bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atropine Premedication
Authors: Kessell J. 
Published: January 2019

A double blind trial on a selected group of 125 adult patients investigated the effect of atropine in premedication. The addition of atropine to premedication of pethidine and promethazine made no statistical difference in the incidence of (a) secretory problems, cough, laryngeal spasm, and vomiting during induction and recovery, (b) arrhythmias during induction, (c) bradycardia during operation.
Changes in Serum Potassium after Suxamethonium in Children
Authors: Keneally J. P. , Bush G. H. 
Published: January 2019

The effect of the administration of intravenous suxamethonium (1 · 5 mg/kg) on serum potassium was measured in 37 children, whose ages ranged from one month to 16 years. In all patients anaesthesia was induced with thiopentone, and maintained with nitrous oxide and oxygen. Serum potassium concentrations were estimated using venous blood taken immediately after induction and at one, two, three and four minutes after suxamethonium. No significant changes were found in the groups aged six to 10 years and 11 to 16 years. However, in the group aged five years and less, a small, but significant, mean increase of 0·23 mEq/l was found. Individual children in each group had significant increases in serum potassium, but this phenomenon was less common than has been reported in adults. Different premedications had no effect on serum potassium, and changes could not be related to the presence or degree of muscular fasciculations.
Acute Iron Poisoning—Clinical Features and Management
Authors: Barker G. A. , Brown T. C. K. , Hosking C. S. 
Published: January 2019

The patients admitted to the Royal Children's Hospital with iron ingestion between 1964 and 1973 are reviewed and the case histories of eight serious ingestions are summarized. The clinical features of vomiting, diarrhoea, cardiovascular collapse, increasing central depression leading to coma, and hepatic necrosis are discussed. The management, including the use of sodium bicarbonate, intravenous fluids and the specific antidote desferrioxamine, is discussed.
Mucosal Changes in the Trachea and Main Bronchi of Newborn Infants after Nasotracheal Intubation
Authors: Fisk G. C. , Baker W. de C. 
Published: January 2019

Permanent sequelae of nasotracheal intubation are uncommon, but acute ulceration and squamous metaplasia occur. Histological sections from the trachea and main bronchi were examined in 12 infants. A nasotracheal tube had been inserted during the first two weeks of life of these infants and had been in place for more than one week. In four cases the patient died some time (7 to 108 days) after extubation. Similar sections from patients who were not intubated, intubated only for attempted resuscitation, or intubated for several hours were studied for comparison. The sections were classified according to the degree of mucosal loss and metaplasia, and the extent of the lesions was estimated. Squamous change was seen in most sections from all 12 patients with the exception of one who died 57 days after extubation. Some respiratory epithelium was seen in all patients. In the eight patients who died while intubated, the changes were more marked in the right main bronchus than the left in seven, and more marked in the lower trachea than the upper in five. In the two patients intubated for several hours, in addition to mucosal loss, early metaplasia was seen. It is suggested that mucosal loss is replaced by the squamous metaplasia, and that trauma caused by suction catheters in the lower trachea and right main bronchus is more extensive than that due to the endotracheal tube itself.
Errors in Pneumotachography with Intermittent Positive Pressure Ventilation
Authors: Abrahams N. , Fisk G. C. , Churches A. E. , Loughman J. , Vonwiller J. B. , Agzarian J. , Harrison G. A. 
Published: January 2019

Instrument errors that can occur when pneumotachography is used during Intermittent Positive Pressure Ventilation (IPPV) have been described previously (Kafer 1973). Our efforts to eliminate these errors led to the discovery of further inaccuracies, which appear to be due to the design of the differential pressure transducers used with the pneumotachograph head. A system was used in which a sine-wave pump delivered a constant tidal volume to a dummy lung, the tidal volume being measured by means of a pneumotachograph. Using Grass, Statham and Devices differential pressure transducers, the volume recorded as leaving the dummy lung was consistently greater than that recorded as entering, and changing the pneumatic polarity of the differential pressure transducer produced large differences in the recorded volume. In some cases the error was greater than the volume being measured. There would seem to be several causes of such errors. The Sanborn 270 differential pressure transducer and the Greer micromanometer appeared to be free of these artifacts. The results of this study throw into doubt much previously published work using pneumotachography during IPPV.
Post-Operative Respiratory Function a Ventilation-Perfusion Study
Authors: Morton A. , Mahoney P. , Hansen P. , McBride M. , Baker A. B. 
Published: January 2019

