Quality in healthcare is hard to define. One approach is based around six goals: safety; effectiveness; patient focus; timeliness; efficiency; and equity ( Table 18.1 ). Although errors and incidents are commonly discussed in relation to safety, the same fundamental…
The ability to measure and monitor patients’ physiology is fundamental to modern anaesthetic practice, and a variety of sophisticated instruments are available. It is crucial that the anaesthetist understands not only the data being generated but also the limitations of…
Anaesthetists must have a sound understanding and knowledge of the functioning of all the anaesthetic equipment they use. Failure to understand the use of or check equipment before use is an important recognised cause of complications and death. This is…
Knowledge of some physics is required to understand the function of many items of apparatus for anaesthesia delivery and physiological monitoring. This chapter emphasises aspects of physical principles, but the reader should expand on this by further reading ( ;…
Haematological conditions and drugs can have a significant impact on the conduct of anaesthesia. Anaesthetists need to have an understanding of the pathophysiology associated with various haematological diseases and drugs that are known to increase the risk of thrombosis, infection,…
Metabolism Metabolism may be defined as the chemical processes that enable cells to function. Basal metabolic rate (BMR) is the minimum amount of energy required to maintain basic autonomic function and normal homeostasis at rest. In a healthy resting adult,…
The realisation that the enzyme systems and metabolic processes responsible for the maintenance of cellular function are dependent on an environment with stable electrolyte and hydrogen ion concentrations led Claude Bernard to describe the milieu interieur more than 100 years…
The kidneys have a number of diverse functions. The main roles are as follows: Filtration and elimination of metabolic waste products Maintenance of fluid and electrolyte homeostasis Control of acid–base status Production of erythropoietin to stimulate red cell synthesis Hydroxylation…
Control of breathing Breathing is primarily concerned with the homeostasis of blood O 2 and CO 2 to ensure that both remain at appropriate concentrations despite wide variations in the body's metabolic needs. Breathing control is also vital for speaking…
The autonomic nervous system The term autonomic nervous system (ANS) refers to the nervous and humoral mechanisms that modify the function of the autonomous or automatic organs. These include heart rate (HR) and force of contraction; calibre of blood vessels;…