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E T Bode

Publications and source records attributed to E T Bode.

3 recordsLinked to original sources

Long-term pharmaceutical cost reduction using a data management system.

UNLABELLED: Cost containment is an important issue in medicine today, and the ability to control costs and maintain quality patient care presents a challenge to practitioners. Educating practitioners about drug costs has been identified as an effective method, but the benefits of education are usually short-lived. To evaluate the role of education in cost control, pharmaceutical use and performance improvement data were analyzed at a tertiary care institution during two time periods. A total of 4,530 anesthesia records and associated performance improvement data from March to June 1993 were analyzed as a baseline. These data were shared with the clinicians of an anesthesia department and used to educate practitioners regarding the costs and use of injectable pharmaceuticals and to identify areas in which cost savings could be achieved. The same information from 10,600 cases during January to October 1996 were compared with the early group. The expenditures for injectable pharmaceuticals to provide anesthesia were decreased by more than $30,000 per month, or $32 per case, without changing the performance indicators that were monitored, and has been maintained for >3 yr. IMPLICATIONS: By using a data management system, the cost for medications to provide anesthesia has been reduced without changing the quality of patient care.

Anesthesia↗

Bronchopulmonary lavage for pulmonary alveolar proteinosis.

In summary, total-lung bronchopulmonary lavage was performed five times on two patients under general anesthesia with controlled ventilation using a Robert-Shaw double lumen ETT. One lavage was complicated by a hydrothorax that was treated without untoward sequelae. No significant hypoxemia, circulatory impairment or leakage of lavaged fluid into the opposite lung was noted on any occasion. The average time of all procedures was 108 minutes (range 80-150 minutes), and patients were extubated on all occasions 2 to 5 hours after the treatment. Patients were discharged 24 to 36 hours after the last lavage with improvement, though not resolution, of the alveolar infiltrates radiographically. The ABG analysis revealed minimal improvement in oxygenation in Case No.1 from a preoperative paO2 of 60 mmHg on room air to a paO2 of 74 mmHg on the day of discharge. However, the patient was able to resume his normal activity level. In Case No.2, the patient's resting paO2 did not improve significantly from the preoperative value of 82 mmHg. Subjectively, however, the patient noted marked improvement. Prior to bronchopulmonary lavage, this patient's SaO2 decreased from 97% to 81% after walking 800 feet. Approximately a week and a half after discharge, the patient reported being able to run without symptoms and generally was feeling well. With careful attention to detail and the coordination of resources from the departments of anesthesia, pulmonary medicine, respiratory therapy and nursing services, bronchopulmonary lavage can be performed safely and efficiently in order to curtail the progressive hypoxemia which often develops in patients with PAP.

Adult↗

Horner's syndrome after epidural block in early pregnancy.

Horner's syndrome after epidural block in a first-trimester parturient has not previously been reported. The authors describe a case of unilateral Horner's syndrome after single-dose epidural block in a 12-week pregnant female.

Adult↗