Many studies have shown that after uncomplicated abdominal surgery arterial hypoxaemia frequently occurs because of regional underventilation in relation to perfusion. This paper produces evidence that shows a small increase in physiological dead space to tidal volume ratio following general anaesthesia for abdominal surgery. This increase is thought to be due to tachypnoea rather than alteration in pulmonary blood flow.
A New Humidifier
Authors: Grant G. C. , Dawson J. J. W. , Roberts B. E. 
Published: January 2019

A new heated water-bath humidifier operates on a new basic principle which overcomes the practical disadvantages of existing systems. A heated hose is used to control a temperature drop along the whole length of the delivery line instead of raising the temperature of the gases in the delivery line as in previous systems. Therefore the tank does not have to fully saturate the gases and a simple, totally cleanable design is possible. A temperature sensor at the delivery point controls the hose heater, constituting a rapid response, low thermal inertia system and delivery temperature is displayed on the unit. Compensation for varying gas flows and ambient temperature changes is inherent and the unit is suitable for neonatal/paediatric and adult use without special adjustment. The tank has a separate reservoir chamber which feeds an evaporation chamber via a cleanable float valve, conferring many advantages including clearly visible water levels, easy filling without breaking the circuit and constant compression volume. Full fail-safe alarm systems are incorporated.
A Diagram to Facilitate the Understanding and Therapy of Mixed Acid Base Disorders
Authors: Worthley L. I. G. 
Published: January 2019

A diagram based on in-vivo relationships between arterial hydrogen ion activity (H+) and carbon dioxide tension (PCO2 ) in primary abnormalities of acid base homeostasis is presented. It is designed to facilitate the interpretation of pH data by including the 95% confidence limits described in patients with simple metabolic and respiratory acid base disorders. These bands have been formulated from observation of simple acid base abnormalities and indicate the appropriate respiratory or renal compensatory response to the primary pH defect. A plot which falls outside these limits therefore indicates the presence of a mixed acid base disorder. The diagram presents a physiological approach to clinical disorders of pH regulation demonstrating maintenance of intra-cellular fluid homeostasis during primary extracellular fluid disturbances. Diagnostic and therapeutic advantages are further illustrated and discussed in six case reports.
Teaching Aids
Authors: Paull John D. 
Published: January 2019

A teaching aid is exactly what it says it is—an aid to teaching. No matter how exciting the aid may be, its production is not an end in itself, merely a means to an end. Teaching aids are most effective and can be best justified when a need for them has been demonstrated and when they can be shown to clarify the teaching of points and problems which students have formerly found difficult to understand. The best teaching aids are the result of a combination of imagination and enthusiasm. Aids should always be evaluated to determine whether the costs of production are justified by an improvement in learning.
Insulin Loss in Parenteral Nutrition Systems
Authors: Oh T. E. , Dyer H. , Wall B. P. , Hall R. A. , Jellett L. B. 
Published: January 2019

This study investigated insulin adsorptive loss occurring in various infusion systems used in regimens of parenteral nutrition. The results suggested early and considerable insulin loss in dextrose infusion solutions with doses of insulin used clinically. Maximum percentage loss occurred within 30 seconds following administration of insulin to infusion bottles of 5% and 50% dextrose. Mean insulin loss over eight hours amounted to 47·6%± 2·0 s.e.m. in 5% dextrose and 34 · 8% ± 1· 5 s.e.m. in 50% dextrose. The combination of infusion bottle and infusion set further increased the mean insulin loss in 50% dextrose to 43 ·6%± 1·7 s.e.m. Percentage insulin loss in bottles of 5% dextrose decreased with increasing insulin concentration, however, insulin loss in 50% dextrose was unaffected by varying insulin concentration. The addition of human serum albumin (0·05% w/v) to 50% dextrose lessened insulin loss to a small but significant extent and mean insulin loss in solutions of Aminofusin 600 was only 14·0% ± 1·6 s.e.m. over 30 minutes. With a regimen of parenteral nutrition in any one patient, it would seem logical where possible to add insulin to one type of parenteral nutrition solution only, so that the variability of insulin adsorptive loss seen with different solutions may be minimized.
Historical Note: Drumine—A New Australian Local Anaesthetic
Authors: Bailey Richard J. 
Published: January 2019

