TRAINING IN FIBREOPTIC TRACHEAL INTUBATION IN THE NORTH OF ENGLAND

Twenty-nine departments of anaesthesia in the North of Englandwere questioned about the availability and teaching of fibreoptictracheal intubation techniques. While 27 departments had bothsuitable equipment and trained consultant staff, only one offeredformal teaching to all its junior anaesthetists.     

RED BLOOD CELL 2,3-DIPHOSPHOGLYCERIC ACID FOLLOWING ETHANOL CONSUMPTION IN MAN

The red blood cell 2,3-diphosphoglycerate (DPG) concentrationis reported in 33 ethanol abusers. 16 healthy ethanol usersand 14 non-users The results demonstrate an ethanol-associatedincrease in DPG content which returns to normal exponentiallyin the week following alcohol withdrawal As well as implyinga significant degree of hypoxia in association with quite moderatedrinking, the fact that ethanol is not catabolized in red cellsindicates that this effect is transmitted there, and hence tothe rest of the organism, by some other agent. Carbon dioxidein subnormal quantities has the necessary characteristics.     

Continuous observations of the arterial oxygen saturation at rest and during exercise in congenital heart disease

Continuous observations, made with the Millikan compensated circuit oximeter, of the arterial oxygen saturation of nineteen normal subjects and of twenty patients with cyanotic and noncyanotic types of congenital cardiac defects are presented.When normal individuals were given pure oxygen to breathe, their arterial oxygen saturation increased, on the averag,, 2.7 percentage points (to reach 100 per cent saturation) in 1.3 minutes. In fifteen patients with a cyanotic type of congenital cardiac defect, breathing pure oxygen produced an average increase in oximeter saturation reading of 6.2 percentage points attained in an average period of 3.0 minutes.Normal subjects showed practically no change in their arterial oxygen saturation when they changed from the supine to the erect position or when they walked on a treadmill for five minutes at 1.7 miles per hour. Patients with a cyanotic type of congenital cardiac defect showed an average decrease in oximeter saturation reading of 2.4 percentage points when they stood up and 10.9 percentage points when they exercised on the treadmill.It is suggested that the compensated circuit oximeter is of considerable value in studying patients with congenital cardiac defects for two reasons: (1) Its use in conjunction with Van Slyke analyses of arterial blood makes possible a more accurate estimation of the resting arterial oxygen saturation of such patients. (2) Measurements of the arterial oxygen saturation can be made continuously during the performance of various cardiovascular and respiratory function tests, thus greatly facilitating an objective interpretation of the results obtained. Such tests serve as a valuable adjunct in the judging of the efficacy of corrective surgical procedures in these patients.