Acta anaesthesiologica Belgica
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The historical development of surgery and anesthesiology, has made the anesthetist an expert in the following fields: 1. Providing analgesia. 2. Homeostasis of the internal environment or respiratory, circulatory and metabolic resuscitation. 3. ⋯ The rules of conduct within this team are discussed. It is concluded that safety during anesthesia has increased, through the activities of the anesthetist outside of the operating theatre. One anesthetist should however remain available at any moment during anesthesia, for every one patient.
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Acta Anaesthesiol Belg · Jan 1978
Cardiovascular monitoring with special emphasis on mixed venous oxygen measurements.
With the advent of complicated surgical procedures the need for invasive hemodynamic monitoring has taken a prominent place in the management of patients. This has resulted in improved morbidity and mortality in overall patient care. ⋯ This paper describes the usefulness of Swan-Ganz catheter (SG catheter) during intensive care. The purposes of the study is to determine the relationship between mixed venous oxygen saturation measurement, peripheral skin temperature and volume replacement in the immediate postoperative period, as well as the need for prolonged mechanical ventilation in shocked patients.
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Acta Anaesthesiol Belg · Jan 1978
The influence of staff and personnel on the safety of the patient during anesthesia.
The safety of the patient under anesthesia is directly correlated to the quality of the service delivered by the anesthetic department. A good organised work, supposes a staff, which accords to numerical and qualitative requirements. ⋯ The quality required for the persons who administer anesthesia, depends upon the intrinsic danger of the procedure. As the nature of anesthesia is still linked with the acute control of vital functions of the patient, the qualifications of the person who administer the narcosis should be of the highest level.
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Death due to anesthesia is a tragic paradox. The numbers about the frequency of anesthesia-related-death published in many reports have a relative value, as it is impossible to compare them one to another. A synoptic table of 20 important studies made on this subject, shows a great variation in figures concerning the incidence of death related to anesthesia. The most common causes of "anesthetic-death" are mentioned and some suggestions are made to decrease the frequency of death due to anesthesia.
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Most of the articles on safety in anesthesia take the mortality as the criterion. This is fallacious. The anesthetist's area of responsibility must be clearly defined before his contribution to any given mortality can be assessed. ⋯ Outdated attitudes must be resolutely abandoned, particularly with regard to monitoring. The use of a coding system for anesthetic complications helps towards an objective assessment of the degree of safety achieved. The results obtained by this means in the Institute of Anesthesiology in Utrecht are reported.