An article in the Australasian Medical Gazette of October, 1886 indicates the method of extraction, experimentation and therapeutic application of an active principle, prepared from Euphorbia Drummondii. Further correspondence is noted, refining the method of extraction, reporting cases, answering criticisms, and announcing eventually, drumine's commercial preparation. Despite enthusiastic support, the drug soon disappears from the therapeutic scene.
Application of the New Australian Standard for Clinical Lighting
Authors: Hood John W. 
Published: January 2019

A new Australian Standard “AS 1765–1975 Artificial Lighting for Clinical Observation “has recently been published. This specifies the quality of light necessary to accurately assess a patient's colour. The physical principles and terminology used in modern lighting are discussed, and the experimental work on which the new Standard is based is outlined. The only readily available fluorescent tubes which conform to the Standard are the imported Philips “TL40W/37” and the more efficient locally made “White Deluxe “tubes.
The Stocks Suction Bullet
Authors: Kerr D. R. , Vonwiller J. B. , Abrahams N. 
Published: January 2019

The Stocks suction bullet is a device allowing maintenance of positive pressure ventilation, continuous distending pressure and high inspired oxygen concentrations during tracheal toilet in intubated patients. The effectiveness of this device was studied using an experimental apparatus and a dummy lung to represent neonates being treated with either C.P.A.P. or I.P.P.V. and P.E.E.P. By using appropriate combinations of suction catheter type and size, bullet lumen size, ventilator settings and suction pressure limit, it was possible to maintain during suctioning ventilation peak pressures between 50% and 100% of presuction levels and continuous distending pressures (P.E.E.P. or C.P.A.P.) at or in excess of 80% of presuction levels.
Prolonged Curarisation in the Presence of Renal Impairment
Authors: Havill J. H. , Mee A. D. , Wallace M. R. , Chin L. S. , Rothwell R. P. G. 
Published: January 2019

Prolonged curarisation in the presence of renal failure occurred in six cases where pancuronium was used, and one case where alcuronium was used. The cases are presented with a brief review of the literature. Pancuronium must be used with great caution if postoperative reversal problems are to be avoided. Greater use of adjuvants will reduce requirements and may eliminate the problems encountered in renal failure.
Arterial Blood Gas Analysis: Potential Errors due to the Addition of Heparin
Authors: Hamilton R. D. , Crockett A. J. , Alpers J. H. 
Published: January 2019

The effect of sodium heparin on the determination of the major arterial blood gas parameters was studied. The addition of heparin produced errors in all three parameters tested, i.e. PO2, PCO2 and pH. The PCO2 determination was most affected, a 12% decrease being introduced into a 1.5 ml blood sample by the volume of heparin which fills the deadspace of a syringe and needle. Small but statistically significant errors were also produced in PO2 and pH by this heparin concentration. The clinical implications of these findings are discussed and certain measures outlined to avoid such errors.
The Effect of EMG Biofeedback on Postoperative Pain following Abdominal Surgery
Authors: Madden Chris , Singer George , Peck Connie , Nayman Jack 
Published: January 2019

To investigate the effects of electromyography (EMG)-biofeedback on pain experienced during the immediate post-operative period following abdominal surgery, twelve patients were randomly assigned to either (1) EMG-biofeedback from abdominal muscles; (2) EMG-biofeedback from the frontalis muscles; or (3) were given no EMG treatment. EMG training consisted of one pre-operative 30 minute session, and three 30 minute postoperative sessions. All patients were able to reduce EMG activity. A within-sessions analysis of pain reports (on a 0–10 pain intensity scale) indicated that EMG biofeedback is an effective method of pain relief only when feedback is given to the muscle site involved in the operation.
D-Tubocurarine Requirement during Hypothermia
Authors: Lam H. S. , Brown T. C. K. , Lampard D. G. 
Published: January 2019

