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Biomedical subjects

M Naraghi

Publications and source records attributed to M Naraghi.

27 records · Page 2Linked to original sources

Complications from unrecognized defects in endotracheal tubes.

Considerable effort has been made to improve endotracheal tubes and make them safer than they have been in the past; yet complications continue to occur, due, in most instances, to inherent defects in the tube. It is not possible to identify these defects in a routine preoperative examination. Three cases are presented illustrating how defects in anode endotracheal tubes almost caused fatalities during anesthesia. Other possible complications and contributing factors causing obstruction of endotracheal tubes are also reviewed. Until some way is devised for the automatic compensation of the increases in volumes and pressures in endotracheal tube cuffs, hourly deflation is recommended to prevent complications.

Adult↗

Acute systemic toxicity from bupivacaine during epidural anesthesia in obstetric patients.

Convulsions occurred within 30 seconds after the injection of bupivacaine through the epidural catheter in four obstetric patients in labor, and mild excitation without convulsions occurred in three others. Since the time between injection and the reaction was so short and since the dose was so small, the response probably was due to intravenous injection resulting from lodgement of the catheter in a vein, rather than to absorption from the epidural space itself. It is not generally known that the epidural veins become thin-walled and engorged during labor; thus, inadvertent placement of a cathether in a vein can occur readily. Convulsions, therefore, may follow even injection of a test dose of a drug. Other colleagues have had similar though unreported experiences. Physicians performing epidural blocks should be aware that such an occurrence is possible and that the catheter may be within a vein without blood returning on aspiration.

Adult↗

Leak rate of latex gloves after tearing adhesive tape.

Anesthesiologists use latex gloves to provide barrier protection against infectious disease or contamination while providing anesthetic services. The performance of these services often involves tearing tape. The purpose of this study was to test the effect of tearing adhesive tape on permeability of latex examination gloves and to test the effect of an adhesive-sparing moisturizing cream on permeability of latex gloves used to tear adhesive tape. In a blinded, randomized, controlled laboratory experiment, 48 nonsterile latex examination gloves (24 pairs) were randomized to 1 of 2 groups. Adhesive-sparing moisturizing cream, 0.1 mL, was applied to 12 glove pairs; the remaining 12 pairs served as controls. Each of the 24 pairs of gloves were used to tear five 4-cm strips of cloth adhesive tape from a standard 1 1/2-inch roll. After initial inspection for obvious tears, each glove was tested for leaks using the watertight test as specified by the American Society for Testing and Materials (ASTM). Data recorded included the identity of the investigator tearing tape, number of holes initially observed, number of holes observed from the ASTM test, location of holes, glove classification as right or left hand, and treatment group. Based on the study, the authors concluded that health care providers who tear adhesive tape while wearing latex gloves should be aware that there is a high probability that the gloves no longer form a protective barrier and that adhesive-sparing moisturizing cream applied before tape is torn increases barrier protection.

Double-Blind Method↗