Search

Summary: William Stewart Halsted developed a novel residency training program at Johns Hopkins Hospital that, with some modifications, became the model for surgical and medical residency training in North America. While performing anesthesia research early in his career, Halsted became addicted to cocaine and morphine. This paper dissects how his innovative multi-tier residency program helped him hide his addiction while simultaneously providing outstanding patient care and academic training. [ABSTRACT FROM AUTHOR]

It is important for academic-minded human anesthesiologists to have an interdisciplinary perspective when engaging in cutting-edge research as well as the practice of human anesthesiology. This was a philosophy promoted by Dr. Robert Dripps, former pioneering Chairman of the Anesthesiology Department at the University of Pennsylvania (Philadelphia, Pennsylvania). Many human and veterinary anesthesiologists as well as biomedical engineers and neuroscientists benefited from Dr. Dripps's constructive outlook personified in the quest to develop dolphin anesthesiology.The motivation to anesthetize dolphins came from the fact that scientists and physicians wanted to study the brain of the dolphin, a brain as large as man's. Also, investigators wanted to develop anesthesia for the dolphin in order to study the electrophysiology of the dolphin's highly sophisticated auditory system, which facilitates the dolphin's amazing echolocation capability.Dolphin anesthesia involves a complex matter of unique neural control, airway anatomy, neuromuscular control of respiration, and sleep behavior. [ABSTRACT FROM AUTHOR]

Inspired Oxygenation in Surgical Patients During General Anesthesia With Controlled Ventilation: A Concept of Atelectasis. By Bendixen HH, Hedley-Whyte J, and Laver MB. New Engl J Med 1963; 269:991-996. Reprinted with permission.Abstract: The purpose of this study was to determine if the pattern of ventilation, by itself, influences oxygenation during anesthesia and surgery and examine the hypothesis that progressive pulmonary atelectasis may occur during constant ventilation whenever periodic hyperventilation is lacking, but is reversible by passive hyperinflation of the lungs. Eighteen surgical patients, ranging in age from 24 to 87 yr, without known pulmonary disease, were studied during intraabdominal procedures and one radical mastectomy. Although ventilation remained constant, changes occurred in arterial oxygen tension and in total pulmonary compliance, with an average fall of 22% in oxygen tension and 15% in total pulmonary compliance. This fall in oxygen tension supports the hypothesis that progressive mechanical atelectasis may lead to increased venous admixture to arterial blood. The influence of the ventilator pattern on atelectasis and shunting is further illustrated by the reversibility of the fall in oxygen tension that follows hyperinflation. A relation between the degree of ventilation and the magnitude of fall in arterial oxygen tension was found, where large tidal volumes appear to protect against falls in oxygen tension, while shallow tidal volumes lead to atelectasis and increased shunting with impaired oxygenation. [ABSTRACT FROM AUTHOR]

Lieutenant Adeline Simonson, a young nurse from McGregor, Minnesota, was one of more than 2,000 nurse anesthetists who served in WWII. Like the 59,000 other nurses who joined the Army Nurse Corps (ANC) between 1941 and 1945, they worked in physically exhausting and often hazardous conditions. Until recently, their vital contribution to the Allied war effort has attracted little scholarly or popular interest. Neither the Veteran's Administration nor historical societies kept any records, and the nurses rarely spoke about their service. A handful of recent studies has finally begun to shed light on the history of the ANC, yet their discussion of nurse anesthetists is surprisingly scant. This article aims to fill a gap in our knowledge by throwing light on the ordeal of one nurse anesthetist attached to the 95th Evacuation Hospital. Drawing on unpublished correspondence and diaries, we recreate the story of Adeline Simonson and examine its lessons for combat nursing. The frontline setting fostered an unprecedented level of collaboration between nurse anesthetists and physician anesthetists. Under the guidance of Captain Marshall Bauer, the 95th Evac's sole anesthesiologist, Simonson not only acquired new techniques such as the administration of spinal anesthesia, but also helped train other nurses. Most important, while under fire the medical officers learned to overcome varying levels of ability and experience and to work together as a unit. [ABSTRACT FROM AUTHOR]

The author reflects on the importance of evidence-based medicine (EBM) in research and medical practice. The author discusses the history of anesthesia, the role of EBM in improving the patient care, and the use of Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework in research.

This paper will present a focused and personal history of physiologic monitoring, beginning with the discovery of modern anesthesia and its development from a technical practice to a scientific discipline. Emphasis will be on the essence of monitoring in the anesthesia evolution, and this work will attempt to answer the question of how to evaluate the impact of monitoring on patient outcome. Understanding that monitors are passive and that only caregivers using monitors can impact outcome is at the crux of this approach to analysis. The limited quality data involving monitoring analysis, including that from pulse oximetry, will be discussed and critiqued. The invention and rapid spread of pulse oximetry will be highlighted and used as an example throughout, but the principles developed will apply to other monitors and patient monitoring in general. The problems created by monitoring alarms will also be discussed. [ABSTRACT FROM AUTHOR]

Robert D. Dripps, M.D. (1911 to 1973), helped found academic anesthesiology. Newly reviewed teaching slides from the University of Pennsylvania (Philadelphia, Pennsylvania) contain six anesthesia records from 1965 to 1967 that involved Dripps. They illustrate the clinical philosophy he taught-to consider administration of each anesthetic a research study. Intense public criticism in 1967 for improper experimentation on patients during anesthesia changed his clinical and research philosophies and teaching. [ABSTRACT FROM AUTHOR]

