ABSTRACT
Peripheral pulse oximetry has become a core monitoring modality in most fields of medicine. Pulse oximeters are used ubiquitously in operating theatres, hospital wards, outpatient clinics and general practice surgeries. This study used a portable spectrometer (Lightman(®), The Electrode Co. Ltd., Monmouthshire, UK) to measure the emission spectra of the two light emitting diodes within the pulse oximeter sensor and to determine the accuracy of 847 pulse oximeters currently in use in 29 NHS hospitals in the UK. The standard manufacturing claim of accuracy for pulse oximeters is ± 2-3% over the range of 70-100% S(p)O(2). Eighty-nine sensors (10.5%) were found to have a functional error of their electrical circuitry that could cause inaccuracy of measurement. Of the remaining 758 sensors, 169 (22.3%) were found to have emission spectra different from the manufacturers' specification that would cause an inaccuracy in saturation estimation of > 4% in the range of 70-100% saturation. This study has demonstrated that a significant proportion of pulse oximeter sensors may be inaccurate.
Subject(s)
Oximetry/standards , Humans , Oximetry/methods , Reproducibility of Results , United KingdomABSTRACT
This article is a review of the peri-operative use of paracetamol. It reviews the pharmacology of paracetamol, highlighting new information about the mechanism of action, and examines its therapeutic use in the peri-operative period, focusing on efficacy, route of administration, and the use of a loading dose to improve early postoperative analgesia.
Subject(s)
Acetaminophen/therapeutic use , Analgesics, Non-Narcotic/therapeutic use , Pain, Postoperative/prevention & control , Acetaminophen/adverse effects , Acetaminophen/pharmacology , Analgesics, Non-Narcotic/adverse effects , Analgesics, Non-Narcotic/pharmacology , Drug Administration Routes , Drug Administration Schedule , Humans , Postoperative Care/methodsSubject(s)
Cholinesterases/deficiency , Isoquinolines/adverse effects , Neuromuscular Nondepolarizing Agents/adverse effects , Paralysis/chemically induced , Postoperative Complications/chemically induced , Fatal Outcome , Female , Humans , Isoquinolines/administration & dosage , Mivacurium , Neuromuscular Nondepolarizing Agents/administration & dosageABSTRACT
A telephone survey of 20 English intensive care units (ICUs) confirmed that visual estimation of patient weight is often performed. Four experienced intensive care staff (three doctors and one nurse) estimated the weight and measured the height of 30 volunteers and the estimates were compared with accurate reference measurements. The estimates were shown to be significantly inaccurate for individual observers. We consider the degree of inaccuracy to be of clinical importance. However, pooling the individual estimates of weight as mean values improved accuracy. Recommendations are made concerning the performance of height and weight determination.
Subject(s)
Body Height , Body Weight , Critical Care , Adult , Humans , Medical Staff, Hospital , Middle Aged , Nursing Staff, Hospital , Observer Variation , Reference Standards , Regression AnalysisABSTRACT
Survival following emergency surgery for ruptured abdominal aortic aneurysm remains poor and is in stark contrast to that for elective repair. We have carried out a 5-year retrospective observational study to determine the long-term (5-year) survival of patients following emergency surgery for ruptured abdominal aortic aneurysm at a district general hospital in East Anglia. A total of 99 patients presented to the operating theatre for emergency repair of ruptured abdominal aortic aneurysm in this 5-year study period. In-hospital mortality was 70% and was unchanged over the 5 years. Overall long-term survival in those patients discharged from hospital was good. The ICU cost per long-term survivor was calculated to be pound sterling 36750.
Subject(s)
Aneurysm, Ruptured/surgery , Aortic Aneurysm, Abdominal/surgery , Aged , Aged, 80 and over , Aneurysm, Ruptured/economics , Aneurysm, Ruptured/mortality , Aortic Aneurysm, Abdominal/economics , Aortic Aneurysm, Abdominal/mortality , Emergencies , Female , Hospital Costs , Hospital Mortality , Humans , Intensive Care Units/economics , Male , Prognosis , Retrospective Studies , Survival RateABSTRACT
A number of methods exist by which the pH of local anaesthetic solutions may be increased. Most commonly, these require the addition of differing amounts of sodium bicarbonate solution according to the local anaesthetic drugs. Sodium bicarbonate (1%) was titrated against pH in six commonly used local anaesthetic solutions. Titration curves of pH and volume of sodium bicarbonate solution added are shown for this group of local anaesthetics. This study demonstrates that 1 mL of 1% sodium bicarbonate solution may be used to alkalinize this range of local anaesthetics without the risk of precipitation. We also conclude that Ropivacaine (at concentration 0.75% and 1.0%), is unsuitable for alkalinization since it precipitates at a pH of 6.0.
