NICU) at The Children's Hospital of Philadelphia were documented using paper anesthesia records in contrast to the operating rooms, where an anesthesia information management system (AIMS) was used for all cases. This was largely because ... |
An anesthesia information system designed to provide physician-specific feedback improves timely administration of prophylactic antibiotics | Surgical site infections are a frequent cause of morbidity and mortality and add significantly to the cost of care. One component of the national Surgical Infection Prevention (SIP) program is to ensure timely administration of prophylactic antibiotics, a key factor to reduce postoperative infection. Our anesthesia dep... |
A Century of Technology in Anesthesia & Analgesia | Technological innovation has been closely intertwined with the growth of modern anesthesiology as a medical and scientific discipline. Anesthesia & Analgesia, the longest-running physician anesthesiology journal in the world, has documented key technological developments in the specialty over the past 100 years. What b... |
Evaluation in an anaesthetic simulator of a prototype of a new drug administration system designed to reduce error | Ten anaesthetists were observed while providing anaesthesia for two simulated surgical procedures, twice using conventional methods and twice using a prototype of a new drug administration system designed to reduce error. Aspects of each method were rated by users on 10-cm visual analogue scales (10 being best) and com... |
Evaluation of four manikins as simulators for teaching airway management procedures specified in the Difficult Airway Society guidelines, and other advanced airway skills | Ten volunteers evaluated the performance of four currently available manikins: Airway Management Trainer™, Airway Trainer™ , Airsim™ and Bill 1™ as simulators for the 16 procedures described in the Difficult Airway Society Guidelines (DAS techniques) and eight other advanced airway techniques (non-DAS techniques), by s... |
Immunosuppression among anaesthetists | Tests of immunological competence were performed on venous blood samples from 14 anaesthetics and 14 age- and sex-matched control subjects not engaged in anaesthetic practice. There was a significant reduction in the total lymphocyte count, the T-lymphocyte count and the phytohaemagglutinin (PHA) transformation on wash... |
Working patterns of trainee anaesthetists in the UK: Results of a national postal survey | The 'New Deal' restrictions on junior doctors' hours have major implications for the staffing of anaesthetic departments and the provision of adequate training. The results of a national postal survey demonstrate a decline in traditional on-call arrangements, especially in hard-pressed work sectors such as intensive ca... |
The "on call" service offered by the department of anaesthesia, manchester royal infirmary | The "on-call" service offered by the Department of Anaesthesia, Manchester Royal Infirmary was studied in December 1981. The reasons for any delay in service were analysed and suggestions for improvement discussed. © 1983 The Macmillan Press Ltd. |
What's new in obstetric anesthesia? The 2011 Gerard W. Ostheimer lecture | The "What's New in Obstetric Anesthesia" lecture was established by the Society for Obstetric Anesthesia and Perinatology in 1975 to update members on the preceding year's medical literature. In 1995, the lecture was renamed in honor of Gerard W. Ostheimer, an obstetric anesthesiologist from Brigham and Women's Hospita... |
Detecting unidirectional valve incompetence by the modified pressure decline method | The 1993 Food and Drug Administration anesthesia apparatus checkout recommendation provides guidance for a standardized circle system checkout but, we believe, inadequately tests unidirectional valve (UDV) function. We developed the modified pressure decline method (MPDM) for checking UDVs. The test involves pressurizi... |
Nerve gas terrorism: A grim challenge to anesthesiologists | The 1995 Tokyo subway strike proved nerve gas to be a fearsome terrorist weapon of mass destruction. Because the clear liquid is easily hidden until released, rescuers must aid nonbreathing casualties near instantly. Anesthesiologists are uniquely qualified to train these rescue squads and to manage nerve gas victims i... |
Surgical face masks and downward dispersal of bacteria | The ability of face masks to prevent forward dispersal of bacteria is offest by the possibility that they may increase vertical shedding of bacteria from the face during facial movement. To investigate this, a blood agar plate was placed 30 cm directly below the lips of 20 volunteers who were encouraged to talk for 20 ... |
Midwive's assessment of the upper sensory level after epidural blockade | The ability of midwives to assess accurately the level of epidural blockade after a short period of instruction was examined. Seventy‐two midwives estimated the upper level bilaterally in 100 patients, by detection of the loss of sensation to a cold stimulus. The midwife and anaesthetist were in complete agreement over... |
Infrared measurement of carbon dioxide in the human breath: "breathe-through" devices from tyndall to the present day | The ability to measure carbon dioxide (CO2) in the breath of a patient or capnometry, is one of the fundamental technological advances of modern medicine. I will chronicle the evolution and commercialization of mainstream capnometry based upon infrared measurement of CO2 in the breath using information from the histori... |
Estimation of tidal volume from the reservoir bag: A laboratory study | The accuracy of 21 anaesthetists in estimating tidal volumes from reservoir bag movements was assessed using a model lung apparatus. The breathing system configuration (Mapleson A or D), the grade of anaesthetist, and the years of anaesthetic experience had no effect on accuracy. Greater precision of tidal volume estim... |
