THE ADVANCEMENTS IN ANESTHESIOLOGY 1
[ED1]
The Advancements in Anesthesiology and
Their Effect on the Risks of Anesthesia Practices
Student Name
Wayne State University
Abstract
This research inquiry paper explores three published articles that report on the advancements in the field of Anesthesiology and how these advancements affect the risks that develop in anesthesia. The first article examines the risks of human error and equipment failure in anesthesia. The second article states the effective uses of ultrasonographic images in Anesthesiology, while the third article observes the risks and long term effects of anesthesia on children and infants. The three articles span 11 years in publication date which develops a historical progression of ideas, facts and theories. The progression foreshadows the future of anesthesia and highlights certain obstacles that Anesthesiologists might face in the future. The three articles are tied and related to one another based on their approach to the research topic. This paper also provides an article critique that analyzes rhetorical approach, methods of argument as well as certain fallacies of argument present in a fourth article[ED2]. Broad sources like the American Medical Association and Access Anesthesiology that helped in the research are annotated describing their academic significances as well as their relevance in the Anesthetic field of research.
Keywords: Anesthesiology risks, technology, long term effect
The Advancements in Anesthesiology and
Their Effect on the Risks of Anesthesia Practices
Part 1: Historical Progression/ Literature Review
The beauty of life is the ability for human practices to evolve over time. What is more striking is the ability of medicine to keep up with the advancements of technology as it races down the road of endless discoveries, theories and experiments. Ever since the first surgery on earth took place, Anesthesiologists were keen to find new ways and effective drugs that would limit the risks of deaths during surgery. Anesthesiologists have all the resources they need for future research, but they certainly do not have a crystal ball to uncover the future of the practice. However, the numerous studies throughout the past ten years foreshadowed the future risks of anesthesia as well as possible solutions to those risks. Anesthesiology has come a long way in identifying risks and long term effects of the practice starting with the “blame it on human error” theory to ultrasound machines leading up to direct studies and animal model experiments. Today, Anesthesiologists, using past discoveries as well as developed technology, are considering the risks of anesthesia and striving to limit the number of anesthesia related deaths in the present and future years.
The main issue that concerns Anesthesiologists has been mainly the risks and safety approaches to anesthesia practices. In the late 1900s, professionals pointed the finger on human error and machine failure as a cause of death in anesthesia. In the article, “Anesthesia Equipment and Human Error”, Doctor Mathew B. Weinger explained that most deaths in anesthesia stemmed from human mistakes, equipment failure, drug overdose or even a wrong diagnose of a disease (Weinger, 1999). Doctor Weinger worked at the Department of Anesthesiology in the University of California Health System where he focused on studying cases of human error in Anesthesiology. Therefore, there is no doubt that his findings in 1999 contributed to modern anesthesia procedures and machines. In fact, he cited cases where anesthesia machines accidentally fed patients a high concentrated dose of morphine(Weinger, 1999). As a result, some patients died and most of them suffered from damages in their nervous system due to a simple anesthetic mishap. Weinger went on to explain how human error comes into the picture. “He explains how humans are not very good monitoring because they are error prone and their performances can be affected by factors such as lack of sleep”(Weinger, 1999). For example, he refers to 27 cases of Cardiac Anesthesia where 75% of those cases resulted in death due to human mistakes (Weinger, 1999[A3]). He points out that human error and equipment failure result from one another. This means that the true test of an Anesthesiologist comes with operating sophisticated machinery knowing that one mistake can cost a life of a patient. Doctor Weinger provides solutions to this problem by fostering new monitoring technologies, national and international equipment standards and funding for this important cause(Weinger, 1999). Moreover, he develops a vision of a device that is not complicated yet not deceptively simple to operate and that device just might be an important discovery that had not had its share of fame until the mid-2000s, the ultrasound.
In the mid-2000s, general anesthesia experienced a renaissance. New techniques, drugs, machinery and procedures came into the light and changed the way Anesthesiologists approached their practice. The article “The Use of Ultrasound-Past, Present and Future” by doctors Peter Marhofer, Harald Willschke, Manfred Greher and Stephan Kapral provided a new perspective of anesthesia. The authors worked at the Anesthesiology Department of the Medical University of Vienna as they gave the audience a complete dissection of the benefits and flaws of the ultrasound in anesthesia. This article built upon the failures of anesthesia equipment and viewed the ultrasound device as an effective replacement because of its advanced technology. Doctor Marhofer and his colleagues explained that the ultrasonographic images offer the advantage to directly visualize body structures like nerve cells (Marhofer, Willschke, Greher, Kapral, 2005). Moreover, the ultrasound proved to be effective in chronic pain therapy and child anesthesia (Marhofer et al., 2005). However, the authors pointed out that a machine as powerful as the ultrasound still has its flaws. The main limitation of the ultrasound is the inability to obtain high-resolution images(Marhofer et al., 2005). Also, the device is certainly not immune to failure, but upon its discovery the number of deaths in anesthesia decreased. Besides, those flaws in the device are what kept the drive to improve the ultrasound alive till today.
