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Questions and Answers
Who were the early advocates for monitoring patients during anesthesia in the mid-19th century?
Who were the early advocates for monitoring patients during anesthesia in the mid-19th century?
What significant event occurred in 1848 related to chloroform anesthesia?
What significant event occurred in 1848 related to chloroform anesthesia?
What was the primary concern that led to the development of monitoring modalities in anesthesia?
What was the primary concern that led to the development of monitoring modalities in anesthesia?
Which committee was established by the Royal Medico-Chirurgical Society in 1864 related to anesthesia?
Which committee was established by the Royal Medico-Chirurgical Society in 1864 related to anesthesia?
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What recommendation did Joseph Thomas Clover make regarding monitoring during anesthesia?
What recommendation did Joseph Thomas Clover make regarding monitoring during anesthesia?
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What was one of the innovations Dr. Clover contributed to the field of anesthesia?
What was one of the innovations Dr. Clover contributed to the field of anesthesia?
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What should irregularities in the pulse during anesthesia indicate to the anesthetist, according to Clover?
What should irregularities in the pulse during anesthesia indicate to the anesthetist, according to Clover?
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In what year did Joseph Thomas Clover pass away?
In what year did Joseph Thomas Clover pass away?
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Who reported the earliest clinical account of auscultation in the operating room?
Who reported the earliest clinical account of auscultation in the operating room?
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Which technique did Dr. Cushing advocate for during anesthesia?
Which technique did Dr. Cushing advocate for during anesthesia?
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What device did Scipione Riva-Rocci develop?
What device did Scipione Riva-Rocci develop?
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What was the primary concern regarding the newer devices for measuring vital signs?
What was the primary concern regarding the newer devices for measuring vital signs?
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What material was used to lengthen the stethoscope mentioned by Dr. Codman?
What material was used to lengthen the stethoscope mentioned by Dr. Codman?
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Which physician published a paper illustrating an actual patient’s anesthetic record?
Which physician published a paper illustrating an actual patient’s anesthetic record?
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What was one of the main benefits of the Kehler stethoscope described by Charles K. Teter?
What was one of the main benefits of the Kehler stethoscope described by Charles K. Teter?
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In which year did Harvey Cushing visit Italy and meet Scipione Riva-Rocci?
In which year did Harvey Cushing visit Italy and meet Scipione Riva-Rocci?
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What was Teter's main reason for praising the stethoscope?
What was Teter's main reason for praising the stethoscope?
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Which method was primarily used to determine blood pressure during anesthesia according to Cushing?
Which method was primarily used to determine blood pressure during anesthesia according to Cushing?
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What major issue was associated with the cuff used to measure blood pressure?
What major issue was associated with the cuff used to measure blood pressure?
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What was the impact of Cushing's advocacy for continuous monitoring during anesthesia?
What was the impact of Cushing's advocacy for continuous monitoring during anesthesia?
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What was the primary limitation of the method used at the time to measure blood pressure?
What was the primary limitation of the method used at the time to measure blood pressure?
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What was a significant benefit of using a stethoscope during surgery according to Teter?
What was a significant benefit of using a stethoscope during surgery according to Teter?
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What technological aspect is highlighted concerning the sphygmomanometer's use in anesthesia?
What technological aspect is highlighted concerning the sphygmomanometer's use in anesthesia?
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What was a key reason for the inaccuracy in measuring blood pressure with the method discussed?
What was a key reason for the inaccuracy in measuring blood pressure with the method discussed?
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What was the main advantage of the Arteriosonde when it was introduced?
What was the main advantage of the Arteriosonde when it was introduced?
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In which decade did the introduction of ultrasound into clinical medicine occur?
In which decade did the introduction of ultrasound into clinical medicine occur?
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What functionality did the Dinamap primarily provide?
What functionality did the Dinamap primarily provide?
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What frequency was used by the Arteriosonde to detect blood flow?
What frequency was used by the Arteriosonde to detect blood flow?
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What was one of the primary uses of ether anesthesia historically?
What was one of the primary uses of ether anesthesia historically?
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What is the main characteristic of an oscillotonometer?
What is the main characteristic of an oscillotonometer?
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Why was the Arteriosonde significant for measuring blood pressure in infants?
Why was the Arteriosonde significant for measuring blood pressure in infants?
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What did Dr. create to train other medical personnel in ether anesthesia?
What did Dr. create to train other medical personnel in ether anesthesia?
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What does an act of commission refer to in the context of negligence?
What does an act of commission refer to in the context of negligence?
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What is meant by an act of omission?
What is meant by an act of omission?
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What is the significance of adhering to a standard of care in malpractice claims?
What is the significance of adhering to a standard of care in malpractice claims?
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Which of the following elements of proof is essential in a malpractice proceeding?
Which of the following elements of proof is essential in a malpractice proceeding?
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In the context of professional negligence, what would be an example of substandard care delivery?
In the context of professional negligence, what would be an example of substandard care delivery?
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What does the burden of proof indicate in a malpractice lawsuit?
What does the burden of proof indicate in a malpractice lawsuit?
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How is the term 'reasonably prudent professional' generally defined?
How is the term 'reasonably prudent professional' generally defined?
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Which of the following areas is NOT considered a source of health care malpractice liability?
Which of the following areas is NOT considered a source of health care malpractice liability?
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Study Notes
Early Stethoscope Use in Anesthesia
- Robert Kirk (1896) first documented operating room auscultation using a modified stethoscope.
- Charles K. Teter praised the stethoscope's ability to provide continuous information on heart and respiratory changes, aiding in the prevention of complications.
- He specifically highlighted the convenience of the flat Kehler stethoscope.
Blood Pressure Monitoring
- Harvey Cushing's advocacy for continuous cardiac and respiratory monitoring during anesthesia led to widespread intraoperative auscultation.
- Cushing's introduction of Riva-Rocci's sphygmomanometer allowed for blood pressure monitoring during anesthesia, initially only systolic pressure due to the radial pulse palpation method. Early cuffs were inaccurate due to design limitations.
- The development of ultrasound in the 1940s enabled Doppler-based blood flow detection and improved blood pressure measurement, particularly in infants (Arteriosonde).
- Automated devices like the Dinamap improved the ease and speed of non-invasive blood pressure monitoring.
Early Anesthesia Monitoring Practices
- The death of Hannah Greener (1848) highlighted the significance of monitoring vital signs (respiration, pulse, skin color) during anesthesia.
- Joseph Clover (1864) stressed the importance of continuous pulse observation during anesthesia, recommending cessation of anesthetic if irregularities were detected.
- Robert Codman (1894), influenced by F.B. Harrigan, encouraged pulse recording during anesthesia. Cushing's 1902 publication of actual patient records further supported this practice. However, some opposed new monitoring devices, fearing the degradation of clinical skills.
Negligence and Standard of Care
- Negligent acts in anesthesia care can be acts of commission (doing something wrong) or omission (failing to do something).
- The "reasonably prudent professional" standard provides an objective measure for evaluating actions within the scope of the individual's training, license, and professional standards.
- Demonstrating adherence to a standard of care helps reduce the likelihood of malpractice claims.
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Description
Explore the early use of the stethoscope and blood pressure monitoring in anesthesia. Discover how pioneers like Robert Kirk and Harvey Cushing contributed to advancing intraoperative monitoring techniques. This quiz covers significant developments that have shaped modern anesthetic practice.