The Nellcor N‐101 pulse oximeter: A clinical evaluation in anaesthesia and intensive care | The accuracy of the Nellcor N‐101 pulse oximeter has been evaluated in adult patients receiving general anaesthesia or intensive care. Readings obtained noninvasively with this instrument were compared with measurements made on arterial blood using a Radiometer OSM2 oximeter. The pulse oximeter was easy to use and with... |
AIDS and anaesthesia | The Acquired Immune Deficiency Syndrome (AIDS) is a group of conditions which is reaching epidemic proportions. It is caused by a virus new to man, with an as yet poorly understood natural history, ominous prognosis and no known cure. Anaesthetists should be aware of the implications of dealing with increasing numbers ... |
A new teaching model for resident training in regional anesthesia | The adequacy of resident education in regional anesthesia is of national concern. A teaching model to improve resident training in regional anesthesia was instituted in the Anesthesiology Residency in 1996 at Duke University Health System. The key feature of the model was the use of a CA-3 resident in the preoperative ... |
International publication trends originating from anaesthetic departments from 2001 to 2015 | The aim of this study was to analyse publication trends from the anaesthetic literature of the G-20 countries. We performed a literature search in Medline to identify articles related to anaesthetic departments published between 2001 and 2015, by specific G-20 countries according to the affiliation field of the authors... |
Design and validation of the Regional Anaesthesia Procedural Skills Assessment Tool | The aim of this study was to create and evaluate the validity, reliability and feasibility of the Regional Anaesthesia Procedural Skills tool, designed for the assessment of all peripheral and neuraxial blocks using all nerve localisation techniques. The first phase was construction of a 25-item checklist by five regio... |
A retrospective observational study of pre-operative sickle cell screening | The aim of this study was to determine the ethnic mix of those patients being pre-operatively screened for sickle cell disease in a London teaching hospital and to determine the rate of carriage of sickle haemoglobin amongst those tested. We retrospectively studied 1879 patients undergoing surgery over a 2-month period... |
Alteration in flow delivery with antisyphon devices | The aim of this study was to determine whether infusion sets containing antisyphon devices increased the time to initial flow from syringe drivers. The antisyphon devices assessed were those manufactured by B Braun, Wescott and Vygon. Each device was placed between a 50-ml syringe and a spiral extension set and primmed... |
Effect of videotape feedback on anaesthetists' performance while managing simulated anaesthetic crises: A multicentre study | The aim of this study was to examine the performance of anaesthetists while managing simulated anaesthetic crises and to see whether their performance was improved by reviewing their own performances recorded on videotape. Thirty-two subjects from four hospitals were allocated randomly to one of two groups, with each s... |
The American Board of Anesthesiology's Standardized Oral Examination for Initial Board Certification | The American Board of Anesthesiology (ABA) has been administering an oral examination as part of its initial certification process since 1939. Among the 24 member boards of the American Board of Medical Specialties, 13 other boards also require passing an oral examination for physicians to become certified in their spe... |
An assessment of the consistency of ASA physical status classification allocation | The American Society of Anesthesiologists’(ASA) Physical Status Classification was tested for consistency of use by anaesthetists. A postal questionnaire was sent to 113 anaesthetists of varying experience working in the Northern Region of England. They were asked to allot ASA grades to 10 hypothetical patients. Ninety... |
The contamination of volatile anaesthetics in an in-circle vaporiser with water during prolonged closed-circle anaesthesia | The amount of water present in sevoflurane in an in-circle vaporiser after long procedures was measured. This demonstrated that the sevoflurane residue was contaminated with a small amount of water. |
A novel device for target controlled administration and reflection of desflurane - The Mirus™ | The Anaconda™ system is used to deliver inhalational sedation in the intensive care unit in mainland Europe. The new Mirus™ system also uses a reflector like the Anaconda; however, it also identifies end-tidal concentrations from the gas flow, injects anaesthetics during early inspiration, controls anaesthetic concentr... |
Anaesthetic experience-the view from below | The anaesthetic experience gained during general professional training is reviewed, indicating the spectrum of patients managed and training received. The experience gained was broadly in line with the guidelines recommended by the Faculty of Anaesthetists. The advantage of movement between hospitals at a junior level ... |
1000 anaesthetic incidents: Experience to date | The anaesthetic incident reporting scheme in Leicester has been running for 11 years and 1000 incidents have now been reported. The scheme has successfully highlighted weaknesses where a procedural change has been able to prevent repetition. It has provided advance notification of problems which could be overcome by pu... |
Relapsing polychondritis and the anaesthetist | The anaesthetic management of a patient with upper airway obstruction secondary to relapsing polychondritis is described. The relevance of this condition to the anaesthetist is discussed. Copyright © 1988, Wiley Blackwell. All rights reserved |
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