Servicio de Anestesiología del Hospital de Urgencia Asistencia Pública: ¿Quiénes somos? / Anesthesia in Asistencia Pública Hospital. Who are we?

The Asistencia Pública was founded on August 7, 1911. It was conceived as a public hospital focused on emergency medicine. Its first location was a building acquired from the Franciscan community located at N° 85 San Francisco street, at the intersection with San Carlos street (later renamed as Alonso Ovalle). A new building was inaugurated on December 15, 1967 and its infrastructure allowed the development of various services and units that modernized, expanded and improved emergency patient care. Recently, a new facility was incorporated, called Torre Valech, inaugurated in February 2019, housing modern facilities for the emergency service, the surgical pavilions and the intensive care unit. The year 1936 marked a milestone for the Anesthesiology, due to the work of Ernesto Frías, MD, specialist trained in United States and Argentina, who organized for the first time an annual anesthesia course, working on an basis. Nevertheless, the true founder of the Anesthesiology Service and Intensive Care Unit of the José Joaquín Aguirre Hospital, was Dr. Max Arriagada Loyola. He was also a pioneer in allowing medical students to do the work of technical assistants in the specialty, during their undergraduate studies. During the eighties, the Asistencia Publica's Anesthesiology Service added new specialists who were filling the available positions both, during the daytime and on call hours. Incorporation of new technology also allowed to offer more complex and safer anesthesia procedures. Teaching has been a fundamental part of the activities of the service since its creation. First with of Dr. Arriagada's disciples, then, with the Ministerial Training Program for Anesthesiologists which in 1999 became the Postgraduate Program in Anesthesiology and Resuscitation of the Universidad de Santiago de Chile. In 2013 the program was accredited for the first time.

La Asistencia Pública fue fundada el 7 de agosto de 1911, pensada como un servicio hospitalario público centrado en los pacientes de urgencia. Su primera ubicación fue un local adquirido a la comunidad franciscana ubicada en calle San Francisco N° 85 esquina de calle San Carlos (hoy Alonso Ovalle). El nuevo edificio fue inaugurado el 15 de diciembre de 1967 y su infraestructura permitió el desarrollo de varios servicios y unidades que modernizaron, ampliaron y mejoraron la atención del paciente de urgencia. Finalmente, su última ampliación, la llamada Torre Valech, fue incorporada al edificio en febrero de 2019, albergando modernas instalaciones para la urgencia, los pabellones quirúrgicos y la Unidad de Tratamiento Intensivo. El año 1936 marcó un hito en la anestesiología de la Asistencia Pública, a partir del trabajo del doctor Ernesto Frías, especializado en Estado Unidos y Buenos Aires, quien organizó en forma un curso anual de anestesia. Pero el verdadero fundador de un servicio de anestesiología y, a su vez, de la Unidad de Tratamiento Intensivo del hospital José Joaquín Aguirre, fue el Dr. Max Arriagada Loyola, quien fue iniciador de la docencia en pregrado, para que alumnos de medicina hicieral la labor de auxiliares técnicos en la especialidad. Durante la década de los 80, el desarrollo del Servicio de Anestesiología de la Posta Central significó la suma de nuevos especialistas que fueron ocupando los cargos disponibles, tanto en horario diurno como de residencia, y la incorporación de nueva tecnología que permitió ofrecer anestesias más complejas y más seguras. La docencia ha formado parte de las actividades del servicio desde su creación: primero con los discípulos del Dr. Arriagada, luego con el Programa de Formación Ministerial de Anestesiólogos y, finalmente, se convirtió en el Programa de Postgrado en Anestesiología y Reanimación de la Universidad de Santiago de Chile a partir del año 1999, acreditándose por primera vez en el año 2013.

Military medical advances resulting from the conflict in Korea, Part I: Systems advances that enhanced patient survival.

The Korean War started several years after the World War II had ended and no recognition of the threat or preparation was made for this possibility. The military and its medical service had been downsized after World War II and had to quickly ramp up to meet the surprise attack. The war provided the laboratory for trials and experimentation with the new technological developments of the era. The Korean conflict led to numerous advances in medical systems and patient care. The Mobile Army Surgical Hospital came of age, and was instrumental in saving many lives. Helicopters saw their first regular use as flying ambulances to take the injured to definitive care in a timely fashion. The national blood banking program was rapidly geared up and new techniques such as plastic bags for collection and delivery resulted. Body armor was developed that would allow mobility while offering protection and was widely used for the first time. Each of these systems improvements saved the lives of soldiers in combat and were soon to be used in the civilian sector to save and improve lives around the world.

