Category: tech

Elucidating the Mechanisms of Anesthesia

The Anesthesia Blog has tended to attract a certain tech-geek type of anesthesia provider.  We have attempted to cater to our audience by highlighting anesthesia tech products, smartphone apps and advances in our field.  Like many who sit and ponder about all things anesthesia, we’ve often wondered how anesthesia actually produces its desired effect?  Meyer-Overton was a nice thought but proven too simplistic.   Last we heard it had something to do with meddling with the lipid bilayer sandwich…but nobody seems to know for sure.

In a provocatively titled article in Scientific American called “What Doctors Don’t Understand About Anesthesia” we dive deeper into an interesting revelation into the effects of anesthesia on the brain:

Highlighting these fundamental gaps in knowledge, a group of researchers recently made a surprising discovery about how we transition out of consciousness and back. The common view holds that going under (induction) and coming back up (emergence) are the same process, albeit in different directions. However, a recent study published in the journal PLoS ONE suggests that going under is not the same as coming back up.

The researchers, led by Dr. Max Kelz at the University of Pennsylvania School of Medicine, observed that less anesthetic is required to keep the brain anesthetized than to induce unconsciousness. To explain these observations, the researchers have introduced a concept they call “neural inertia,” referring to the brain’s resistance to transitions between consciousness and unconsciousness. Elucidating the mechanisms of neural inertia could be critical to the task anesthesiologists perform every day, namely preventing patients from experiencing pain or awareness during surgery and in helping those patients who exhibit delays returning to the conscious state. This line of research could also provide insights into disrupted states of consciousness like coma.

Excellent work by Dr Kelz.  Thanks for adding to our understanding.

Feb 29, 2012 | 0 comments View Post

iPhone App Review: Anesthesia Drugs Fast

Review by contributing author Tech Nick Lee:

Anesthesia Drugs Fast is an app for the iPhone, iTouch and iPad. It is designed as a point-of-care utility for calculating dosages for the most common anesthesia drugs. There is no Android version at this time.

Review:

One of the tenets of a well-designed app is simplicity and elegance. This is a single view app with only one control: the weight selection. Unlike other apps where you have to navigate through different screens to get information, everything is presented on one page.  Choose the patient’s weight from 1 to 200 kilograms, and this app will immediately give you a dosage range.

 

The drug categories are induction agents, muscle relaxants, sedatives, antiemetics and basic resuscitation medications. It gives you intravenous and intramuscular dosages for some of the medications. By touching the information button you can see the formulas used for the range calculation. With just one selection control and one page view, I found I could determine the proper dose while running down a hallway. It was that easy.

 Pros:

  1. Probably the easiest to-use app I’ve seen.
  2. Simple presentation, packed with the most common drugs on a single page.
  3. Only one selection needed to get drug dosages

 Cons:

  1. An Android version is lacking

Conclusion:

This is a well-designed app for the anesthesia provider. While those new to anesthesia will find it invaluable, seasoned clinicians will find it useful for pediatrics and bariatrics. It is so easy to use you can determine the correct dosage range while running down the hallway to a code.

Feb 13, 2012 | 0 comments View Post

Moore’s Law and Anesthesia

Moore’s Law is a well-known axiom amongst the tech-geek set.  It states that your iPhone will get smaller every year until it disappears.  No really, Moore’s law describes a long-term trend in the history of computing hardware: the number of transistors that can be placed inexpensively on an integrated circuit doubles approximately every two years (or 18 months), and thus making your iPhone smaller every year.

This, of course, applies to anesthesia tech as well.  I have previously blogged about the Vein Viewer.  The VeinViewer uses near-infrared light and other technologies to detect subcutaneous blood and create a digital image of the patient’s superficial vein pattern projected directly onto the surface of the skin in real time.  It’s a pretty neat device who’s original dimensions and cost made it damn near useless on a practical level.  Thanks to Moore’s law and perhaps the desire to actually sell a few of these devices we know have the Vein Viewer Flex.

From The Christie Medical’s Website:

Ideal for alternate care facilities, such as surgery and blood/plasma centers, as well as home healthcare and EMS, VeinViewer Flex is designed for durability and maximum portability. Flex is also suited for hospital departments such as the ER and NICU where space requirements and speed of assessment demand ultra-portable and VeinViewer reliable.

See the Vein Viewer in Action

No word on availability or price.  Stay tuned.

 

Nov 25, 2011 | 0 comments View Post

Iphone Apps For Anesthesia Providers (and Critical Care and OB)

Airstrip Technologies out of San Antonio,TX recently unveiled a remote monitoring app for the iPhone and many other portable and non portable devices:

From the company website:

AirStrip Technologies, a pioneer in mobile medical software applications, today announced that it has received U.S. Food and Drug Administration (FDA) clearance to market the AirStrip Remote Patient Monitoring solution (RPM), including AirStrip RPM CRITICAL CARE and AirStrip RPM CARDIOLOGY.

With FDA clearance in place, AirStrip now extends its virtual real time remote patient monitoring technology to a broad array of acute patient clinical settings, which include the intensive care unit, the emergency department, the operating room, the neonatal ICU, and virtually any other care environment.

The AirStrip RPM solution allows clinicians unprecedented remote access to critical patient data in virtual real time. Medical professionals will use their smartphones to see vital signs, critical waveform data and other clinical information, which is sent directly from the hospital and can be accessed from virtually anywhere a cell-phone or other wireless connection is available.


Notice the lack of an anesthesia-related uses in the marketing materials?  Me too.  My guess is that the idea of remote monitoring in the OR is still a ways off.  The app is much more suited to the critical care provider monitoring from afar.  The OB app which can display FHR tracings also seems the most immediately useful.  The cost basis for implementation is not discussed and I fear too high to retrofit most ICUs, ORs and/or L&D suites.  Maybe if they can demonstrate a cost savings in personnel (i.e. crnas) then perhaps they may have at viable product.  :)

Sep 25, 2010 | 0 comments View Post

Iphone Apps For Anesthesia Providers

The iPhone is in my humble opinion the greatest gadget ever. It’s essentially a handheld computer that make phone calls.

Anesthesia providers now have an iPhone app to call their own:
iAnesthesia: Case Logs is a an app designed for easy caseload tracking. From perusing the website it appears pretty robust for those who need this sort of thing. Take a gander if you will.   What apps do you use?  Comment below.

Mar 02, 2009 | 2 comments View Post