ABSTRACT
BACKGROUND: Although early proponents for each of the four basic articles of operating room clothing--gowns, caps, masks, and gloves--can be identified, it is unclear from historical commentaries when each article achieved general acceptance and was consistently worn by surgeons and by anesthesia providers. METHODS: Historical photographs were identified from the Web sites of the National Library of Medicine, Google, and the archives of the Wood Library-Museum of Anesthesiology for the 11 decades 1860 to 1970. The presence or absence of each article of clothing was then determined for the surgical and anesthesia providers depicted. RESULTS: Over 1,000 photographs were identified and examined. Photographs were then eliminated for repetition, lack of available dating, questionable dating, and poor quality. In 338 remaining photographs that met inclusion criteria, 640 surgical providers and 219 anesthesia providers were depicted and used in the analysis. Statistical definitions for historical terms general acceptance and routine use were proposed. The probability that a surgeon was wearing nonstreet clothes (gown) was 0.66 (95% CI, 0.22 to 0.93) in 1863. The years (95% lower bound to 95% upper bound) associated with a 0.5 probability for wearing cap, gloves, and mask were 1900 (1896 to 1904), 1907 (1903 to 1910), and 1916 (1913 to 1919), respectively. The years associated with a 0.5 probability that an anesthesia provider would be wearing nonstreet clothes (gown), cap, and mask were 1883 (1863 to 1889), 1905 (1900 to 1911), and 1932 (1929 to 1937), respectively. CONCLUSION: Timelines for the adoption of each basic article of surgical attire by surgeons and anesthesia providers were determined by analysis of historical operating room photographs from 1863 to 1969.
Subject(s)
Anesthesiology/history , Operating Rooms/history , Photography , Protective Clothing/history , History, 19th Century , History, 20th Century , Humans , Masks , United StatesSubject(s)
Anesthesiology/history , Anesthetics , Anesthetics, Inhalation , History, 19th Century , History, 20th Century , Humans , Nitrous Oxide , XenonSubject(s)
Hypertension, Pulmonary/drug therapy , Phosphodiesterase 5 Inhibitors , Phosphodiesterase Inhibitors/therapeutic use , Preoperative Care , Humans , Hypertension, Pulmonary/complications , Phosphodiesterase Inhibitors/administration & dosage , Piperazines/administration & dosage , Piperazines/therapeutic use , Pulmonary Disease, Chronic Obstructive/complications , Purines/administration & dosage , Purines/therapeutic use , Sildenafil Citrate , Sulfones/administration & dosage , Sulfones/therapeutic useABSTRACT
With advancing age, interpatient variability increases. Physiologic and pathologic apoptosis progress at widely different rates in each organ system in each person. The effect of any disease on an individual depends on the genetic makeup, social and environmental insults, and adequacy of and compliance with medical therapy. Time spent interviewing, examining, and preparing elderly patients preoperatively pays dividends intra- and postoperatively, with fewer "rescue requiring events," fewer "failures to rescue," lower observed-to expected morbidity and mortality ratios, better patient care, and greater patient and professional satisfaction. Elderly patients will require anesthetic services in greater numbers in the years to come. The baby boomers are coming. Are you ready for them?
