Principles Introduction The basic principle of closed-circuit anesthesia is maintenance of a constant anesthetic state by adding gases and vapors to the breathing circuit at the same rate at which the patient’s body removes those same substances. Often, the desired…
History Decades ago, accidental delivery of hypoxic gas mixtures was a constant threat during general anesthesia. Many instances of hypoxia were attributed to human error. In some cases, the anesthesiologist mistakenly turned the wrong gas flow control knob or failed…
Acknowledgments We gratefully acknowledge the contributions, advice, and support of Carl E. Englund, Larry T. Dallen, Holly Forcier, Steve Howard, and David Gaba. Norman Ty Smith was a critical contributor to a previous version of the chapter. Overview This chapter…
Background History And Evolution Of Infusion Pumps In 1638 a British physician named William Harvey first described the circulatory system and found that the heart pumps blood throughout the body by continuous circulation. Before this, most people believed that blood…
Overview This chapter focuses on preventing the spread of infectious disease during anesthesia care, especially when equipment is used. Box 15.1 provides a glossary of common terminology. BOX 15.1 Glossary Airborne transmission: Spread of disease by means of liquid particles…
“It is amazing the frequency in medical history, with which ideas are lost and reinvented” George Bernard Shaw Establishing and maintaining airway patency and providing support of oxygenation and ventilation are essential skills for many health care practitioners including anesthesiologists.…
Overview Body temperature is a critical part of homeostasis, a process that biological systems use to preserve a stable internal state that allows for normal functioning and survival. Humans use thermoregulation to maintain a somewhat consistent internal body temperature to…
Overview Hemodynamic monitoring is the repeated measurement of circulatory function over time. Perturbations in circulatory function are expected during physiologic stress such as surgery. Uncontrolled, these perturbations can lead to tissue hypoxia, ultimately resulting in perioperative morbidity and mortality. As…
No monitor of oxygenation has had more impact on the practice of anesthesiology than the pulse oximeter. Unknown in the operating room (OR) before the 1980s, the pulse oximeter is now a minimum standard of care for all anesthetics, whether…
Overview The capnograph functions in many respects as an “electronic stethoscope” that shows the cyclic appearance and disappearance of carbon dioxide (CO 2 ): a cycle is present when the lungs are being ventilated and is absent or disappears when…