ABSTRACT
In previous studies, the use of mechanical ventilation in a push-over configuration with the Ohmeda Universal Portable Anesthesia Complete vaporizer was evaluated by bench testing and clinical application. During the clinical evaluation, it was noted that airway pressure transmitted back through the vaporizer during inspiration affected performance based on the concentration of inhalation agent delivered. This study evaluated the effects of airway pressure on vaporizer performance and established concentration curves for clinically significant incremental increases in airway pressure. Vaporizer performance was consistent, predictable, and correlated with the data obtained in previous studies.
Subject(s)
Airway Resistance , Anesthesiology/instrumentation , Nebulizers and Vaporizers , Ventilators, Mechanical , Humans , Military Medicine/instrumentation , Pressure , United StatesSubject(s)
Accidents, Aviation , Anesthesia, General , Disasters , Military Personnel , Amputation, Traumatic/surgery , Amputation, Traumatic/therapy , Burns/surgery , Burns/therapy , Conscious Sedation , Craniocerebral Trauma/surgery , Craniocerebral Trauma/therapy , Critical Care , Emergency Service, Hospital , Fractures, Bone/surgery , Fractures, Bone/therapy , Hospitals, Military , Humans , Intubation, Intratracheal , Neuromuscular Agents/administration & dosage , North Carolina , Postoperative Care , Triage , Wounds, Penetrating/surgery , Wounds, Penetrating/therapyABSTRACT
Until recently, the use of draw-over anesthesia (DA) for elective cases has been prohibited in American military hospitals. The reasons cited for this have included the possibility of increased patient risk and the delivery of a second level of care. In this article, the authors outline a method of employing DA so as to bring its use up to the safety level of the modern operating room. This allows for the clinical training of those military anesthesia care providers who may find themselves deployed with highly mobile surgical units whose missions demand this technique of anesthesia.
Subject(s)
Anesthesia, Inhalation/instrumentation , Hospitals, Military , Operating RoomsABSTRACT
Clozapine is a tricyclic dibenzodiazepine derivative that is classified as an "atypical" antipsychotic drug. A 25-year-old male was brought to a hospital emergency room following the ingestion of an estimated 20 100-mg tablets of clozapine. After several hours in the hospital, the patient died. The cause of death was listed as acute clozapine intoxication. It was also noted upon autopsy that the patient had an unusual eosinophilic myocarditis. The toxicological and pathological findings are presented in this report.
Subject(s)
Clozapine/pharmacokinetics , Clozapine/poisoning , Adult , Chromatography, Gas/methods , Clozapine/analogs & derivatives , Drug Overdose/metabolism , Gas Chromatography-Mass Spectrometry , Humans , Male , Suicide , Tissue DistributionSubject(s)
Evoked Potentials, Somatosensory , Hypothermia/physiopathology , Adult , Female , Forearm , Humans , Reaction Time , Skin TemperatureABSTRACT
Epidural abscess is a neurologic emergency. Diagnosis may be difficult and costly to patients and health care providers in terms of time and money expended. We present a case of epidural abscess diagnosed in a cancer patient with an implanted epidural catheter. Diagnostic studies were performed that documented the presence of a spinal epidural abscess. Routine aspiration of an implanted epidural catheter facilitated the early diagnosis of epidural abscess in our patient prior to the performance of these studies.
Subject(s)
Abscess/diagnosis , Analgesia, Epidural/instrumentation , Catheters, Indwelling/adverse effects , Epidural Space , Spinal Diseases/diagnosis , Staphylococcal Infections/diagnosis , Abscess/etiology , Female , Humans , Middle Aged , Spinal Diseases/etiology , Staphylococcal Infections/etiology , Time FactorsABSTRACT
Data collected from 25 cases of fetal or newborn death associated with maternal cocaine use are reported. The average week of gestation at which fetal death occurred was week 30. Abruptio placentae was observed in 7 cases and placental infarct was found in 4 cases. The average fetal blood cocaine and benzoylecgonine levels were 0.26 and 1.73 micrograms/mL. The average maternal levels were 0.14 and 1.80 micrograms/mL, respectively.
Subject(s)
Cocaine/toxicity , Fetal Death/chemically induced , Infant, Newborn, Diseases/chemically induced , Cocaine/analogs & derivatives , Cocaine/metabolism , Female , Fetus/metabolism , Humans , Infant Mortality , Infant, Newborn , Infant, Newborn, Diseases/mortality , Male , PregnancyABSTRACT
Selegiline is a relatively new antiparkinson's drug whose metabolites include methamphetamine and amphetamine. A 72-year-old female with apparently suicidal intentions was found dead at her residence. The cause of death was listed as coronary heart disease with a history of polypharmacy. The tissue methamphetamine and amphetamine concentrations resulting from selegiline administration are presented in this report.
Subject(s)
Methamphetamine/analysis , Selegiline/poisoning , Aged , Amphetamine/analysis , Amphetamine/blood , Amphetamine/urine , Chromatography, Gas , Chromatography, Thin Layer , Female , Humans , Liver/chemistry , Methamphetamine/blood , Methamphetamine/urine , Myocardium/chemistry , Postmortem Changes , Radioimmunoassay , Reagent Kits, Diagnostic , Selegiline/metabolismSubject(s)
Neoplasms, Germ Cell and Embryonal/classification , Neuroblastoma/classification , Nose Neoplasms/classification , Tumor Cells, Cultured/metabolism , Adult , Antibodies, Monoclonal , Cell Line , Cytoskeletal Proteins/metabolism , Female , HLA Antigens/metabolism , HLA-A1 Antigen , Humans , Male , Neoplasms, Germ Cell and Embryonal/metabolism , Neoplasms, Germ Cell and Embryonal/pathology , Neuroblastoma/metabolism , Neuroblastoma/pathology , Nose Neoplasms/metabolism , Nose Neoplasms/pathology , Oncogenes , Tumor Cells, Cultured/cytologyABSTRACT
The death of an individual under the influence of mescaline is presented. Concentrations of the drug were 9.7, 70.8, and 1163 micrograms/mL or micrograms/g in blood, liver, and urine respectively.
Subject(s)
Mescaline/analysis , Substance-Related Disorders , Bile/analysis , Chromatography, Gas , Chromatography, Thin Layer , Humans , Liver/analysis , Male , Mescaline/blood , Mescaline/urine , Stomach/analysisABSTRACT
Headspace gas chromatography was used to reanalyze forensic blood specimens for ethyl alcohol content after storage at room temperature for 3.0 and 6.75 years. All samples exhibited a decline in ethanol concentration, with most losses falling within the expected 20 to 40 mg% range.
Subject(s)
Ethanol/blood , Chromatography, Gas/methods , Forensic Medicine , Humans , Specimen Handling/methods , Time FactorsABSTRACT
A spectrophotometric method for the analysis of blood and urine has been used to quantify trichloroethanol in fatal chloral hydrate poisonings. Trichloroacetic acid and chloral hydrate do not interfere. A 4 mL blood sample is extracted at the pH of the blood with ether. A reaction product is formed during heating of the ether phase with pyridine and sodium hydroxide. A spectrum of the reaction product has maxima at 368 and 530 nm. Results obtained in fatalities are given.
