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Anesthesia Equipment
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
Rachel Reed, Stephanie Kleine, Michele Barletta
The anesthetist should check to ensure that the gas source is present and with adequate oxygen supply. This involves checking the pressure of an oxygen cylinder, ensuring that the oxygen concentrator is functioning properly, or that the main oxygen supply is working appropriately.
Assessing and responding to sudden deterioration in the adult
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
You may have thought of: Displaying No Smoking signs.Removing devices that can spark.Educating individuals and relatives about the risk of smoking during oxygen administration and alcohol-based sprays (e.g. in perfume).Knowledge of fire procedure and equipment.Oxygen cylinders in the home should be kept away from gas fires, naked flames and hot radiators (NHS 2020).
Anaesthesia and resuscitation
Published in Jan de Boer, Marcel Dubouloz, Handbook of Disaster Medicine, 2020
Joost J. L. M. Bierens, Francois P. Gijsenbergh, Marc Sabbe
In disasters, inhalation anaesthesia needs to be executed in a simple way. Oxygen is often not or insufficiently available, which makes the use of a combined carrier gas with oxygen and nitrous oxide very dangerous. Nitrous oxide as a single carrier gas is lethal. In these situations the use of open air as a carrier gas is a good alternative, as this contains 21% oxygen and does not have the risk of pollution or mistakes by suppliers. As there is often the issue of (impending) absence of electricity and compressed gases, one can also not put a lot of trust in mechanical ventilation, and therefore it is safer that the patient breathes spontaneously. Because during spontaneous ventilation the volatile anaesthetic are tranported by the breathing movements of the patient only, extraordinary demands are set on vaporisers, valves and the ‘non-rebreathing valves’ in the exhaling system. Special vaporisers have been designed, like the Epstein-Macintosh-Oxford (EMO) vaporiser, which enable the delivery of a stable concentration of the volatile anaesthetic under difficult circumstances as in developing countries and disasters. Inhalation anaesthesia can be reliably given using these ‘draw-over systems’ and vaporisers. There always has to be a ‘self-inflating bag’ connected to the drawover system, so that the patient can be ventilated. If available and necessary, oxygen can be added (Fig. 1). When there is no compressed oxygen available in oxygen cylinders, ‘oxygen concentrators’ can be used, which filter the nitrogen out of the air.
Maxillary mucormycosis and concurrent osteomyelitis in a post-COVID-19 patient with new onset diabetes mellitus
Published in Baylor University Medical Center Proceedings, 2023
Pallak Arora, Geetpriya Kaur, Nutan Tyagi, Madhu K. Nair
Mucormycosis is a rare fungal infection caused by a group of fungi called Mucoromycetes that decompose organic matter found in soil and dust.4 The infection is extremely rare in healthy individuals, but numerous medical conditions such as immunosuppression, diabetic ketoacidosis, corticosteroid therapy, iron overload or hemochromatosis, deferoxamine therapy, voriconazole prophylaxis for transplant recipients, severe burns, acquired immunodeficiency syndrome, and intravenous drug abuse are known risk factors.1,5 Contamination from the use of industrial oxygen, low-quality oxygen cylinders, low-quality oxygen piping system, and ordinary tap water in ventilators are also considered risk factors.4 The predisposing factor in the present case could be corticosteroid therapy or the supplemental oxygen used in the treatment of pneumonia following COVID-19 infection. Pathological changes in the pancreas have been observed in patients with severe COVID-19, indicating that SARS-CoV-2 can impair pancreatic insulin secretion. This could be one of the reasons why COVID-19 patients who do not have a history of diabetes have higher blood glucose levels, as observed in this patient who was recently diagnosed with diabetes.
Effective training-of-trainers model for the introduction of continuous positive airway pressure for neonatal and paediatric patients in Kenya
Published in Paediatrics and International Child Health, 2019
Bernard Olayo, Caroline Kendi Kirigia, Jacquie Narotso Oliwa, Odero Nicholas Agai, Marilyn Morris, Megan Benckert, Steve Adudans, Florence Murila, Patrick T. Wilson
Two DeVilbiss IntelliPAP (Somerset, PA, USA) CPAP machines, approximately 50 Hudson RCI nasal prongs (Durham, NC, USA) of various sizes, two pulse oximeters and supplies needed to apply CPAP (head wrap, rubber bands, safety pins) were provided to each hospital. The CPAP machines were set-up and locked to deliver five centimeters of water pressure. Oxygen, if indicated, was administered via the CPAP inspiratory limb from the available oxygen source at each hospital (oxygen concentrator, oxygen cylinder or wall oxygen). Humidification was provided through nasal saline drops to the nares as needed or through humidified oxygen. Data on demographics, diagnosis, duration, outcome and adverse events of patients placed on CPAP from 16 July 2014 to 31 March 2016 were entered onto a one-page case report form by the healthcare provider applying the CPAP. Adverse events related to the use of CPAP were recorded prospectively by the treating clinician. Aspiration pneumonia was reported if an episode of emesis was followed by worsening respiratory status, regardless of chest radiograph findings.
A new low-cost commercial bubble CPAP (bCPAP) machine compared with a traditional bCPAP device in Nigeria
Published in Paediatrics and International Child Health, 2019
Hippolite O. Amadi, Ikechukwu R. Okonkwo, Ifeoluwa O. Abioye, Amina L. Abubakar, Eyinade K. Olateju, Christiana T. Adesina, Sule Umar, Bessie C. Eziechila
The necessary components of an IbCPAP set-up include: (i) an appropriately-sized commercial nasal cannula (Figure 1(a)); (ii) a commercial water or dextrose water bottle; (iii) a drinking straw for connecting the expiratory tube to the water bottle (often ignored in some NNUs); (iv) Elastoplast for marking on the water bottle the depth (in cm) to determine the water pressure; (v) an intravenous fluid (IVF) administration set for extending the length of the expiratory tube to reach the bottom of water bottle; and (vi) an oxygen cylinder or concentrator (Figure 1(b)).