Moving past the hurdles of human error and the ultrasound’s flaws, Anesthesiologists turned back and examined the progression of the field only to look at the present and analyze its own problems. In the article “FDA Considers Data in Potential Risks of Anesthesia Use in Infants, Children”, Doctor Bridget M. Kuehn from the American Medical Association puts it in plain English that the US Food and Drug Administration are concerned of the potential risks of anesthesia on children. Kuehn states “that children exposed early to anesthesia grow up with cognitive and behavioral deficits” (Kuehn, 2011). Machines like ultrasound as well as animal model studies identified the emerging problems (Kuehn, 2011). For example, one study found that rats exposed to 6 hours of anesthesia experienced nerve damage(Kuehn, 2011[A4]). Using those results, Anesthesiologists discovered that the case in infants is no different. “Anesthesiologists conducted a study in the Netherlands on a pair of 1143 twins, where they revealed that the twin exposed to anesthesia had problems in school unlike the other twin who was not exposed to anesthesia at early age”(Kuehn, 2011). Doctor Kuehn urges for ongoing research for more answers. Also, she brings up that the Pediatric Anesthesia Neurodevelopment Assessment (PANDA), an organization that is dedicated to child anesthesia solutions, is currently looking for anesthetic drugs that limit cell death in children as well as research other long-term effects (Kuehn, 2011).
Overall, the three sources provide a broad progression of how far has Anesthesiology has come throughout a period of 11 years. The sources feature concepts and facts that feed off one other. For example, the definition of human error and equipment failure in 1999 drove doctors and technologists to synthesize sophisticated machinery to decrease death numbers. At the same time, Anesthesiologists would have never found the risks of anesthesia in children without the discovery of devices like the ultrasound in anesthesia practices that took place in 2005. There is no stopping point that would exterminate the ongoing research. Instead, the race continues as professionals continue to uncover the future of anesthesia practices, but hurdles may come in the way. Nevertheless, what is a race without its hurdles?
Part 2: Article Critique/ Rhetorical analysis
[ED5]The article “Hand Contamination of Anesthesia Providers Is an Important Risk Factor for IntraoperativeBacterial Transmission first appeared in an issue of Anesthesia and Analgesiamagazine and was featured on the magazine’s website. Doctor Randy Loftus and colleagues of Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire directed a study on whether sanitation is related to bacteria transmission in anesthesia (Loftus et al, 2011). The researchers claim that Anesthesiologists spread dangerous infection and viruses during an operation due to the lack of sanitation, specifically not washing hands. The authors approached their article in a form of hypothesis/experiment/result format. As they stated their hypothesis, proof or a support for their argument needs to be present. Therefore, they designed an experiment to investigate the origin of bacteria transmission for surgery in 164 operating rooms that involved anesthesia. “The researchers discovered that about 89% of procedures transmitted bacteria causing infections” (Loftus et al, 2011). By reaching effective results, and obtaining accurate statistics, Doctor Loftus and his colleagues provided an adequate proof that supports their hypothesis which makes their guess correct. This article is not only geared towards Anesthesiologists, but it targets an audience ranging from all doctors from all professions to patients. The issue of sanitation should not only be stressed in Anesthesiology but it should constitute as a main issue in any medical-related field.
The purpose of the article is to raise awareness on an issue that may seem unimportant compared to other dangerous risks. However, judging by the results of the experiment, the researchers called the attention of the audience by providing them with high percentage statistics that highlight exactly how dangerous the issue is. By analyzing the article in depth, one can find that it contains a few fallacies of argument. The first fallacy is argument by generalization. The researchers provided effective results to their hypothesis, but they need to be aware that the spread of bacteria could not be solely blamed on hand hygiene. Bacteria can also come from the patients themselves, previously used machines or even medication used in the operating room but the authors generalized the causes of their results. They reached a conclusion where contamination is the result of the lack of hand washing among anesthesia providers. Moreover, towards the end of the article, the authors proposed several solutions to eliminate contamination in an operation room. By including such solutions, the authors are demanding impossible perfection, because regardless of how much anesthesia providers wash their hands, bacteria can still spread from other sources. Overall, the article structure helped in the understanding of the main points and arguments of the authors. Each section was titled appropriately and definitions were included for terms that the audience may be unfamiliar with.This allowed the authors to create a specifically designed research that was beneficial in helping them present their discoveries.
