Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Influence of form structure on the anesthesia preoperative evaluation.
To determine the impact of changes in form design on the capture of administrative and clinical data elements. ⋯ Design of a form can have a significant impact on the completion rate of form elements. Visual cues such as a labeled space for medication doses may improve the completion of these elements. Design layout can also have an influence on completion. In this case, changes to the layout may have impeded the completion rate for ASA Physical Status.
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We present the case of a patient status post previous burn injury, undergoing elective surgery in which the Combitube was used because contractural formation of the mouth and tracheal stenosis precluded tracheal intubation. The Combitube proved to be highly successful in this patient who had a very limited mouth opening.
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Patient positioning for operative procedures has long been associated with perioperative complications. We present a case report of shoulder dislocation, which occurred following positioning in the prone position, and was detected by axillary artery occlusion resulting in the loss of the radial artery blood pressure line waveform. We discuss the diagnosis and consequences of this complication.
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To assess the patient's understanding and knowledge of the anesthesiologist's role and responsibilities in the operating room and in other areas of hospital activity, and to delineate the effect of previous anesthetic experience on this knowledge. ⋯ If able to be extrapolated to all of Israel, our results show a high appreciation for the physician status of the anesthesia professional and role in safe recovery. Passive learning from a prior anesthetic experience did not appear to improve such appreciation.
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To investigate prospectively whether blood gas samples drawn from extracorporeal membrane oxygenation (ECMO) cannulae help to exclude at least clinically significant recirculation volumes in patients with acute respiratory failure. ⋯ The median arterial oxygen tension (PaO(2)) obtained from the arterial cannula was 537 mmHg (range, 366 to 625 mmHg), the median mixed venous oxygen tension (PvO(2)) drawn from the venous cannula was 42 mmHg (range, 25 to 54 mmHg), which was less than 10% of that observed in the arterial cannula, and also within the physiologic range of PvO(2). The ECMO flow necessary to maintain patients' oxygen saturation above 90% (4.1 L/min; range, 1.95 to 5.8 L/min) was significantly lower than the patients' cardiac output (CO; 6.2 L/min; range, 4.1 to 7.9 L/min; p < 0.001). CONSLUSIONS; We recommend obtaining blood gas samples-immediately after initiation of ECMO-from both cannulae. A PvO(2) within physiologic range and below 10% of PaO(2) rules out any clinically relevant recirculation volume.