What is it - a modern anesthesia? A technocracy of
what the anesthesiology turned today into and how the modern anesthesia looks? What changed since 1942 when Harold Griffith and Enid Johnson for the first time applied a curare to the operated muscular relaxation and opened an era of modern highly effective and safe anesthesia?
With great difficulty it was succeeded to find images of the first devices for an anesthesia.
This, American - one of the first devices which it was possible to call the narcotic device.
And this - Soviet - for 60 - x was years very quite good product.
I found such in working order, and on the sixth course even gave an anesthesia with its help. (There was a big accident at plant, and used everything, capable though somehow to work, and everything, capable though somehow to work.)
You know that? It seems to me, boring stories already fine bothered readers... A picture is worth a thousand words I will explain
A (do not forget to click pictures for increase).
Here, this my workplace.
Directly on the center - narcotic (more true, narkozno - respiratory) the device. Not the newest, to it years five.
Modern narkozno - the respiratory device provides carrying out an anesthesia on any to a method known now in any mode of the operated or spontaneous breath, to any patient: from the premature newborn to the adult of any dimensions.
From sets of the inhalation (inhaled) anesthetics tested for sesquicentennial history presently three widely are applied: izoflyuran, sevoflyuran and nitrous oxide (which too gradually quits the stage).
Two cylindrical details on the device - evaporators for these substances.
Each such evaporator - the exact, calibrated device capable to give anesthetic vapors to within the tenth shares of percent, irrespective of air temperature.
The rectangular screen in the center - the display of the device. The device is arranged so that he controls himself, comparing the set and actual parameters of ventilation, and traces compliance of a task to execution.
Besides, extreme sizes are set. At an exit for a framework admissible the device will report about it a sound signal and will display the necessary information.
The screen at the left - the display of the anesteziologichesky monitor. This monitor is capable to trace a set of parameters of an organism (I do not remember a case that all its opportunities were at the same time involved) and composition of the inhaled and exhaled gas mix (it is one more line of safety which is partially duplicating “security guard“ of the narcotic device).
According to the standards accepted by WHO, are surely traced: Electrocardiogram, arterial pressure, hemoglobin saturation by oxygen (pulsoksimetriya) and content of carbon dioxide in the exhaled air (kapnografiya). In the absence of any of these measurements the anesthesia is forbidden to be given.
Everything is removed in a digital and graphic form and stored in memory of the monitor. At any time it is possible to check what was any last minute of this anesthesia. At desire monitors turn on in a network...
I was surprised first by an insight of the boss: the devil brings it exactly on complications! Then reached...
To the right of the narcotic device - a working little table with boxes for any personal belongings.
Pay attention to a two-storeyed shelf from above. These are ribbons with stickers on syringes.
Iron rule: the gathered syringe without sticker - invalid. Flies to a garbage can (at the left).
For the non-standard, seldom applied drugs white stickers are prepared.
The doctor - is not great the barin, maybe itself to inscribe. Also it is obliged. No, of course, if he is a masochist and loves enemas with patefonny needles...
Thus, even in wild haste (and it in our business happens) to mix and roll something by mistake - it it is necessary to try very strongly. One more line of safety.
By the way, about drugswas Already mentioned by
above that the set of any substances came and left anesteziologichesky practice. Air, chloroform, trilen and many other things sank Into oblivion.
The flying anesthetics applied now are safe, they do not undergo any changes in an organism, so, there are no products harmful or dangerous to bodies.
The same destiny comprehended means for an intravenous anesthesia. Their transfer is of only historical interest now.
Propofol - is very similar to milk. White opaque liquid at intravenous administration causes fast (on a needle tip) and a sweet dream.
It is very good for children. Kids so are surprised that in the syringe milk (“sweet, only for very good children“) that they forget to povypendrivatsya. And if to consider that propofol - excellent antiemetic... However, reduces pressure that is not always good.
On this case - etomidat . Twin brother of a propofol. Pressure does not reduce absolutely, even when it strives to fail. By sight not to distinguish from a propofol, and to mix - better by the night not to mention. They differ on force by 10 times! (By the way, about stickers.)
At an etomidat is which - what minuses therefore now prepare for it replacement.
And barbiturates did not leave for good. They protect a brain at a hypoxia (a lack of oxygen). It is sometimes very important.
In special cases is used ketamin . Pharmacy miracle! Here if it did not cause frustration of mentality (fortunately, short-term and completely passing) in adults...
But its antishock action is something with something! It is only which can just be pricked in a muscle and it will work. Battlefield anesthetic. And “Ambulance“. For children, especially with a trauma, anything better was thought up yet!
The curare is not used long ago. This natural product had too many shortcomings.
Modern synthetic miorelaksant are deprived them at all, but each of them has convenient features, and it means - it is possible to choose for this, this most sick ideally.
And so - in all that concerns an anesthesia! In a magic little table of the anesthesiologist there is everything. Everything that is necessary for management of an organism when he - an organism - threw a wheel and carries him on reeves.
REGENS - - OPERATING DEFENDO, I PROTECT.
Old communistic slogan: “All for the sake of the person, all for the benefit of the person!“ - in anesthesiology works as now it is accepted to speak, unambiguously.
How all this occurs? I will tell in the following article.