PubMed HealthSearch

Biomedical subjects

R A Leonard

Publications and source records attributed to R A Leonard.

16 recordsLinked to original sources

Recognition accuracy of current operating room alarms.

This prospective study was performed to determine whether anesthesia clinicians (i.e., both anesthesiologists and nurse anesthetists) can identify operating room alarms by their distinctive sounds and to identify factors related to alarm recognition accuracy. Nineteen alarms from 15 commonly used devices were recorded. These sounds were played, in a quiet room, to 44 anesthesia clinicians. The clinicians were asked to choose from a list the device that produced the alarm. After this recognition test, the clinicians rated the importance of each alarm and the frequency with which they heard it in the clinical situation. Clinicians correctly identified the alarm source 34% of the time. The recognition rate was higher for alarms rated as heard more frequently; however, alarms that were rated as more important were less likely to be correctly identified. Complexity of the sound did not influence accuracy of recognition. Most errors were attributed to similarities in sound or function, or both, among alarms. We conclude that anesthetists cannot reliably identify current operating room alarms by their distinctive sounds.

Anesthesiology

The action of corticosteroids on proteolysis.

1. The corticosteroids cortisol, cortisone and corticosterone were tested for their ability to affect the hydrolysis of serum albumin, insulin and oxyhaemoglobin incubated with trypsin, chymotrypsin, papain and pepsin. 2. Corticosteroids stimulated the hydrolysis of albumin and oxyhaemoglobin with trypsin between 10% and 200% and inhibited the hydrolysis of insulin by 15% (steroid/substrate molar ratio, 5:1). 3. The degree of stimulation of proteolysis for a given substrate depended on both the nature of the steroid and the protease. Corticosterone did not increase the activity of papain and pepsin with any of the substrates tested. 4. Corticosterone stimulated (fivefold) the denaturation of oxyhaemoglobin measured spectroscopically in 2.4% (w/v) sodium hydroxide. Small changes in the absorption spectrum of haemoglobin solutions were also noted at pH7.8 without a marked change in the basic properties of haemoglobin. 5. With regard to the action of corticosterone on the activity of trypsin, the lack of stimulation when benzoylarginine amide was used as a substrate, the lowering of the stimulation on prior heat denaturation of haemoglobin and the high temperature coefficient for stimulation suggest that the steroid resulted in improved access of the protease to susceptible bonds of the substrate.

Animals