British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Randomized controlled trial of effects of the airflow through the upper respiratory tract of intubated brain-injured patients on brain temperature and selective brain cooling.
Pyrexia is common after brain injury; it is generally believed to affect outcome adversely and the usual clinical methods of reducing temperature are not effective. The normal physiological mechanisms of brain cooling are heat loss from the upper airways and through the skull, and these can produce selective brain cooling. ⋯ A flow of humidified air at room temperature through the upper respiratory tracts of intubated brain-injured patients did not produce clinically relevant or statistically significant reductions in brain temperature measured in the frontal lobe.
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Using commercial computer graphics software (TrueSpace), we constructed a virtual-reality model for teaching interscalene brachial plexus block. This tool combines the clarity of schematic drawings and the clinical relevance of video clips and live demonstrations. The aim is to accelerate learning and aid retention of relevant information. ⋯ Three-dimensional animation is a promising new tool to accelerate the learning of regional anaesthetic techniques.
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A case is described of extensive subcutaneous emphysema with rapid and life-threatening airway obstruction. The incident followed inadvertent removal of a chest drain in a patient with a persistent air leak from an iatrogenic pneumothorax. The pneumothorax had developed during pacemaker insertion.