BACKGROUND AND OBJECTIVE: In this preliminary study we wanted to explore the attitudes of anaesthesiologists to a point-of-care information system in the operating room. The study was conducted as a preliminary step in the process of developing such a system by the European Society of Anaesthesiologists (ESA). METHODS: A questionnaire was distributed to all 2240 attendees of the ESA's annual meeting in Gothenburg, Sweden, which took place in April 2001. RESULTS: Of the 329 responders (response rate of 14.6%), 79% were qualified specialists with more than 10 yr of experience (68%), mostly from Western Europe. Most responders admitted to regularly experiencing lack of medical knowledge relating to real-time patient care at least once a month (74%) or at least once a week (46%), and 39% admitted to having made errors during anaesthesia due to lack of medical information that can be otherwise found in a handbook. The choice ofa less optimal but more familiar approach to patient management due to lack of knowledge was reported by 37%. Eighty-eight percent of responders believe that having a point-of-care information system for the anaesthesiologists in the operating room is either important or very important. CONCLUSIONS: This preliminary survey demonstrates that lack of knowledge of anaesthesiologists may be a significant source of medical errors in the operating room, and suggests that a point-of-care information system for the anaesthesiologist may be of value.
Technetium 99m may now be used to identify sentinel nodes for surgical excision in a growing number of cancer sites. The pathology specimens of these sentinel nodes and of any injected tumoural sites are radioactive. Consequently, specific clinical and laboratory procedures must be developed to handle these specimens safely. It is recommended that specimens containing the injection site should be quarantined for a period to permit decay of radioactivity. This quarantine does delay the reporting of pathology results to surgeons, oncologists and other clinicians, but it does not adversely affect final patient management.
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Health Canada, Population and Public Health Branch, Centre for Infectious Disease, Prevention and Control, Health Care Acquired Infections Division, Nosocomial and Occupational Infections. Linda_kingsbury@hc-sc.gc.ca
Halothane and nitrous oxide (N2O) concentrations were measured in operating theatres, in the areas corresponding to theinhalation zones of the anaesthetists and operating nurses. The measurements were performed in an operating theatre with a non-recirculating air exchange rate of 20/h. This was performed partly in model experiments and partly during the administration of anaesthesia by intubation. In the model experiments. the measurements were taken both with and without a specially constructed scavenging system. During anaesthesia, the measurements were taken exclusively with the scavenging system, although well-defined leakages were fitted into the otherwise gas-tight anaesthetic system. The results were supplemented by smoke experiments which showed the air distribution patterns. The investigation showed that the gases were concentrated over and around the operating table. Activities during surgery diluted this concentration. Furthermore, it was shown that leakage in the anaesthetic system significantly influences the achieving of a low gas-air mixture. Halothane concentrations in the inhalation zone of the anaesthetist and operating nurse can be reduced to 0.02 and 0.01 p.p.m. respectively, if the anaesthetic system is completely gas-tight.