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Biomedical subjects

A Kopka

Publications and source records attributed to A Kopka.

7 recordsLinked to original sources
PubMed2005

Anaesthetists should wear gloves--touch sensitivity is improved with a new type of thin glove.

BACKGROUND: Sterile gloves should be worn for all invasive procedures. However, loss of touch sensitivity when wearing gloves leads to poor compliance among anaesthetists in the UK. Our aim was to investigate whether new surgical glove types, such as extra-thin or latex-free gloves, offer any advantage in touch sensitivity. METHODS: The skin-pressure sensibility threshold of the gloved pulp of the dominant index finger was established in 24 anaesthetists using nine self-made modified von Frey hairs. The range of forces generated by nylon monofilaments was evenly distributed between 0.5 and 17 mN. The gloves tested were latex Biogel standard, latex-free Biogel Neotech, and extra-thin latex Ansell microthin surgical gloves. The different glove types were assessed in a counterbalancing algorhithm, the individual was blinded, and the filaments were applied in random order. RESULTS: The median threshold force to touch was significantly lower for the extra-thin surgical gloves in comparison to the standard latex (P = 0.014) and latex-free gloves (P = 0.001). There was no significant difference between the standard latex and latex-free gloves (P = 0.166). CONCLUSION: We have demonstrated that wearing extra-thin surgical gloves offers increased touch sensitivity. This may improve dexterity when carrying out delicate invasive procedures. Latex-free surgical gloves performed similar to standard latex gloves. Our findings should encourage more widespread glove use among anaesthetists.

Anesthesia↗
PubMed2004

Cricoid pressure: a simple, yet effective biofeedback trainer.

BACKGROUND AND OBJECTIVE: Only regular training of anaesthetic personnel ensures safe and reliable application of cricoid pressure during rapid sequence induction of anaesthesia. Previously described training devices are either complicated, too expensive and usually unavailable, or they are very simple and do not correctly simulate the process of applying cricoid force. We designed and tested a cricoid pressure trainer with real-time display of applied force. The device is easy to assemble at relatively little cost with material widely available. It allows effective biofeedback training of the force required during the Sellick manoeuvre and can be used for routine staff assessment. METHODS: Thirty-six anaesthesia assistants were assessed for their correct application of cricoid pressure. Previous training in, and knowledge of, applying cricoid pressure was first evaluated by a questionnaire. We designed a model for testing the application of cricoid force. Pre-training cricoid forces were obtained by asking the subjects to apply 'awake' (10 N = 1.020 kg) and 'asleep' (30 N = 3.060 kg) cricoid pressure on our model while blinded to the actual pressure produced. The volunteer was then trained to apply correct pressure employing real-time biofeedback. Post-training values were later determined with the subject again blinded to the actual applied pressure. RESULTS: Post-training performance showed significant improvement in the application of the correct cricoid force (P < 0.0005). Only 8% (3/36) of subjects applied incorrect 'awake' cricoid pressure after training vs. 56% (20/36) before training. All participants applied correct 'asleep' cricoid pressure after training vs. 72% (26/36) failing before training. CONCLUSIONS: Our biofeedback cricoid pressure trainer is effective in the assessment and training of correct cricoid pressure application by anaesthetic personnel.

Anesthesiology↗
PubMed2004

Interobserver reliability between a nurse and anaesthetist of tests used for predicting difficult tracheal intubation.

We examined the interobserver reliability, between a nurse and anaesthetist, of five tests used to predict difficult tracheal intubation: mouth opening; thyromental distance; head and neck movement; mandibular luxation; and assessment of oropharyngeal view. For each test, an anaesthetic nurse and a specialist registrar anaesthetist were trained to use a standard method of examination. Most of the tests had either good or very good reliability. Assessment of mouth opening demonstrated only moderate reliability and assessment of oropharyngeal view demonstrated poor reliability. The interobserver reliability estimates between a nurse and an anaesthetist are similar to those previously demonstrated between two anaesthetists.

Head Movements↗
PubMed2004

Anaesthesia for cholecystectomy in two non-parturients with Eisenmenger's syndrome.

Eisenmenger's syndrome consists of high pulmonary vascular resistance with reversed or bidirectional shunt at aortopulmonary, ventricular or atrial level. We describe the anaesthetic management of two adult females with Eisenmenger's syndrome admitted for laparoscopic cholecystectomy. One patient suffered post-operative complications, but the other case was uncomplicated. We used sevoflurane and total intravenous anaesthesia to provide general anaesthesia. Both techniques were tolerated.

Adult↗