Ritchie Whistle

Ritchie WhistleRitchie WhistleThe Ritchie Whistle senses pressure that has become significantly reduced below 4 bar in the oxygen supply. It is designed to be used as an oxygen failure alarm on an anaesthetic machine where it is connected to the 4 bar oxygen circuitry. Low pressure causes the remaining gas to be directed through a whistle. This alarms momentarily every time...

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Airway Blocks

Airway Blocks1-Superior laryngeal n. block:Block of the superior laryngeal nerve can provide anesthesia of the larynx from the epiglottis to the level of the vocal cords. This block may be appropriate for any patient requiring TI before anesthetic induction.Anatomy (Fig. 1):The superior laryngeal n. is a branch of the vagus n. After it leaves the main vagal trunk, it courses...

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Awareness during Anesthesia

Awareness during Anesthesia Groups at risk for awareness: Awareness is due to too light plane of anesthesia. It is more likely where muscle relaxants are used. They may be due to: 1-Inadequate anesthetic dose: -Emergency surgery -Hypotensive anesthesia -Cardiac surgery -Inability to monitor dose in TIVA -Obstetric surgery -Normal variability in MAC 2-Resistance: -Hypermetabolic...

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How to avoid ALI after Thoracic Surgery

How to avoid Acute Lung Injury (ALI) after Thoracic Surgery -Fortunately, Acute Lung Injury (ALI) occurs infrequently, with an incidence of 2.5 % of all lung resections combined, and an incidence of 8% after pneumonectomy. However, when it occurs, ALI is associated with a risk of mortality or major morbidity of about 40%. Causes of ALI: I. Ventilated Lung: 1-Hyperoxia: (Oxygen...

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What is the meaning of Research?

 The word “research” originated from the old French word “researcher” meaning to search and search again.It literally implies repeating a search for something and implicitly assumes that the earlier search was not exhaustive and complete in the sense that there is still scope for improvement.Research in common parlance refers to a search for knowledge.It may be defined...

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Steps of Systematic Research

 Systematic Research follows certain steps that are logical and in order.These steps are:1- Understanding the nature of the problem to be studied and identifying the related area of knowledge.2- Reviewing literature to understand how others have approached or dealt with the problem.3- Collecting data organized and controlled to arrive at valid decisions.4- Analyzing data...

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Ultrasound Artifacts

Ultrasound Artifacts 1-Reverberation artifact: ➧ The processing unit in the ultrasound machine assumes echoes return directly to the processor from the point of reflection.  ➧ Depth is calculated as D = V × T, where V is the speed of sound in biological tissue and is assumed to be 1,540 m/sec, and T is time.  ➧ In a reverberation artifact, the...

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Laryngeal Mask Airway

Laryngeal Mask Airway (LMA) 1-The LMA-Classic™: -It is a reusable LMA™ airway for general anesthesia. -The LMA-Classic™ is available in eight sizes: (1, 1½, 2, 2½, 3, 4, 5, and 6). Advantages: -A safe and effective alternative to the endotracheal tube and the facemask. -Over 100 million uses worldwide. -Leaves the anesthetist's hands free to attend, to monitoring and...

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Rheumatoid Arthritis

 Rheumatoid Arthritis: A common, autoimmune connective tissue disease, primarily involving joints, but with widespread systemic effects. There are hypergamma-globulinemia and rheumatoid factors, which are autoantibodies of IgE, IgA, and IgM classes. Preoperative abnormalities: 1. Articular problems: -The joint disease involves inflammation, formation of granulation...

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Anesthetic Considerations for Patients with Liver disease

Anesthetic Considerations for Patients with Liver Disease Preoperative: 1. Assess the Degree of hepatic impairment, Severity, and Hepatic reserve by the Child-Turcotte-Pugh scoring system. 2. AVOID: Premedication, IM injections, Contact with blood or body fluids, unnecessary esophageal instrumentation. Regional Anesthesia: -Regional anesthesia might be used when possible...

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