Anaesthesia and intensive care
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Anaesth Intensive Care · May 1987
In-hospital cardiopulmonary resuscitation: prospective survey of management and outcome.
A sixteen-month prospective survey of in-hospital cardiac arrests indicated that of 168 patients who received cardiopulmonary resuscitation, 27 (16%) survived to leave hospital. Ninety-three per cent of these patients were ambulant and 81% were able to care for themselves. Poorest outcome was associated with initial rhythm of asystole, prolonged resuscitation and arrest in the Intensive Care Units. When compared with recent and past literature, these figures suggest that the incidence of successful outcome for cardiopulmonary resuscitation in hospitals has not changed significantly over the past twenty years.
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A prospective survey was conducted over a one-month period in all surgical patients admitted to the recovery room of a university-affiliated teaching hospital. Complications arising in the recovery room were documented by the nursing staff according to predefined criteria and were critically evaluated. A total of 443 patients were admitted to the recovery room and in 133 (30%) of these, some form of complication was noted. ⋯ The results are discussed, with emphasis on their relevance to current anaesthetic practice. It is concluded that many patients exhibit recovery room complications when they are specifically sought. The recovery period remains a time of great potential danger to patients.
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Anaesth Intensive Care · May 1987
Randomized Controlled Trial Clinical TrialThe effects of formulation and addition of adrenaline to cocaine for haemostasis in intranasal surgery.
Twenty patients presenting for submucous resection of the nasal septum under general anaesthesia were randomly allocated to four groups to receive either 1.0 ml 25% cocaine HCl in paraffin paste, 1.0 ml 25% cocaine HCl combined with 0.1% adrenaline in paraffin paste, 4.0 ml aqueous 4% cocaine HCl combined with 0.05% adrenaline or 4.0 ml aqueous 4% cocaine HCl on ribbon gauze applied to the nasal mucosa. Mean intraoperative blood loss was significantly decreased when the 25% cocaine 0.1% adrenaline combination in paraffin paste was used (11 (SD 8) ml, 60 (SD 30) ml, P less than 0.05, for adrenaline and plain paste respectively). ⋯ Heart rate and blood pressure changes were similar in all four groups and cardiovascular toxicity was not observed. One ml of topical intranasal 25% cocaine HCl with 0.1% adrenaline in paraffin paste provided the best haemostasis for nasal septal surgery.
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Anaesth Intensive Care · May 1987
Oxygen saturation during transfer from operating room to recovery after anaesthesia.
Transcutaneous oxygen saturation of haemoglobin was measured in 101 patients en route from the operating room to the recovery room. Twenty-nine became significantly hypoxaemic during the journey. The incidence of hypoxaemia was not found to relate to age, weight, duration or type of surgery, type of anaesthesia or pre-existing disease. Duration of the interval between cessation of oxygen in the operating room and arrival in recovery room was the only significant finding in patients who became hypoxaemic.
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Plasma osmolalities were measured in 100 normal, 100 general hospital and 100 intensive care patients, and compared with the osmolalities calculated from the plasma concentrations of sodium, potassium, glucose and urea, using five different published formulae. The mean osmolar gaps in the 100 consecutive intensive care patients and the 100 general hospital patients were not significantly different from the mean osmolar gap in the 100 normal individuals. The formula which gave the least difference between the measured and calculated osmolality was 2 X Na + urea + glucose, where the concentrations of sodium, urea and glucose were measured in mmol/l.