ABSTRACT
Securing the airway in Juvenile papillomas of the vocal cords and trachea is sometimes hazardous and potentially lethal. In our case, when such patient was planned under GA, her right sided chest developed decreased air entry with varying degree of severity, while her left side chest presented as silent chest gradually during surgery. On exploration, the possible reason for ventilation on the right side was found to be the presence of Murphy’s eye, which functioned as a vent, when the primary distal opening of an ETT became occluded.
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Objective To investigate effect of Murphy's law on the nursing safety management of the hemodialysis patients. Methods 4598 hemodialysis cases in a blood purification center of a first class grade A hospital from April to July in 2011 was assigned as pre-implementation group.Then Murphy's law was used in the nursing practice.In the following,another 5683 hemodialysis cases from November in 2011 to January in 2012 were assigned as post-implementation group.The incidence of nursing risks and hemodialysis equipment failures were compared between the two groups.Result The incidences of nursing risks and hemodialysis equipment failures in the post-implementation group were significantly lower than those of the pre-implementation group(P<0.05).Conclusions Murphy’s law is effective for the declines of nursing manipulative defects and hemodialysis equipment failures.Besides,the law can be good for the strengthened awareness of safety and enhanced consciousness of all staff participating in the safety management so as to ensure the safety and quality of hemodialysis.
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Objetivo: Narrar la vida y obra de John Benjamín Murphy. Diseño: Ensayo histórico (16 referencias). Sede: Departamento de Investigación, Escuela de Medicina. Resultado: John Benjamin Murphy nació en Apletton, Wisconsin el 21 de diciembre de 1857. Egresó del Rush Medical College en 1876. Tras ejercer algunos años, en 1882 decide continuar su preparación en Europa siendo discípulo de Theodore Billroth. Regresa a su país como profesor en su Alma Mater, al tiempo que comenzó sus prácticas quirúrgicas e investigación clínica ante la Chicago Medical Society. Su investigación a lo largo de esos años lo llevó, en 1895, a convertirse en Jefe de Cirujanos en el Hospital Mercy en Chicago. A lo largo de su desempeño profesional, trabajó en distintas áreas de la medicina; se le reconocen valiosas aportaciones en cirugía vascular, tuberculosis pulmonar, neurocirugía y principalmente en semiología digestiva, donde define el signo de Murphy revolucionando el tratamiento para pacientes con colecistitis. Murphy publicó sus primeros trabajos en los primeros números de lo que hoy son Clínicas Quirúrgicas de Norteamérica. En el hospital Mercy, innovó en la enseñanza de la medicina a través de sus ''wet clinics''. Sin duda, un hombre muy propositivo para su época, que marcó la diferencia en la práctica quirúrgica, respetado y a la vez muy criticado por sus colegas. Falleció el día 11 de agosto de 1916, marcando los inicios de la práctica médica moderna.
Objective: To narrate the life and work of John Benjamin Murphy. Design: Historical Assay (16 references). Setting: Research Department, School of Medicine, Universidad Cristobal Colón, Veracruz, Mexico. Result: John Benjamin Murphy was born in Apletton, WI, USA, on the 21st of December 1857. He graduated from Rush Medical College in 1876. After practicing medicine for some years, in 1882, he decided to continue his preparation in Europe and became a pupil of Theodore Billroth. He returned to his country as a professor at his Alma Mater, and at the same time he started his surgical practices and clinical research at the Chicago Medical Society. His research along these years, led him, in 1895, to become the surgeon-in-chief at the Mercy hospital in Chicago. Along his professional career he worked in different areas of medicine, and he is known for valuable work done in vascular surgery, pulmonary tuberculosis, neurosurgery, and mainly in digestive semiology, where he defined the Murphy sign, changing completely the treatment of patients with cholecystitis. Murphy published his first works in what is known today as The Surgical Clinics of Northamerica. At the Mercy hospital, he innovated the teaching of medicine through his ''wet clinics''. Without any doubt, he was a very purposeful man for his time, who made a difference in the surgical practice, he was respected and, at the same time, criticized by his colleagues. He died on August 11, 1916, hallmarking the start of modern medical practice.
ABSTRACT
Various causes of endotracheal tube obstruction during general anesthesia exist. Herein, the case of a 77-year old male patient, with tracheal deviation, who was intubated with an endotracheal tube in the emergency room, without a Murphy eye, is reported. He was transferred to the operating room for the removal of a subdural hematoma. The endotracheal tube suddenly became obstructed during flexion of neck for the craniotomy procedure. The distal bevel of the endotracheal tube, without Murphy eye, was discovered to have come into contact with the tracheal wall, with the airway being obstructed during the fiberoptic bronchoscopy. Shortly after extubation of the obstructed tube, an armored tube, with a Murphy eye, was reintubated, after which the respiration pattern immediately returned to normal.