Simple and effective ultrasound needle guidance system.

In this paper, we describe our prototype of an ultrasound guidance system to address the need for an easy-to-use, cost-effective, and portable technology to improve ultrasound-guided procedures. The system consists of a lockable, articulating needle guide that attaches to an ultrasound probe and a user-interface that provides real-time visualization of the predicted needle trajectory overlaid on the ultrasound image. Our needle guide ensures proper needle alignment with the ultrasound imaging plane. Moreover, the calculated needle trajectory is superimposed on the real-time ultrasound image, eliminating the need for the practitioner to estimate the target trajectory, and thereby reducing injuries from needle readjustment. Finally, the guide is lockable to prevent needle deviation from the desired trajectory during insertion. This feature will also allow the practitioner to free one hand to complete simple tasks that usually require a second practitioner to perform. Overall, our system eliminates the experience required to develop the fine hand movement and dexterity needed for traditional ultrasound-guided procedures. The system has the potential to increase efficiency, safety, quality, and reduce costs for a wide range of ultrasound-guided procedures. Furthermore, in combination with portable ultrasound machines, this system will enable these procedures to be more easily performed by unskilled practitioners in non-ideal situations such as the battlefield and other disaster relief areas.

Scavenging in the operating room.

PURPOSE OF REVIEW: The use of inhalation general anesthetic gases has led to contamination of the operating room environment. Chronic exposure to these agents has been associated with a number of adverse health effects. Controversy remains with regard to these health effects, and whether further reducing the level of operating room contamination should be a high priority. Current methods are outlined by which anesthetic waste gases contaminate and are removed from the operating room. These controversies are explored in the light of recent research. RECENT FINDINGS: Recent work employing genotoxicity studies suggests that National Institute for Occupational Safety and Health recommendations may be appropriate to protect healthcare workers. New developments over the past year include the suggestion of employing devices such as the Anesthetic Scavenging Hood (ASH), SiBI tube connector and mask stopper. The use of these devices, in concert with efficient anesthesia machine scavenging, may further reduce operating room contamination. SUMMARY: The National Institute for Occupational Safety and Health calls for lower levels of exposure when compared with those found in European standards. It may be appropriate for European guidelines to be re-addressed; however, more conclusive studies need to be undertaken to identify the precise effects of these agents at a given exposure level. It may also be appropriate to expand the arena of monitoring and scavenging to all areas where inhalation anesthetics are used or emitted, such as in the post-anesthesia care unit and research laboratory settings.

A novel ambulatory intravenous holder: preliminary findings.

IMPLICATIONS: Many devices serve as portable systems for IV equipment but are expensive and use complex electronic controls. We present a novel device to facilitate safe ambulation of IV-dependent patients. This device was effective in delivering required therapeutic flow rates over time periods desired for unattended operation.

The use of a uniquely designed anesthetic scavenging hood to reduce operating room anesthetic gas contamination during general anesthesia.

UNLABELLED: Numerous studies have suggested that chronic exposure to trace levels of anesthetic gas is harmful to operating room (OR) personnel. In the delivery of pediatric general anesthesia, an uncuffed endotracheal tube (ETT) is normally used which can result in considerable volatile anesthetic and nitrous oxide contamination of the OR. In this report, we present a method to reduce exposure to these anesthetic gases by means of an anesthetic scavenging hood (ASH). The ASH was used on six pediatric patients undergoing general endotracheal anesthesia via an uncuffed ETT. Measurements of all ambient gas levels were made 6 in. horizontally from the patient's ear and 6 in. from the table surface. The application of the vacuum source to the ASH resulted in a very significant (P < 0.01, paired t-test) decrease in levels of ambient anesthetic gas, with no measurable change in ventilatory variables or changes in body temperature (P > 0.05, paired t-test). Discontinuation of the vacuum force to the ASH resulted in a marked increase in ambient levels of anesthetic gas. We conclude that the ASH is extremely effective in reducing waste anesthetic gas associated with anesthesia administered via an uncuffed ETT. The ASH may be a valuable and cost-effective addition in the OR for both reducing ambient anesthetic waste gas levels and conserving patient heat. IMPLICATIONS: Chronic exposure to trace levels of anesthetic gas is harmful to operating room personnel, especially in the delivery of pediatric general anesthesia via an uncuffed endotracheal tube. The anesthetic scavenging hood is a cost-effective and efficient method to reduce these waste anesthetic gases, and it offers patient heat conservation.