Southern medical journal
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Southern medical journal · Jul 1978
Case ReportsComplications from unrecognized defects in endotracheal tubes.
Considerable effort has been made to improve endotracheal tubes and make them safer than they have been in the past; yet complications continue to occur, due, in most instances, to inherent defects in the tube. It is not possible to identify these defects in a routine preoperative examination. ⋯ Other possible complications and contributing factors causing obstruction of endotracheal tubes are also reviewed. Until some way is devised for the automatic compensation of the increases in volumes and pressures in endotracheal tube cuffs, hourly deflation is recommended to prevent complications.
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Southern medical journal · May 1978
Comparative StudyContinuous monitoring of skin temperature using a liquid-crystal thermometer during anesthesia.
Forehead skin temperature measured by a stip of liquid-crystal material was compared to esophageal, rectal, and axillary temperatures measured by thermistor probes in patients having general anesthesia for coronary artery bypass grafting. Before extracorporeal circulation, forehead skin temperature was lower than axillary, rectal, and esophageal temperatures by approximately 2.2 C (4.0 F). ⋯ The liquid-crystal strip may be useful as a safe, convenient method for routine monitoring of temperature trends during general anesthesia in patients whose exact core temperature need not be continuously monitored. We believe that infants, patients undergoing extracorporeal circulation, major abdominal, vascular, or neurosurgical procedures, or patients with a history of temperature regulatory problem are probably best monitored by a method which more exactly reflects core temperature.
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Cesarean section is associated with increased maternal and fetal risks. It should not be done except for direct and positive indications. Current emphasis on early conduction anesthesia, the use of the fetal monitor in low-risk patients, section approach to breech delivery, and overemphasis on tests and roentgenograms contribute to excessive cesarean sections. Aggressive obstetrics is also expensive and compares unfavorably with a more conservative approach.