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Biomedical subjects

R S Newbower

Publications and source records attributed to R S Newbower.

8 recordsLinked to original sources
PubMed1979

Intrathoracic electrical impedance measurements from an esophageal probe.

The sensing of intrathoracic electrical impedance from an esophageal probe may allow relatively noninvasive monitoring of cardiac and respiratory functions of particular interest in anesthesia and intensive care. We have obtained a partial solution of the intrathoracic current-field problem for impedance measurements made from a four-terminal linear array of electrodes located in the esophagus. It allows prediction that aortic root motion will exceed aortic distension as a major determinant of the cardiac intrathoracic esophageal impedance signal. This prediction was confirmed for a specific carefully selected and placed electrode array in anesthetized dogs. In general, motions of organs will be more important than volume changes in affecting the esophageal impedance signal. Thus, timing information (preejection period and left ventricular ejection time) is available from electrodes on an esophageal probe, but cardiac output information appears to be inaccessible for fundamental reasons.

Cardiography, Impedance↗
PubMed1978

A new anesthesia delivery system.

A prototype anesthesia delivery system has been developed to test the appropriateness of new technological design approaches. The objectives were to eliminate human-factors problems associated with present anesthesia apparatus and to lay a suitable technical foundation for the development of new techniques in anesthesia management. This prototype performs all the functions of a conventional anesthesia machine, as well as many monitoring and surveillance tasks. Eventual incorporation of new teaching functions, and additional monitoring and record-keeping activities, are intended. The system is fundamentally electronic with few moving parts. Reliability, safety, and clarity of operation were the primary criteria in selection and application of the specific technologies employed. The result is a promising first step in the development of a system oriented toward supporting rather than preoccupying the anesthestist.

Anesthesia↗
PubMed1978

Preventable anesthesia mishaps: a study of human factors.

A modified critical-incident analysis technique was used in a retrospective examination of the characteristics of human error and equipment failure in anesthetic practice. The objective was to uncover patterns of frequently occurring incidents that are in need of careful prospective investigation. Forty-seven interviews were conducted with staff and resident anesthesiologists at one urban teaching institution, and descriptions of 359 preventable incidents were obtained. Twenty-three categories of details from these descriptions were subjected to computer-aided analysis for trends and patterns. Most of the preventable incidents involved human error (82 per cent), with breathing-circuit disconnections, inadvertent changes in gas flow, and drug-syringe errors being frequent problems. Overt equipment failures constituted only 14 per cent of the total number of preventable incidents, but equipment design was indictable in many categories of human error, as were inadequate experience and insufficient familiarity with equipment or with the specific surgical procedure. Other factors frequently associated with incidents were inadequate communication among personnel, haste or lack of precaution, and distraction. Results from multi-hospital studies based on the methodology developed could be used for more objective determination of priorities and planning of specific investments for decreasing the risk associated with anesthesia.

Accident Prevention↗