Anaesthesia and intensive care
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Anaesth Intensive Care · Feb 1998
Case ReportsAirway management for an uncooperative patient with recessive dystrophic epidermolysis bullosa.
We describe a case of an unco-operative patient with recessive dystrophic epidermolysis bullosa in whom difficult tracheal intubation was anticipated and fibreoptic bronchoscope guided tracheal intubation was successfully achieved after induction of general anaesthesia. Other problems in airway management associated with this disorder are discussed.
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The formal project has been a requirement for the F. A. N. ⋯ A. diploma, which ideally should be taught before the Primary (30%) or in the Provisional Fellowship year (36%). Few respondents indicated a willingness to undertake a major commitment to research in the future (4%) but 46% wanted some contact with research and teaching as part of their normal work practice. A more structured teaching in research methodology, assessment of published work and presentation skills may be more suited to the longterm goals of the majority of clinical anaesthetists.
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Anaesth Intensive Care · Feb 1998
The effects of antivenom and verapamil on the haemodynamic actions of Chironex fleckeri (box jellyfish) venom.
The efficacy of antivenom and verapamil against Chironex fleckeri (box jellyfish) venom was investigated in monitored mechanically ventilated piglets. Chironex fleckeri tentacle extract alone, a mixture of tentacle extract with antivenom, and verapamil before tentacle extract were administered intravenously to groups of animals. Tentacle extract caused severe systemic hypotension, cardiac dysrrhythmias, pulmonary hypertension, haemolysis and hyperkalaemia. ⋯ Verapamil did not prevent any effect of venom, exacerbated cardiovascular collapse and increased mortality. We conclude that antivenom neutralizes the cardiovascular, haemolytic and hyperkalaemic effects of box jellyfish venom. Verapamil does not prevent any of these effects and is contra-indicated for treatment of envenomation.