Anaesthesia
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Oxygen and nitrous oxide pipes were cross-connected during the servicing of an anaesthetic machine. This resulted in the delivery of 100% nitrous oxide instead of 100% oxygen at the end of the operation. The patient fully recovered and was discharged on the 13th day.
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The work of the Parachute Field Surgical Team in the Falkland's campaign is described. Data are provided on the methods of resuscitation and anaesthesia used. Suggestions are made for improving drugs and equipment for use in civil disaster or war.
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The work of nine Naval anaesthetists deployed with the Task Force during the Falklands campaign is described. The anaesthetists worked in a field hospital (Ajax Bay), a hospital ship (SS Uganda), a troop ship (SS Camberra), aircraft carriers (HMS Hermes and HMS Invincible) and a Royal Fleet Auxiliary (Tidespring). The problems of staffing and providing the stores for various teams in different locations at short notice are discussed.
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An etomidate infusion was used in the place of nitrous oxide during one lung anaesthesia for 40 patients undergoing thoracic surgery. Analgesia was provided by fentanyl. ⋯ There was no incidence of awareness or dreams. This technique provides satisfactory anaesthesia and oxygenation during thoracic surgery when one lung only is being ventilated.
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A scheme for teaching nasotracheal intubation with the aid of fibreoptic instruments on models and live patients is described and evaluated. Twelve trainees completed 74 out of 75 intubations successfully on sedated patients to the satisfaction of themselves, their patients and their instructors.