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Standards for Monitoring During Anesthesia at Harvard

Maxwell Weingarten, MD
JAMA. 1987;257(1):25-26. doi:10.1001/jama.1987.03390010029010.
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To the Editor.—  I would like to applaud Eichhorn et al1 for their article on standards for patient monitoring during anesthesia. This article should provide a powerful impetus for the adoption of mandatory standards, as is currently being encouraged by the American Society of Anesthesiologists and the Food and Drug Administration through their patient-safety videotapes.In particular, the author's recommendation that ventilation or circulation be continuously monitored will certainly aid in the early detection of catastrophic events. However, the selection of only one parameter "or the equivalent" may be inadequate, and it is becoming increasingly evident that if outcome is to be changed, the adequacy of both ventilation and oxygenation must be monitored.For example, "palpation or observation of the reservoir breathing bag" will not accurately differentiate hypoventilation or hyperventilation, an abnormal respiratory pattern, or an incorrect gas mixture. "Auscultation of breath sounds" has repeatedly been found, as previously

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