[Infection hazards in the hospital. I. Hygienic measures in the intensive care units and recovery room].
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The investigation includes measurement of the N2O-concentration in the recovery rooms of three hospitals with different room ventilation systems. The amount of ventilation determines the elimination of the gas exhaled by the patients and, therefore, is related to the number of patients in the recovery rooms. The investigation has shown that non-recirculating room ventilation of 500 m3/pt./hour in recovery rooms gives personnel the same protection against inhalation of anaesthetic gases as is afforded to personnel in operating theatres with scavening equipment.
Three groups of activities taking place in the recovery room are separately analyzed and compared with the same done on the wards. It is concluded that all three of them are preferably done in the recovery room. When these principles are followed, mortality in the direct postoperative period can be reduced to an absolute minimum. Data from 50,000 cases confirmed this statement.
A new and very simple scoring system for recording post-anaesthetic recovery is described. When numerical values are assigned to factors indicating recovery progress or lack of it is obvious. The records may have medico-legal value. It can be incorporated into the Recovery Room Record.
Ventilation and the ventilatory response to a steady-state of isocapnic hypoxaemia were measured in six healthy volunteers, both awake and while sedated with low doses of halothane (0.05 and 0.1 MAC). Halothane sedation markedly reduced ventilatory responses to sustained hypoxaemia, in a dose-related fashion. We estimated the length of time after anaesthesia that halothane 0.1 MAC would be present in patients in the recovery room. In five healthy patients who had halothane anaesthesia with a mean duration of one hour, halothane 0.1 MAC or more persisted for approximately one hour. We conclude that, during emergence from halothane anaesthesia, patients may have a significant impairment of the ventilatory response to hypoxaemia, which persists for some time even after regaining consciousness.
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