The discovery of anesthesia occurred during a narrow time span in the mid-19th century, but there is no agreement about who deserves credit for this important American contribution to medicine. Based mostly on an examination of primary sources, we explore how formal and informal interactions between the principals affected their careers, lives, and attribution of credit for the discovery of anesthesia. There should be no controversy as to which individual deserves credit for the discovery of anesthesia if credit is ascribed for specific contributions. We suggest that credit for the discovery of anesthesia be divided among 4 individuals who played specific roles. Crawford W. Long first used ether as an anesthetic during surgery, Horace Wells introduced nitrous oxide for pain relief during dental surgery, and William T. G. Morton gave the first public demonstration of ether anesthesia and spread the word about its efficacy. Charles T. Jackson suggested the use of ether as an anesthetic agent to Morton. We also assert that had these individuals not known one another, the discovery of anesthesia would have proceeded in approximately the same timeframe, but Wells, Morton, and Jackson would have enjoyed more productive careers as well as longer, more peaceful lives. [ABSTRACT FROM AUTHOR]

The article offers the author's insights regarding the influence of social values on obstetric anesthesia.

The model of evidence-based practice (EBP) of Alice Magaw places the practice of nurse anesthesia as an early pioneer in patient safety and is prophetic to the aims of the Institute of Medicine (IOM). In its 2001 report, Crossing the Quality Chasm, the IOM identified 6 aims essential to improving the delivery of care. These aims include safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. Magaw used her vast expertise in anesthetic administration to develop protocols and a body of knowledge that could be used as a template for practitioners near and far. This early use of EBP principles places nurse anesthesia at the forefront of the model and the movement to provide high-quality care. Practitioners sought her practice model out as she demonstrated her techniques to visiting providers as well as through her published ideal anesthetics in the literature. She wrote, “Pioneers are noted for building upon a body of knowledge, establishing a model for continuous improvement, and exemplifying notable methods of research with subsequent documentation of their findings.” Magaw exemplified the EBP model. [ABSTRACT FROM AUTHOR]

Mechanical ventilators have evolved from basic machines to complicated, electronic, microprocessing engines. Over the last 2 decades, ventilator capabilities and options for critical care and anesthesia ventilators have rapidly advanced. These advances in ventilator modalities—in conjunction with a better understanding of patient physiology and the effects of positive pressure ventilation on the body—have revolutionized the mechanical ventilation process. Clinicians today have a vast array of mechanical ventilator mode options designed to match the pulmonary needs of the critically ill and anesthetized patient. Modes of mechanical ventilation continue to be based on 1 of 2 variances: volume-based or pressure-based. The wording describing the standard ventilatory modes on select present-day ventilators has changed, yet the basic principles of operation have not changed compared with older ventilators. Anesthesia providers need to understand these ventilator modes to best care for patients. This literature review encompasses a brief history of mechanical ventilation and current modes available for anesthesia and critical care ventilators, including definitions of each mode, definitions of the various descriptive labels given each mode, and techniques for optimizing and meeting the ventilator needs of the patient while avoiding complications in the surgical and critical care patient. [ABSTRACT FROM AUTHOR]

Thematic or topical philately deals with stamp collection based on a particular topic or theme. This article deals with a thematic depiction of the history of anesthesia from ancient to modern times using stamps, postal stationery and cancellations. [ABSTRACT FROM AUTHOR]

The article features the history and development of general anaesthesia in Malta. It mentions that the first general anaesthesia given to patients took place at the Naval Hospital in Bighi on March 6, 1847 by young medical officer Thomas Spencer Wells, using ether through Hooper inhaler. It states that in April 20, 1855, the first anesthetic-related death occurred when English doctor Sankey gave chloroform to a strong thirty-five year old man, for toe amputation. Also discussed are the history of anaesthesia on other countries.

The history of modern anaesthesia started on October 16, 1846 when WTG Morton demonstrated ether anaesthesia in Massachusetts General Hospital in USA. For about one month the new born branch of medicine was without a name. The word anaesthesia as we know of now as a science and art was suggested by Oliver Holmes Wendell in November 1846. New discoveries and inventions followed. Most of them needed new names or terminologies. Some of them were named by the people who discovered them, some by the people who did studies later. Few words existed before 1846 and majority naturally came after. A peep is made into the glorious past of anaesthesia which is one of mankind's greatest discoveries. This article salutes the great personalities who coined those words, which millions of tongues speak daily around the globe [ABSTRACT FROM AUTHOR]

A biography of Heyman Harold (Heymie) Samson, anaesthetic innovator, in South Africa, is presented. He was born in Cape Town in 1911, matriculated at the South African College School in 1928, and studied medicine at London University. He became the first South African to be awarded a Member of the Order of the British Empire (MBE) for gallantry in the North African Campaign, his inventions included neonatal resuscitator, halothane vaporiser and carbon dioxide absorber.

The article discusses the pioneers of medical care and how often their thoughts and practices were mocked and criticised. Topics include the cases of such medical pioneers like James Young Simpson, Elizabeth Blackwell and William Smellie, and how medical process like Underwater birth and minimal access surgery have all been a subject of ridicule.

The article discusses the book fair "History of Anaesthesia," which runs until May 12, 2013 at Fisher Library, University of Sydney in New South Wales. It states that the event focuses on pain relief, and presents special collections and rare books and preserved equipment museum by the Australian Society of Anaesthetists. It also considers the book "The Herball: An Expositive Worke After the Order of the Alphabet," translated by surgeon John Halle as the most precious book in the event.

The article discusses the risk factors associated with administering anesthesia in emergency patients and patients with severe comorbidities. Some 230 million major surgical procedures are being carried out under anesthesia every year across the world, according to the data from the World Health Organization (WHO). The risk factors of anesthesiological management relative to postoperative morbidity and mortality were investigated by a Dutch case-control study.