File:Interstate medical journal (1917) (14596970730).jpg

Identifier: interstatemedica2419unse (find matches)
Title: Interstate medical journal
Year: 1917 (1910s)
Authors:
Subjects: Medicine
Publisher: St. Louis, : Interstate Medical Journal
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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ed ratherclosely throughout anesthesia, barring changes due to oncoming 22 INTERSTATE MEDICAL JOURNAL shock, asphyxia, sudden cerebral anemia, or changes in the patientsposition on the table. Certain other factors, such as struggling,depth of anesthesia, and manipulation of organs, also influence thepressure, but to a. less degree. (Charts I, II.) Shock.—In several cases of shock of varying degree, there was,as a rule, a gradual fall in the pressure, as shown by the readings,starting from twenty to thirty minutes before there appeared anappreciable rise in the pulse rate. This fall was too slight to detectwithout a recording apparatus, but was gradual in the succeedingreadings, showing a progressive fall of from 5 to 10 degrees.This made it possible to notify the operator of the patients failingcondition a considerable time before there was noticeable change OH DISSKCTION OF MECK FOR CAHCIMOM/Y OF TONSIL. \- m *5 m uiS n11,511B -■a* 5> OPKH/KTION na STAUTK!) -w HEAD ^ SHOULDERS
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HIM % noin Chart VII.—At 12:00 m. the first upward rise was noted. During the next fiveminutes it went from 150 to 180. At this point the interference with respira-tion was eliminated and the pressure immediately dropped. The continuedfall was probably a forerunner of shock. in the quality or rate of the pulse, signs on which it is ordinarilythe custom to depend for warning of imminent failure or shock;and by acting early in these cases, conditions which easily mighthave become serious were rendered harmless. The rule that thepressure falls first does not, however, invariably hold true, for insome instances the beginning drop in pressure and the rise in pulserate were virtually simultaneous. (Charts III, IV, V, VI.) Asphijxia.—Janeway has pointed out that in first-stage asphyxia,during which the respiratory center is stimulated and the breathingis rapid and deep, the vasomotor center in the medulla is alsothrown into action, and a marked rise in the blood-pressure occurs. INTERSTA

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