The effect of hypothermia on the action of d-tubocurarine (d-TC) was studied under carefully controlled experimental conditions. It was found that with computer controlled infusion, 60% less d-TC was required to sustain 75% muscle paralysis in cats, during steady-state, in vivo, when the temperature was changed from 37°C to 30°C. The corresponding relaxant consumption rates were 0.136 ± 0.025 and 0.055 ± 0.012 mg/kg/1/2 hr respectively. When there was no temperature change the maintenance dosage of d-TC remained constant for up to four hours denoting the equilibrium phase of the relaxant kinetics. Temperature transitions introduced dynamic changes in these kinetics and altered the constancy of the maintenance dosage.
Neonatal Tetanus
Authors: Krishna S. Radha 
Published: January 2019

Forty-eight babies were treated for neonatal tetanus and there were ten deaths. Twenty-seven patients were treated with neuromuscular blockade, nasotracheal intubation and intermittent positive pressure ventilation. In this group there were five deaths and three of these were the direct or indirect result of respiratory complications. A management regime for neonatal tetanus is outlined and the complications are discussed.
Volume Replacement in Acute Anaphylactoid Reactions
Authors: Fisher M. McD. , Dicks I. 
Published: January 2019

Two patients who experienced cardiovascular collapse due to anaphylactoid reactions are described. The first patient showed haemoconcentration which was rapidly restored with colloid solutions and vasoconstrictors. The second patient showed haemoconcentration in spite of massive infusion of crystalloid and repeated adrenaline; her circulatory status was restored with colloid solution. In acute anaphylactoid reactions both sympathomimetics and colloid solutions are necessary to restore circulation.
Salbutamol, Obstetrics and Anaesthesia: A Review and Case Discussion
Authors: Crowhurst John A. 
Published: January 2019

Salbutamol and related beta-2 sympathomimetic drugs have been used in Australia recently for the inhibition of premature labour and also to prevent uterine activity in acute foetal emergencies during labour. General anaesthesia in these situations presents the anaesthetist with a number of pharmacological difficulties, which can have profound effects on both mother and neonate. The use of beta-blockers to correct the cardiovascular and metabolic instability is discussed and recommendations are made for their use in association with anaesthesia for operative delivery. Ante-natal beta-blockade of mother may increase the morbidity and possibly the mortality of an already at risk pre-term neonate. The case report illustrates some of the hazards associated with salbutamol, obstetrics and anaesthesia.
Total Intravenous Anaesthesia for Major Gynaecological Surgery
Authors: Rocke D. A. , Rubin J. , Brock-Utne J. G. , Downing J. W. 
Published: January 2019

A technique of total intravenous anaesthesia using etomidate by bolus intravenous (IV) injection for induction and by continuous intravenous infusion for maintenance of anaesthesia, with supplementary intravenous fentanyl analgesia, is described. Muscle relaxation was provided by competitive neuromuscular blockade, allowing controlled ventilation of the lungs with oxygen-enriched air. Arterial blood pressure, heart rate and rhythm remained stable throughout the procedure. Few complications were encountered of which the most significant was a 13% incidence of nausea and/or vomiting. Pain on injection, abnormal muscular movements on induction, and post operative venous sequelae were uncommon. Patients were easily rousable shortly after termination of drug infusion. The technique proved acceptable to the patient, surgeon and experienced anaesthetist and, thereby, would appear to offer a reasonable alternative to the more conventional inhalational anaesthetic technique.
An Evaluation of the Hellige Transoxode (Servomed Oxymonitor SM 361 System): Response to Halothane and Enflurane in Vitro
Authors: Downing J. W. , Mankowitz M. , Brock-Utne J. G. , Holloway A. M. 
Published: January 2019

