[Central venous catheter. Better routine for placing of catheters]. / Sentralt venekateter. Bedret rutine for kateterplassering.

Malposition of a central venous catheter is a major cause of serious complications such as perforation and cardiac tamponade. To prevent such complications it is necessary to confirm that the catheter tip is in the correct position. Intravascular electrocardiography is a reliable way of ensuring that the catheter tip is placed above the right atrium. With a minimum of extra equipment and training, we have tested the electrocardiography technique applied to our standard central venous catheter equipment (Secalon Seldy and Hydrocath). Our experience is that this technique makes catheter tip placement distal to the right atrium more easy to achieve.

[The British Health Services System--major changes once again. The White Paper and commercialization of the National Health Service]. / Britisk helsevesen--på ny i støpeskjeen. The White Paper og kommersialiseringen av National Health Service.

In February 1989 Prime Minister Margaret Thatcher presented her Proposals in a White Paper. These proposals imply essential changes in the National Health Service (NHS) in Great Britain. The changes will result in a more commercial way of managing both the hospitals and the offices of general practitioners. Among other things, they will imply buying and selling health services. Important objectives in the proposals are cost control, quality assurance and a greater choice for patients. During a visit to London this winter, the author studied the main topics of the proposals. This article discusses the content and aims of the White Paper, also with relevance to Norwegian health policy. Some aspects of the British health system today are also considered, with special reference to the development of the NHS during last 10 to 15 years.