Nobody succeeds easily without complete self-control and strong perseverance.
没有人随随便便成功！需要顽强的毅力和严格的自我管理！（哈佛图书馆）
Nobody succeeds easily without complete self-control and strong perseverance.
没有人随随便便成功！需要顽强的毅力和严格的自我管理！（哈佛图书馆）
Anesthesia Machine Checkout Recommendations
This checkout, or a reasonable equivalent, should be conducted before administration of anesthesia. These recommendations are only valid for an anesthesia system that conforms to current and relevant standards and includes an ascending bellows ventilator and at least the following monitors: capnograph, pulse oximeter, oxygen analyzer, respiratory volume monitor (spirometer), and breathing system pressure monitor with high and low pressure alarms.
• Verify backup ventilation equipment is available and functioning.*
• High Pressure System
o Check oxygen cylinder supply.*
o Check central pipeline supplies.*
• Low Pressure System
o Check initial status of low pressure system.*
o Perform leak check of machine low pressure system.*
o Turn on machine master switch and all other necessary electrical equipment.*
o Test flowmeters.*
• Adjust and check scavenging system.*
• Breathing System
o Calibrate O2 monitor.*
o Check initial status of breathing system.
o Perform leak check of the breathing system.
• Test manual and automatic ventilation systems and unidirectional valves.
• Check, calibrate, and/or set alarm limits of all monitors.
• Check final status of the machine.
o Vaporizers off.*
o APL valve open.
o Selector switch to 鈥淏ag鈥�.
o All flowmeters to zero.
o Patient suction level adequate.
o Breathing system ready to use.
*Note: If an anesthesia provider uses the same machine in successive cases, the steps denoted by an asterisk need not be repeated or may be abbreviated after the initial checkout.
麻醉机检查的建议
这一结帐，或一个合理的等效，前应进行麻醉管理。这些建议只适用于一个麻醉系统，符合当前和相关标准，包括一个提升波纹管呼吸至少有以下监测：capnograph，脉搏血氧仪，氧分析仪，监测呼吸量（呼吸），和呼吸系统压力监测与高，低报警。
•验证备份通风设备可以和运作。*
•高压力系统
阿检查氧气钢瓶供应。*
阿检查中央管道用品。*
•低压系统
阿检查初始状态的低气压系统。*
进行泄漏检查机低压系统。*
求你转向机上的主开关和其他一切必要的电气设备。*
测试流量计。*
•调整检查清除系统。*
•呼吸系统
阿校准氧监测。*
哦，初始状态的呼吸系统的检查。
进行泄漏检查呼吸系统。
•试验手动和自动通风系统及单向阀。
•检查，校准，及/或设置报警限制所有监视器。
•检查最终状态的机器。
哦，汽化器了。*
阿磷脂阀打开。
输出选择开关鈥�鈥淏银。
所有流量计零。
患者吸入水平足够的。
阿呼吸系统准备使用。
*注：如果一个麻醉提供商使用相同的机器在连续的情况下，将以星号表示不需要重复或可缩写后的初步检验。
anesthesia and elective surgery should not proceed untill the patient is in optimal medical condition
麻醉和择期手术只有在病人状态最优时才能进行.
临床麻醉学(英文第四版)
Malignant Hyperthermia (MH)
MH Hotline (800) 644-9737
Outside US (315) 464-7079
For the name and telephone number of the MH consultant physician on call, dial the MH Hotline of MHAUS (Malignant Hyperthermia Association of the United States). For further information, visit MHAUS website http://www.mhaus.org.
Once the diagnosis of MH has been made:
• Stop anesthesia and curtail surgery immediately.
• Hyperventilate with 100% oxygen.
• Administer dantrolene 2.5 mg/kg IV, which may be repeated every 5鈥�10 minutes toward a total dose of 10 mg/kg but more as needed if symptoms persist.
• Give sodium bicarbonate 2鈥�4 mEq/kg IV and more as guided by arterial pH and Paco2.
• Initiate cooling.
• Maintain urine output with mannitol 25 g IV, furosemide 20 mg IV, and copious intravenous fluid administration.
• Monitor patient and continue therapies until the patient is stable and further until the danger of additional episodes is past.
恶性高热（晚上）
晚上热线（800）644-9737
（315）464-7079美国以外
的名字和电话号码的顾问医生的电话，拨打热线的氢mhaus（恶性高热协会美国）。为进一步的信息，mhaus http://www.mhaus.org访问网站。
一旦诊断已经取得的荣誉勋章：
•麻醉和减少手术立即停止。
•深呼吸100%氧气。
•辖丹曲林2.5毫克/公斤四，这可能是重复每5鈥�10分钟对总剂量为10毫克/公斤，但更多的需要，如果症状持续。
•给予碳酸氢钠2鈥�4毫克当量/千克四和更多的指导下动脉和动脉血二氧化碳分压。
•开始冷却。
•维持尿量25克四甘露醇，速尿20毫克四，和丰富的静脉输液。
•监测病人和继续治疗的病人是稳定的，直到进一步直到额外的危险事件已经过去了。
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局部麻醉用药必须遵循最小有效剂量和最低有效浓度的原则
Local anesthetic must follow the principle of minimum effective dose and the minimum effective concentration
Pain relief is a basic human right.解除疼痛是患者的基本权利！
麻醉是介于睡眠和死亡之间的一种状态
Anesthesia is a state between sleep and death
There is no accurate measure of the overall risk of anesthesia.
目前尚没有关于麻醉总体风险的精确评估。
低氧血症
Hypoxemia
颈静脉怒张
Jugular vein engorgement
呼吸音不对称
Asymmetric breath sounds
气管偏移
Tracheal deviation
纵隔移向健侧
Contralateral mediastinal shift