The effects of halothane (0.5-2%) and enflurane (1-4%) on two Transoxode transcutaneous oxygen (TcPO2) electrodes (Hellige Servomed Oxymonitor SM.361 system) were serially tested in atmospheres of nitrogen, air and 50% nitrous oxide in oxygen. Both TcPO2 electrodes reduced and “read” halothane but not enflurane. Calibration drift was significantly greater (p < 0.05) after electrode exposure to halothane; 5.40 s.e.m. 1.37 kPa vs enflurane; – 0.60 s.e.m. 0.93 kPa. Halothane has a direct effect in rendering the Transoxode inaccurate, which is probably clinically less important than the indirect cardiovascularly medicated influence of both halothane and enflurane on TcPO2 levels. A reduction in the electrode polarisation voltage is recommended to obviate the direct effect of halothane on Transoxode performance.
An Evaluation of Blood Pressure Measurement
Authors: Runciman W. B. , Rutten A. J. , Ilsley A. H. 
Published: January 2019

The accuracy of routine measurements by nursing staff of systemic arterial, central venous, pulmonary artery and pulmonary capillary wedge pressures was determined. There was a significant difference between direct mean arterial blood pressure measurements and routine indirect measurements by the nursing staff in the pressure range of 50-100 mmHg, whereas there was no significant difference between direct and indirect measurements when indirect measurements were made by specially trained hypertension clinic personnel. However, there was a good correlation between direct and indirect measurements in each instance, indicating that changes in blood pressure could be adequately followed by both groups. Systems commonly used to measure blood pressure directly were tested. Limits in frequency response preclude the routine direct measurement of systolic or diastolic blood pressures. If direct systolic and diastolic pressure measurements are required, it is necessary to check the performance of the amplifier and recording system, attach the transducer to the patient, and determine and adjust, if necessary, the natural frequency and damping coefficient of each system before each measurement. However, it is suggested that a knowledge of systolic and diastolic pressure measurements seldom improves patient management, and if mean pressures are accepted, reliable routine measurements may be obtained by the nursing staff. The digital display of the systems tested may be accepted for mean arterial pressure, but for accurate mean central venous and pulmonary capillary wedge pressure measurements, it is necessary to interpret the trace on a chart recorder; pulmonary artery pressure can often only be estimated.
Immediate Problems Associated with Infraclavicular Subclavian Catheterisation; A Comparison between Left and Right Sides
Authors: Matthews N. T. , Worthley L. I. G. 
Published: January 2019

A comparison was made between 126 left and 126 right percutaneous infraclavicular subclavian vein cannulations. Compared with the right side, insertion of the cannula on the left side resulted in significantly (p < 0.01) fewer catheter tip misplacements although both sides showed the same incidence of cannulation failures and immediate complications. Using the infraclavicular approach to the subclavian vein for central venous cannulation, the left side is to be preferred.
Epidural Morphine after Caesarean Section
Authors: Binsted R. J. 
Published: January 2019

Morphine sulphate 5 mg and placebo administered epidurally after caesarean section under epidural analgesia were compared in a double-blind fashion. Morphine was significantly superior to placebo for pain relief, duration of pain relief, and reduction of parenteral narcotic requirements. Pruritis was the most commonly encountered side-effect. There was no statistical difference between morphine and placebo in the incidence of urinary catheterisation, vomiting, nausea, dizziness or drowsiness. No serious respiratory depression requiring treatment was observed.
Perioperative Management of Tetralogy of Fallot Repair
Authors: Jones R. D. M. 
Published: January 2019

Understanding the morphological and haemodynamic changes associated with surgical correction of tetralogy of Fallot is vital in planning a rational basis for the postoperative management. The past five years have seen a fall in mortality figures from more than 10% to 2% and the reasons for this improvement are reviewed. There have been changes in the preoperative assessment and therapy, but perhaps the most significant change has been in operative technique. The correction now is performed by a transatrial approach, whereas in the past a large ventriculotomy was used. There has been a change in emphasis in the various postoperative manoeuvres employed. Early low-dosage inotrope support, cavity drainage, intravenous hyperalimentation, peritoneal dialysis, sequential pacing and ventilation until cardio-respiratory stability is achieved, form the basis of our postoperative regime.