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Biomedical subjects

P Southorn

Publications and source records attributed to P Southorn.

9 recordsLinked to original sources

Multicenter study of contaminated percutaneous injuries in anesthesia personnel.

BACKGROUND: Anesthesia personnel are at risk for occupational infection with bloodborne pathogens from contaminated percutaneous injuries (CPIs). Additional information is needed to formulate methods to reduce risk. METHODS: The authors analyzed CPIs collected during a 2-yr period at 11 hospitals, assessed CPI underreporting, and estimated risks of infection with human immunodeficiency virus and hepatitis C virus. RESULTS: Data regarding 138 CPIs were collected: 74% were associated with blood-contaminated hollow-bore needles, 74% were potentially preventable, 30% were considered high-risk injuries from devices used for intravascular catheter insertion or obtaining blood, and 45% were reported to hospital health services. Corrected for injury underreporting, the CPI rate was 0.27 CPIs per yr per person; per full-time equivalent worker, there were 0.42 CPIs/yr. The estimated average 30-yr risks of human immunodeficiency virus or hepatitis C virus infection per full-time equivalent are 0.049% and 0.45%, respectively. Projecting these findings to all anesthesia personnel in the United States, the authors estimate that there will be 17 human immunodeficiency virus infections and 155 hepatitis C virus infections in 30 yr. CONCLUSIONS: Performance of anesthesia tasks is associated with CPIs from blood-contaminated hollow-bore needles. Thirty percent of all CPIs would have been high-risk for bloodborne pathogen transmission if the source patients were infected. Most CPIs were potentially preventable, and fewer than half were reported to hospital health services. The results identify devices and mechanisms responsible for CPIs, provide estimates of risk levels, and permit formulation of strategies to reduce risks.

Anesthesiology↗

Reducing the potential morbidity of an unintentional spinal anaesthetic by aspirating cerebrospinal fluid.

We describe two cases where we attempted to reduce the adverse effects of inadvertent spinal anaesthesia by aspirating local anaesthetic-contaminated cerebrospinal fluid (CSF). Analysis of this CSF for its local anaesthetic concentration revealed that we were able to recover 51% and 39% of the administered lignocaine. It is suggested that such aspiration may be a helpful additional measure to the supportive management of this complication.

Adult↗

Sedation and respiratory mechanics in man.

The effects of sedation with halothane, enflurane or midazolam on respiratory mechanics and lung volumes were studied in young healthy volunteers, in the supine position. Functional residual capacity increased with halothane sedation, but was unchanged with sedation produced by enflurane or midazolam. Sedation with halothane and enflurane, but not midazolam, tended to increase lung static recoil pressure. Total lung capacity was decreased during sedation with midazolam. No evidence was found that sedation with these three agents increased airway resistance. These findings imply that changes in respiratory mechanics induced by the residual effects of anaesthetic agents are unlikely to contribute significantly to the impairment in pulmonary gas exchange which may occur in the period immediately after operation.

Adult↗

Halothane anesthesia and respiratory mechanics in dogs lying supine.

Functional residual capacity (FRC) and quasi-static deflation pressure-volume (PV) curves of the total respiratory system, lung, and chest wall were measured in eight trained dogs lying supine, first awake and then anesthetized with halothane. Two of the eight dogs were repetitively examined 10 times during a 15-mo period. FRC decreased with anesthesia in six of the eight dogs and incresed with anesthesia in the remaining two dogs. There was a significant mean anesthesia-induced reduction in FRC of 16.9% (P < 0.05). FRC change with anesthesia varied between studies in one of the two dogs repetitively examined. Mean PV curves of the total system, lung, and chest wall of the six dogs whose FRC decreased with anesthesia were shifted to the right by anesthesia. PV curves from the two dogs whose FRC increased with anesthesia were shifted to the left. Anesthesia produced a significant reduction (P < 0.05) in mean lung compliance and significant increases (P < 0.05) in mean chest wall and total system compliances.

Anesthesia, Inhalation↗