Anaesthesia
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A questionnaire was sent to 293 anaesthetists in the West of Scotland to assess their attitudes to the recommendations for standards of monitoring during anaesthesia and recovery published by the Association of Anaesthetists of Great Britain and Ireland. Such standards are considered achievable and affordable in terms of costs and allow the early detection of events occurring during anaesthesia, which might lead to injury to the patient. The survey shows that there is wide acceptance of the recommendations by anaesthetists of all grades, with resultant improvements in the quality of patients care.
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Two patients with respiratory distress are described in which the laryngeal mask airway and continuous positive airway pressure were used with good effect. The laryngeal mask airway may be useful in some cases of respiratory distress occurring in the intensive care unit when a patient is unable to tolerate a tracheal tube.
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Case Reports
Fatal subclavian artery haemorrhage. A complication of subclavian vein catheterisation.
Subclavian artery puncture occurred during attempted subclavian vein catheterisation. Although initially stable, the patient became shocked one day later and died from massive local haemorrhage. This case emphasises the need for continued vigilance following accidental arterial puncture.
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Reflex sympathetic dystrophy is one of the commoner neurogenic pain syndromes; the typical onset follows peripheral trauma and is characterised by diffuse burning pain and hyperalgesia, accompanied by variable vasomotor and dystrophic changes. Successful treatment of an established reflex sympathetic dystrophy may be difficult. A case is reported describing the successful use of a series of continuous axillary brachial plexus blocks for the treatment of this syndrome.