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Biomedical subjects

C S Webster

Publications and source records attributed to C S Webster.

27 records · Page 2Linked to original sources

Attitudes and practices of New Zealand anaesthetists with regard to emergency drugs.

A postal survey of anaesthetists practising in New Zealand assessed practices with regard to the preparation of pre-drawn syringes of emergency drugs in theatre, and attitudes towards the drawing up of drugs by non-medically qualified assistants. Opinion and practice varied widely; a quarter of respondents routinely draw up such drugs and a third either never or very infrequently do so. The drugs most commonly drawn up in this way were suxamethonium, atropine, syntocinon, ephedrine and metaraminol. Providing anaesthesia single-handed, anaesthesia involving paediatric, obstetric or vascular cases, the use of major regional techniques and laryngeal mask anaesthesia were reported as factors which prompted a number of respondents to draw up one or more of these drugs. The majority (68.5%) had received no teaching on the issue and nearly all (83.5%) reported that there was no institutional policy in their workplace(s). "Syringe swap" or "wrong drug" errors related to such pre-drawn drugs were reported by 26.5%, while delay in drawing up a drug in an emergency was reported by 37%. Nearly all (98%) respondents believed that it was acceptable for an anaesthetic technician (or similar assistant) to draw up drugs in an emergency but only 14% approved of assistants drawing up drugs routinely. We conclude that there is no uniformity of opinion amongst New Zealand anaesthetists about which if any drugs should be pre-drawn for possible emergency use, and that few would endorse the drawing up of drugs by non-medically qualified assistants, except in emergency, or under other clearly delineated circumstances.

Anesthesiology↗

A prospective randomized clinical assessment of a new pigtail central venous catheter in comparison with standard alternatives.

The Cook Pigtail central venous catheter (CVC) has been designed to diminish the risk of vascular perforation and consequent cardiac tamponade. With the participation of 12 consultant anaesthetists and 19 registrars, adults undergoing elective surgery were randomized to receive either a Pigtail (n = 101) or their consultant anaesthetists' "standard" CVC (n = 102). Median ease of insertion was rated 8 for Pigtail CVCs and 9 for standards (10 being best; P = 0.001). Arrhythmias occurred during 16 standard and 33 Pigtail central venous catheter insertions (P < 0.006). No significant difference was found in insertion time or radiographically assessed tip depth for standard and Pigtail central venous catheters. A perforated right atrium of uncertain cause occurred in a patient who received an Arrow triple-lumen central venous catheter. Participating consultant anaesthetists preferred their "standard" central venous catheter for routine use, but five indicated that they would select a Cook Pigtail where long-term use was planned because of in vitro evidence of its greater safety.

Adolescent↗

Integrated RF coil with stabilization for fMRI human cortex.

Functional brain imaging of the human cortex is limited by poor contrast to noise ratio (CNR) and image degradation due to subject motion during the acquisition period. The work described here combines the use of closely coupled phased array receiver coils with a stabilization system to address these needs. Several phased array designs are evaluated and compared with the conventional "birdcage" design. Coil performance is reported in terms of relative SNR and fMRI results. Relative improvements of up to 360% are obtained for the occipital region and 180% in the temporal region. More modest gains of 10-30% were obtained for a "dome"-shaped birdcage volume coil covering the entire cortex.

Cerebral Cortex↗