File:Interstate medical journal (1917) (14783677815).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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12:10 p. m. was in all probability due to the fact that no moretraumatizing work was going on in the pelvis. 20 INTERSTATE MEDICAL JOURNAL of 8.5 mm., the necessity for care is obvious; and conversely, ifthe point of reading be above the heart, a corresponding error inthe negative direction occurs, so that we do not get the full pressurevalue.2 Second, the cuff sometimes slips on the arm, even to belowthe elbow. It must be firmly adjusted; otherwise the reading maybe from 20 to 30 mm. too high. Third, the air may be partially orcompletely shut off, either by a kink in the tubing or by the opera-tor leaning against it, both easily overlooked, since the tubing iscovered by the sheet. Fourth, the radial artery should not be on astretch by extension of the hand, as thus the pulse beat is morequickly obliterated. Flexion of the wrist, as we observed it, givesbetween 5 and 10 more degrees in the reading. Fifth, it is alwayswell to allow 10 degrees of pressure as the limit of error, as con-
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Chart IV.—Moderate shock, with gradual fall in pressure and rise in pulse rate.Observe that the pressure fall began from a quarter to half an hour beforethe pulse rate appreciably increased. The sudden drop at 12:25 p. m. wasvery likely due to the increased Trendelenburg- position and to the muscularstraining. stant compression of the patients pulse may cause vasomotorparalysis in the recorders finger tips. In no instance was the difference in the individual levels—theterm we have applied to the patients normal waking rate—astaken when the patients entered the hospital and when they reachedthe etherizing room, great enough seriously to regard. Theirreadings were, as a rule, slightly greater when they came to theoperating floor than at the time of the initial physical examination.This was due, no doubt, to fear or excitement. As a general rule, immediately after the start of anesthesia thereis a rise of from 10 to 30 degrees in the pressure, but after afew minutes it again falls

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