Variabilities Across British Of Anaesthesia Essay

1.The Condition The Patient Was Initially Diagnosed With And a Brief Explanation Of This,

2.What Medications The Patient Would Be Expected To Be Using, Considering They Will Be In Severe Stage Of Disease

3.What Medication They Would Be Expected To Be Using After Transitioning To Palliative Care And What Medications Would Be Expected As They Progress To The End Stage Of Their Disease.

4.Other Aspects Which Should Be Considered.

5.The Main Aspect Of Quality Of Life That The Patient Would Like To Maintain. Variabilities Across British Of Anaesthesia Essay.

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Answer:

Introduction
The patient Amy first reported problems in finding appropriate words and was also found to repeat herself, while participating in conversations. This was noticed by her son Eric, who also noted that his mother faced difficulties in concentrating on certain tasks for long period of time. Furthermore, memory deficits were also heightened by the fact that she forgot to pay the telephone bills for two consecutive months. This behaviour was quite unlikely of her and made her son worried. Furthermore, it is quite evident from Amy’s story that she is gradually facing problems in remembering things or words that have already been communicated, such as the visit of her son with his partner. The aforementioned symptoms and presenting complaints led to the diagnosis of Alzheimer’s disease. This was usually diagnosed based on the medical history, the information from the close relatives and behavioural observations. Persisting neuropsychological and neurological features also supported the diagnosis of Alzheimer’s disease that can ne defined as a condition involving a chronic neurodegenerative disease. This condition usually worsens over time (1).  Variabilities Across British Of Anaesthesia Essay.This has also been established as the major reason of dementia in around 60-70% individuals.

Research evidences have investigated the most common symptoms of the condition as short term memory loss that makes it difficult for the affected individuals to remember recent events. The gradual loss of bodily functions often makes it difficult for the individual to form an active part of the society and community, and ultimately results in death (2). According to the reports, there were approximately 46.8million people suffering from dementia on a global scale. management, the report also suggested that 58% of individuals with dementia and Alzheimer’s disease live in middle and low income countries (3). The fastest growth is observed among the elderly population in India, China, and other south Asian and western Pacific regions.

The genetic heritability of the condition is based on different twin and family studies that have been conducted on a large scale. Most research studies provide evidence for the fact that 0.1% of the diseases are familial kinds of autosomal dominant inheritance that shows an onset near 60-65 years of age (4). Most of the autosomal dominant familial condition can be attributed to presence of mutations in one of the three genes, namely amyloid precursor protein (APP), presenilins 1 and presenilins 2 (5). Furthermore, the amyloid hypothesis postulatws that extracellular deposits of amyloid beta (Aβ) acts as the contributing factor to the development of the disease (6). In addition, abnormalities or misfolding of the tau proteins have also been identified as major risk factors for the condition. These give rise to the formation of neurofibrillary tangles inside the cyton of neurons, thereby resulting in disintegration of the microtubules (7).

Laboratory tests conducted on the patient included FBC, ESR, thyroid function test, vitamin B12 and folate, cholesterol tests, LFT, U&E, and calcium and magnesium tests. The results were within

We expect to feel no pain during surgery or at least to have no memory of the procedure. But it wasn’t always so.

Until the discovery of general anaesthesia in the middle of the 19th century, surgery was performed only as a last and desperate resort. Conscious and without pain relief, it was beset with unimaginable terror, unspeakable agony and considerable risk. Variabilities Across British Of Anaesthesia Essay.

Not surprisingly, few chose to write about their experience in case it reawakened suppressed memories of a necessary torture.

One of the most well-known and vivid records of this “terror that surpasses all description” was by Fanny Burney, a popular English novelist, who on the morning of September 30, 1811 eventually submitted to having a mastectomy:

When the dreadful steel was plunged into the breast … I needed no injunctions not to restrain my cries. I began a scream that lasted unintermittently during the whole time of the incision … so excruciating was the agony … I then felt the Knife [rack]ling against the breast bone – scraping it.

But it wasn’t only the patient who suffered. Surgeons too had to endure considerable anxiety and distress.

John Abernethy, a surgeon at London’s St Bartholomew’s Hospital at the turn of the 19th century, described walking to the operating room as like “going to a hanging” and was sometimes known to shed tears and vomit after a particularly gruesome operation.

Discovery of anaesthesia

It was against this background that general anaesthesia was discovered.

A young US dentist named William Morton, spurred on by the business opportunities afforded by technical advances in artificial teeth, doggedly searched for a surefire way to relieve pain and boost dental profits.

His efforts were soon rewarded. He discovered when he or small animals inhaled sulfuric ether (now known as ethyl ether or simply ether) they passed out and became unresponsive.

A few months after this discovery, on October 16, 1846 and with much showmanship, Morton anaesthetised a young male patient in a public demonstration at Massachusetts General Hospital.

The hospital’s chief surgeon then removed a tumour on the left side of the jaw. This occurred without the patient apparently moving or complaining, much to the surgeon’s and audience’s great surprise.

So began the story of general anaesthesia, which for good reason is now widely regarded as one of the greatest discoveries of all time. Variabilities Across British Of Anaesthesia Essay.

Anaesthesia used routinely

News of ether’s remarkable properties spread rapidly across the Atlantic to Britain, ultimately stimulating the discovery of chloroform, a volatile general anaesthetic.

According to its discoverer, James Simpson, it had none of ether’s “inconveniences and objections” – a pungent odour, irritation of throat and nasal passages and a perplexing initial phase of physical agitation instead of the more desirable suppression of all behaviour.

Chloroform subsequently became the most commonly used general anaesthetic in British surgical and dental anaesthetic practice, mainly due to the founding father of scientific anaesthesia John Snow, but remained non-essential to the practice of most doctors.

This changed after Snow gave Queen Victoria chloroform during the birth of her eighth child, Prince Leopold. The publicity that followed made anaesthesia more acceptable and demand increased, whether during childbirth or for other reasons.

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By the end of the 19th century, anaesthesia was commonplace, arguably becoming the first example in which medical practice was backed by emerging scientific developments.

Anaesthesia is safe

Today, sulfuric ether and chloroform have been replaced by much safer and more effective agents such as sevoflurane and isoflurane.

Ether was highly flammable so could not be used with electrocautery (which involves an electrical current being passed through a probe to stem blood flow or cut tissue) or when monitoring patients electronically. Variabilities Across British Of Anaesthesia Essay. And chloroform was associated with an unacceptably high rate of deaths, mainly due to cardiac arrest (when the heart stops beating).

The practice of general anaesthesia has now evolved to the point that it is among the safest of all major routine medical procedures. For around 300,000 fit and healthy people having elective medical procedures, one person dies due to anaesthesia.

Despite the increasing clinical effectiveness with which anaesthesia has been administered for over the past 170 years, and its scientific and technical foundations, we still have only the vaguest idea about how anaesthetics produce a state of unconsciousness.

Anaesthesia remains a mystery

General anaesthesia needs patients to be immobile, pain free and unconscious. Of these, unconsciousness is the most difficult to define and measure.

For example, not responding to, or then not remembering, some event (such as the voice of the anaesthetist or the moment of surgical incision), while clinically useful, is not enough to decisively determine whether someone is or was unconscious.

We need some other way to define consciousness and to understand its disruption by the biological actions of general anaesthetics. Variabilities Across British Of Anaesthesia Essay.