Hospital Cristo Redentor S/A: influências internas e externas na sua formação identitária (1956-2006), Porto Alegre/RS

Este trabalho tem por objetivo identificar as marcas identitárias do Hospital CristoRedentor no contexto de sua criação e quando do seu cinquentenário, analisando e colocandoem comparação as suas diferenças e/ou semelhanças, indicando quais as razões das mudançasou permanências diante do seu projeto original. Pois, esta entidade de saúde localizada nazona norte da cidade de Porto Alegre, no tempo de seu cinquentenário, tem característicasinstitucionais identitárias distintas das características de seu tempo de criação, determinadaspor postura e conduta no âmbito do estado no tocante à política de saúde no plano nacional.Ou seja, são questões internas e externas à instituição que fazem esta ter, atualmente,características de existência diferentes daquelas de sua fundação. E essas questões refletemdiretamente no atendimento à população e seus objetivos como instituição.Assim, para realizar a tarefa optamos por organizar o estudo em quatro partes: umacaracterizando a cidade e região no início do século XX; outra, estabelecendo o porquê dafundação do hospital e caracterizando o que identificamos como sua primeira fase; umaterceira esclarecendo a grande ruptura ideológica que o HCR sofreu na década de 70 e comoseguiu a partir daí até seu cinquentenário; e um último momento analítico, aonde destacamosas principais semelhanças e diferenças entre os períodos.

Notes from a war diary--the filter system of sorting casualties from the battle of Cassino--Italy May 1944.

This is the second extract taken from the War Diaries of Brigadier JG Morgan CBE TD MD and is specifically taken from papers he used to prepare a talk for a Civil Defence Audience in the 1950's. Having introduced a system of filtering in Tripoli in 1943 when in command of 48th General Hospital, he was specifically appointed to oversee the medical arrangements for the Battle of Cassino and was awarded the CBE for his work which is outlined below. It has been prepared from the original documents and edited by his sons.

Field expediency: how army nurses in Vietnam "made do". An ability to improvise is a valuable nursing skill, on and off the battlefield.

In the early years of the Vietnam War, when resources were in short supply, nurses improvised in the field to provide care to the sick and wounded under extremely adverse conditions. This "field expediency" was the result of nursing knowledge as well as flexibility, creativity, audacity, and pragmatism. Nurses in other settings--for example, those practicing in remote areas, in developing nations, or during natural disasters--may also find themselves facing severe shortages or too few essential supplies or a lack of equipment. Familiarity with the methods associated with field expediency will help nurses adapt quickly--on the battlefield and off.

Developments in the RN first assistant role during the Korean War.

During times of war, demand for health care providers has stimulated increased employment of nurses and broadened the dimensions of the scope of nursing practice in the surgical arena. This article examines how the work of army nurses during the Korean War helped develop the role of the RN first assistant.

The Aerochir: the first "flying hospital".

The concept of providing light and far-forward mobile surgical support teams to care for battle casualties is being increasingly adopted by most NATO nations as a result of military and political-economic considerations. Similar considerations led to the design of a mobile surgical hospital capable of flying a surgical team and all its equipment to a location of need as early as 1919. Unlike many of the early attempts to fuse medicine and aviation, the Nemirovsky-Tilmant Aerochir was not a dead-end. It served as a proof-of-concept product which led to the development and adoption of the Breguet "Aerochir," which was used in French colonial wars of the 1920s, and eventually led to adoption of the concept of air-mobile far-forward surgical care by many of the world's militaries. This design from over 80 yr ago, along with its creators, should be remembered and honored by those of us involved in providing aeromedical support to battlefield casualties.

The mobile Army surgical hospital (MASH): a military and surgical legacy.

Operation Iraqi Freedom was perhaps the last military campaign that will ever utilize the services of a mobile Army surgical hospital (MASH). The Army has now essentially replaced the MASH with combat surgical hospitals (CSH) and forward surgical teams (FST). MASH units were designed as mobile, flexible, forward-deployed military hospitals, providing care for the wounded near the frontlines of the battlefield. These hospitals not only saved thousands of lives during war but also greatly influenced the delivery of trauma and critical care in civilian hospitals. The MASH was made popular by the television series of the 1970s, depicting the 4077th during the Korean War. Although a comical series, these television episodes provided viewers with a glimpse of life in a MASH during time of war. This article chronicles the history of the MASH from its inception during World War II to recent experiences in Operation Iraqi Freedom.

Use of a deployable medical system during the remodeling of an OR.

How can a five-suite OR be remodeled while providing continuous, cost-effective surgical procedures without decreasing workload? Such a question was met with an innovative answer at the Veterans Affairs Medical Center, Fresno, Calif. Deployable Medical System units were selected to provide surgical support. The decision-making process, challenges, and surgical capabilities will be reviewed. Methods of quality control are presented, and cost benefits are described.

The origins of the Common Cold Unit.

In 1941 Harvard University and the American Red Cross provided an epidemiological team and an infectious diseases hospital for Britain. Since 1946 the buildings have been occupied by the Common Cold Unit where research has been carried out into many aspects of the causative viruses and their role in the disease, and also into methods of preventing it. The establishment is to be closed down this year.

Is war surgery a specialty? Part I.

Since 1950 the peacetime practice of civilian and military surgery has shifted from general surgery to increasing specialization and subspecialization. The surgical management of war wounds continues to require a solid foundation in general surgery training and experience, plus additional specific training in wartime surgery. Even the trauma specialist will face significant differences and difficulties treating war wounds in field hospitals. Neither military nor civilian surgical programs provide this training. This two-part essay identified major characteristics of War Surgery and explores the essential training and education required to prepare civilian and military surgeons for the practice of war surgery.