ABSTRACT
The development of automated techniques for the measurement of electrolytes using ion-selective electrode technology has resulted in the availability of such machines for use by clinicians. A study is described which compares values obtained for plasma sodium and potassium by interested clinicians using a Beckman Electrolyte 2 analyser, with results obtained by laboratory staff using a Beckman E2A autoanalyser. A total of 14 estimations each for sodium and potassium were made on 96 samples of venous blood from patients on an intensive care unit. Comparisons were made using the coefficient of variation and analysis of variance (ANOVA). Seventy-three percent of observations of sodium and 87% of observations of potassium made by clinicians lie within 2 mmol l-1 and 0.2 mmol l-1 respectively, of observations made by laboratory staff. Observations outside these ranges are examined. The authors conclude that the results obtained by interested clinicians lie well within acceptable limits for medical usefulness, that inappropriate therapy based on such results is unlikely, and that such estimations would appear to be safe and acceptably accurate.
Subject(s)
Autoanalysis , Clinical Competence , Potassium/blood , Sodium/blood , Clinical Laboratory Techniques , Humans , Intensive Care UnitsABSTRACT
Thirteen commercially available ventilator monitoring alarms supplied by the distributors were evaluated. It was decided that devices with no power failure precautions or unprotected variable controls could not be recommended for general use. By these criteria only two devices could be recommended for general use as ventilator alarms and a further three as disconnect alarms; in each instance these recommendations are subject to certain reservations and suggested modifications. A ventilator alarm should be regularly serviced and checked before use and should be not used by anyone unfamiliar with the applications or limitations of that particular device.
Subject(s)
Equipment Design , Monitoring, Physiologic/instrumentation , Ventilators, Mechanical , Equipment Safety , Evaluation Studies as Topic , HumansABSTRACT
Reports of two hypoxic episodes which occurred during the use of the East Radcliffe PNA 1 ventilator in the 'complete rebreathing' mode led to the study of the efficiency of the emergency air entrainment system. The inability of this system to maintain adequate oxygen concentrations during interruption of the fresh gas supply results in the development of a hypoxic gas mixture despite patency of the entrainment valve. The reasons for this, and their clinical implications during intermittent positive pressure ventilation in the 'complete rebreathing' mode, are discussed.
