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Volume 20 Number’? The choice of electrical versus mechanical monitoring can be left to the user. He should realize that either is an adjuvant to careful continuous observation of the patient. Neither the modification for the carbon button nor the magnetic device prevents the immediate alter- nate use of the instrument as an electrocardiac monitor. This adaptation of the monitor has been found to extend its usefulness. |———BRASS PLUG |——-NYLON CASE GRANULES. “4 IN. TUBING {—prass PLUG —— LEAD WES (A) Commercial and home made pulse pickups. (B)_ Construction of pickup. | ‘The parts were turned from rod stock on a lathe. Covent Dr. Severinghaus of San Francisco com- ments as follows on the preceding report. “Shock due to disease, hemorrhage or as here, anesthesia, may essentially stop the heart with- out stopping its electrical activity. The addi- tion of a pulse monitor to the electrical pickup type monitor adds a factor of safety to monitor- ing, in that failure of signal should always occur either before or when a patient is in trouble. It should be pointed out, however, that: (1) The pulse signal frequently disap- pears due to vasoconstriction, cooling, weak pulse peripherally, or mechanical problems in mounting. The user then switches back to the electrocardiographic monitor, assuring him- self that the patient still has cardiac action. (2) If the failure of pulse was due to shock, or anesthetic overdose, the user may be falsely reassured, and be in the same fix the authors describe above. Which again suggests that the anesthesiologists must diagnose circulatory CURRENT COMMENT 219 difficulties primarily by the usual clinical signs such as absent carotid pulse and inaudible pressure and heart beat.” GADGETS Conductive Heel Application Comar, Thomas C, Deas of Philadelphia has solved the problem of “person to floor” conduction in part by applying conductive rubber heels to conventional street shoes. With the technical assistance of the Artificial Limb and Brace Shop of the U. S. Naval Hos- pital, a simple method has been devised that can be accomplished with case using a few simple tools. The existing heel is removed and two holes are drilled through the heel portion of the sole. Large flat head copper rivets are placed through the holes and clinched over washers on the underside. A conductive rubber heel is then cemented into place with contact cement, Using the original heel liner as a pattern, a new liner is cut from conductive rubber sheeting and cemented in place. Care should be exercised in applying the cement to avoid applying it to the area of the rivet heads or washers, Copper Rivets ‘onductive Insole =p Condvetive Heel Diagram of conductive heel. Shoes with conductive heels applied in this manner have been in use over one year and have maintained satisfactory conductivity upon test with a standard shoe test meter. Recovery Room Record Dr. William F. Powers of Wichita, Kansas, submits a record for use in the recovery room. Tt was developed through the cooperation of the anesthetists of Wichita and has been used with satisfaction for over 11,000 cases during the past two years. " Anesthes 220 CURRENT COMMENT sian hee ISB WESLEY HOSPITAL RECOVERY-ROOM RECORD pean segeer Arata inn aevry Reon iad cancion Zonder en it INFUSION ‘ORD Di oe = eh Re ie ee TREATMENTS AND MEDICATIONS ‘gnats of Bacorar oom Seperee