Part 3: Annotated Bibliography
[ED6]Access Anesthesiology.McGraw-Hill.Web. 10 Oct. 2011.
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This site is dedicated to the study of Anesthesiology and its numerous sub-fields. Not only does this site have many articles and books to choose from, but it contains actual footages taken inside the operation room of Anesthesiologists doing their job. Articles range from cardiac anesthesia to child anesthesia. Moreover, this site, unlike other sites, features calculators that calculate the rate of heart diseases, body mass, diabetes and even pregnancy due dates. This website contains a drug index with millions of drugs used in anesthesia along with their definition, structure and real life application. Procedural steps in anesthesia, textbooks as well as question and answer sessions on the website are effective in research. The website updates almost every two weeks where new or modified information is presented.
American Medical Association.Web. 10 Oct. 2011. 1995-2011.<
Geared for both a broad medical audience and professional doctors from thousands of fields, this site provides an insight into the medical field. Not only is this website informative, but it is interactive and dedicated to make people more aware about current health issues. This site features physician resources that contain information for students interested in pursuing medical school. Also, the website has a wide variety of career opportunities in the medical field for students to browse and a chance for students to communicate with professionals that work in sophisticated fields. Most important, medical journals and videos provide tons of information to fuel research ranging from neurology to plastic surgery. This site features leadership/volunteer activities and is considered more credible than other sites based on its reputation in the public and media as well as its wide range of accurate publications. The website was founded in 1995 and till today, it continues to update the public with the latest medical news and publications by the day.
American Society of Anesthesiologists.Web. 10 Oct. 2011. <
This website provides information about what a day in the life of an Anesthesiologist is like. It raises important issues about the risks of anesthesia and how professionals address those problems by discovering new solutions, design experiments, develop theories and apply research to real life situations. The site is organized in the same fashion as the American Medical Association with journals, books and questions. However, this site goes more in depth when it comes to research opportunities focused on Anesthesiology. In fact, this site has press room videos, facts, journals, publication and periodicals to analyze. This site is one’s cup of tea if he or she is pursuing Anesthesiology and in order to learn what to expect in the world of operation rooms. The website was founded in 1995 and it updates its information most often by the day.
References
Kuehn, B. M. (2011, May 4). FDA Considers Data on Potential Risks of Anesthesia Use in Infants, Children. The Journal of the American Medical Association. Retrieved October 10, 2011, from
Loftus, R., Muffly, M., Brown, J., Beach, M., Koff, M., Corwin, H., &Surgenor, S. (2011, January). Hand Contamination of Anesthesia Providers Is an Important Risk Factor for Intraoperative Bacterial Transmission [Electronic version]. Retrieved October 11, 2011, from
Marhofer, P., Willschke, H., Greher, M., & Kapral, S. (2005). New Perspectives in regional anesthesia: the use of ultrasound-past, present, and future. Retrieved October 10, 2011, from
Weinger, M. B. (1999). Anesthesia Equipment and Human Error. . Retrieved October 9, 2011, from
[ED1]NOTE: This essay is done in APA style. If you are in the sciences or social sciences this is the style format you should be using for this essay!
[ED2]This is something that is not required this semester. I keep it as a model for how to discuss and incorporate a current article in your essay. You won’t need to evaluate or analyze in-depth any single article for our current assignment.
[A3]After the first mention of author and date, include only page numbers.
[A4]Put page numbers instead of full citation. However, if you are describing/paraphrasing a large section, it’s okay to include just overarching citation at the end of the string of ideas or few sentences.
[ED5]NOTE: Again, you don’t need this section in your paper! I keep this here as an example of how the student used a contemporary article. You should use it as inspiration for including a similar discussion as part of your overall historical progression.
[ED6]NOTE: last semester I asked students to annotate a large source like a journal or a database. This is NOT what we’re doing for this semester. You should provide an annotated bibliography for AT LEAST TWO ARTICLES. The third bib can be a book, database or journal like in this example.