AANA journal
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The intent of this research was to address the following question: Will an alteration in the drug aspiration technique cause a significant difference in the incidence of multidose vial contamination? The control group consisted of multidose vials collected at the end of each day from staff anesthetists. The use of these vials reflected the practice technique of a single needle and syringe for each vial. The vial, as well as needle and syringe, were used on all cases managed for the day. ⋯ Of the 369 multidose vials, one tested guaiac positive, 0.27%. A chi-square test on the cumulative data demonstrated a significant (p less than .05) difference between the two groups. The research demonstrated that occult blood may be contained within the used multidose vials suggesting that contaminated drug may then be injected into another patient.(ABSTRACT TRUNCATED AT 250 WORDS)
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Our present state of research and knowledge strongly suggests that the volatile agents, halothane, enflurane and isoflurane, present only a minimal threat to our environment. Nitrous oxide, however, has ozone-depleting potential as well as a greenhouse gas effect which may contribute much to the problem of global warming over the next few decades. ⋯ Each of us should play a critical role in monitoring harmful substances and should actively practice techniques which would lessen the hazards. We should be cognizant of the fact that sources not yet introduced into our environment may have adverse effects on our health and that vigilance and education are key factors in maintaining a safe work environment.
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Situations wherein patients cannot be ventilated or intubated rarely occur. When they do, however, death is imminent unless rapid and accurate actions are taken to restore adequate gas exchange. ⋯ Discussion of the cases and the therapeutic modality follows. The summary includes a call for the immediate availability of TTJV at all anesthetizing locations.
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A 64-year old female requiring prolonged ventilatory support was scheduled for an elective tracheostomy. Anesthesia consisted of surgical infiltration of 1% lidocaine and supplemental isoflurane. The patient was mechanically ventilated with an FIO2 of 1.0. ⋯ Proper management of an endotracheal tube fire includes stopping ventilation, disconnecting the oxygen source, removing the endotracheal tube, diagnosing injury, administering short-term steroids, administering antibiotics if indicated, providing ventilation and medical support as necessary and monitoring the patient for at least 24 hours. Extreme caution is necessary when using electrocautery in close proximity to an endotracheal tube. If electrocautery is used in close proximity to an endotracheal tube, an FIO2 of 0.3 or less with helium should be used.