Anaesthesia
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A case is presented of a patient who required anaesthesia for the removal of an inhaled silver tracheostomy tube. The anaesthetic problems are discussed. Regular inspection of silver tracheostomy tubes is recommended.
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Letter Case Reports
A serious hazard associated with the Fluotec mark 4 vaporizer.
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Difficult intubation has been classified into four grades, according to the view obtainable at laryngoscopy. Frequency analysis suggests that, in obstetrics, the main cause of trouble is grade 3, in which the epiglottis can be seen, but not the cords. This group is fairly rare so that a proportion of anaesthetists will not meet the problem in their first few years and may thus be unprepared for it in obstetrics. ⋯ Laryngoscopy is carried out as usual, then the blade is lowered so that the epiglottis descends and hides the cords. Intubation has to be done blind, using the Macintosh method. This can be helpful as part of the training before starting in the maternity department, supplementing the Aberdeen drill.