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The anaesthetized patient is at risk of complications resulting from the actions, or inaction, of the anaesthetist, from the actions of the surgeon, and from failure or malfunction of anaesthetic equipment. The state of anaesthesia may be considered to be intrinsically unsafe. Patients are subjected to administration of drugs which have side-effects,(More)
We aimed to validate the mathematical validity and accuracy of the respiratory components of the Nottingham Physiology Simulator (NPS), a computer simulation of physiological models. Subsequently, we aimed to assess the accuracy of the NPS in predicting the effects of a change in mechanical ventilation on patient arterial blood-gas tensions. The NPS was(More)
Most patients admitted to an intensive care unit (ICU) require analgesia, sedation or both during at least part of their stay. However, the methods used to achieve these are often determined by tradition and convenience rather than by the needs of the patients, who are exposed to a number of noxious stimuli. These include relatively constant factors such as(More)
UNLABELLED Using an original, validated, high-fidelity model of pulmonary physiology, we compared the arterial to end-tidal CO(2) gradient divided by the arterial CO(2) tension (Pa-E'CO(2)/PaCO(2)) with alveolar dead space expressed as a fraction of alveolar tidal volume, calculated in the conventional manner using Fowler's technique and the Bohr equation:(More)
101 critically ill patients admitted to five intensive-care units were allocated randomly to receive a continuous intravenous infusion of either propofol or midazolam for sedation for up to 24 h. In addition, morphine was given to provide analgesia. The mean duration of infusion was 20.2 h (range 3.0-24.5) in the propofol group and 21.3 h (4.0-47.0) in the(More)
Tussometry involves a continuous measurement of airflow produced by a cough manoeuvre displayed as an airflow-time wave. There is a rapid rise to its peak (cough peak flow rate) and the time taken to reach the peak (peak velocity time) is determined by the laryngeal opening at the onset of cough. Cough peak flow and peak velocity time were measured in 10(More)
The aim of this study was to examine the performance of anaesthetists while managing simulated anaesthetic crises and to see whether their performance was improved by reviewing their own performances recorded on videotape. Thirty-two subjects from four hospitals were allocated randomly to one of two groups, with each subject completing five simulations in a(More)
The differences in phonation between men and women are thought to occur from anatomical differences in the larynx. However, it is not known if there are any differences in cough dynamics between the sexes. We investigated this by asking 100 healthy, non-smoking adults (50 male) to perform a voluntary cough into a tussometer. Each volunteer coughed at four(More)
Twelve patients presenting to an accident and emergency department in asystolic cardiac arrest were randomly allocated to treatment with endotracheal adrenaline (five patients) or peripheral intravenous adrenaline (seven patients). Femoral-artery blood samples were taken for assay of adrenaline and noradrenaline. After intravenous adrenaline there was a(More)