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Objectives: Because the AVOXimeter uses disposable cuvettes and makes its measurements directly in whole blood without first hemolyzing the sample, it does not need the care and maintenance that conventional co-oximeters require, it operates faster than conventional co-oximeters, and it is less expensive. Therefore, the objectives of the study were (1) to evaluate the precision and linearity of the AVOXimeter's measurements of total hemoglobin concentration and oxyhemoglobin saturation; (2) to assess its long-term stability and thus the required interval for recalibration; (3) to determine whether measurements can be made without anticoagulants; and (4) to assess the feasibility of storing blood samples in the disposable cuvettes., Methods: Measurements made by the test instrument were compared with those of conventional co-oximeters or with standardized hemoglobin solutions. Blood samples were also collected with and without heparin to determine whether anticoagulation is necessary., Results: Our tests confirmed the specified precision of 0.3 g/dl for total hemoglobin and 0.5% for oxyhemoglobin. The results also showed that these measurements were linear when compared with a conventional co-oximeter, and they were consistent with the specified accuracy of 0.45 g/dl for total hemoglobin and 1% for oxyhemoglobin. Weekly checks with control solutions showed that the instrument holds its calibration for a year or more. Although treating syringes with heparin caused dilution errors, heparin did not affect the measurements when dilution was avoided. When blood samples were placed in disposable cuvettes and read repeatedly at 1-min intervals for 20 min, the readings drifted appreciably away from the original value. This drift occurred so slowly that readings taken at the first and second minute after the cuvette was filled were within 1 or 2% of the original reading., Conclusions: In our experience the test instrument was simple and easy to operate. It met the specification for precision and accuracy, its measurements were highly linear, and it maintained a stable calibration for one year. If the cuvettes are filled as soon as blood is drawn, anticoagulation is unnecessary. However, the cuvettes should be read with 1 min of filling the cuvette.

Oxicom oximeters are widely used in cardiac catheterization laboratories. To calibrate the Oxicom oximeter, samples of oxygenated and deoxygenated whole blood are first analyzed on a CO-Oximeter, and then the Oxicom is adjusted to agree with the CO-Oximeter's readings. Subsequently, the Oxicom's calibration is confirmed at frequent intervals by taking readings from a white plastic stick that is inserted into the instrument to simulate a blood sample. The data in this report demonstrate that the readings from the white plastic "test simulator" failed to detect an out-of-calibration condition. By contrast, when the Oxicom was carefully adjusted to agree with a CO-Oximeter's readings on arterial and venous blood, a linear calibration curve resulted, and the Oxicom achieved its specified accuracy (2.5%). The precautions necessary to calibrate the Oxicom correctly are enumerated in the text.

The use of emergency departments for baccalaureate nursing education has proved to be a rewarding experience for students, emergency department (ED) staff, and nursing school faculty. The primary factor for the success of this experience was the collaborative interaction of ED nursing personnel, and school of nursing faculty in designing the educational experience. ED staff complemented the faculty role and facilitated clinical experiences for the nursing students. This article identifies various teaching principles and strategies ED staff used to create a successful clinical experience for baccalaureate nursing students.

Attempts to identify streptococcal throat infections on clinical evidence alone do not provide an adequate or reliable index of the prevalence of these infections in the community. Epidemiologic information on streptococcal throat infections based on bacteriological identification permits a more accurate assessment of the situation and more logical and more effective control measures. Recent refinements in laboratory procedures have provided a simple, reliable and relatively inexpensive method for the identification of Group A beta hemolytic streptococci by public health or clinical laboratories. In Orange County a program for the identification of streptococcal throat infections by cooperative action of the medical profession, the health department and the school authorities greatly aided in control of the disease. A voluntary health agency (heart association) made an important contribution toward the success of the control program.

Since June 1958 the medical society, the medical institutions and the medical professions in Orange County have conducted an intensive program to control and prevent the spread of antibiotic resistant infections.In this community-wide effort, rules designed to protect the hospital population against infectious dangers have been developed and enforced, courses in food-handling and housekeeping sanitation have been given to hospital employees, and a program to solve some of the laboratory aspects of antibiotic resistant infections has been developed.

Seventeen states provide for admission of patients to mental hospitals by medical certification without judicial procedure. The aim is to avoid the police aspects of dealing with mentally ill persons without depriving them of constitutional rights. The California law, passed in 1947, has now had ten years' trial. In Orange County, 888 patients were examined under this act between 1947 and 1957. Of these, 486 were admitted to state mental institutions while 402 did not currently require hospitalization. Local modifications have provided additional safeguards to the patient, have made it more acceptable professionally, and have resulted in wider use of the act in Orange County.A comparison of costs between the medical certification procedure and court commitments indicated that, in 1957, court commitments were seven times more expensive than admissions by medical certification. The greater humanity of the procedure and the economy of it lead to the conclusion that, with a few changes, medical certification of mentally ill patients should be more widely used.