Medicine 3: Changes in Surgery Flashcards
1
Q
Surgery in 1850
A
3 main issues:
* Pain - all surgery very painful and had to be very fast
* Blood - large numbers of patients died from blood loss
* Infection - No knowledge of sterlisation or germs
1
Q
Anaesthetics
Use of Ether
A
- Ether used in 1847 by Robert Liston
- John Snow later used it
Limitations - High Flammable, irritated lungs, unknown length of effects
2
Q
Anaesthetics
Chloroform
A
- 1847 James Simpson discovered
- 1848 John Snow invents Chloroform inhaler
- 1853 John Snow used on Queen Victoria
Limitations - Christian opposition, untested
Longer surgeries meant more blood loss and infection
3
Q
Anaesthetics
Other Anaesthetics
A
- 1884 Cocaine (addictive)
- 1898 Heroine (addictive)
- 1905 Novocaine (less addictive)
4
Q
Antiseptic
Semmelweis hand washing
A
- Semmelweis encouraged doctors to wash hands after handling corpses before delivering babies. Decreased infection in child birth. Semmelweis seen as crazy and later incarcirated.
5
Q
Antiseptic
Carbolic Acid
A
- First used 1860s, Lister
- Added onto surgical wounds
- Noticed more survival in compound fractures and other air-exposed injuries
- 1866-70 Listers death rate fell from 45% to 15%
6
Q
Limitations to Antiseptic
A
- Methods were not reproduced correctly, so thought to be false
- Opposition to Germ theory
- Carbolic Acid irritated surgeons skin and was expensive
7
Q
Antiseptic
Aseptic surgery
A
- 1878 Koch Steam Steriliser
- By 1887 all instruments had to be sterilised before use
- Ensured no germs ever entered the surgery
8
Q
Bloodloss
Lister and Catgut
A
- 1881
- Lister discovered Catgut ligatures
- These prevented blood loss but later dissolved in the body
- Could be soaked in Carbolic Acid
9
Q
Blood loss
Blood Groups
A
- 1901
- Landsteiner discovers blood groups
- Makes it possible to give succesful blood transfusions
10
Q
WW1
Blood
A
- 1910s discovered that anticoagulant meant blood could be stored
- First non-direct transfusion in 1914
- First blood bank on Western front in 1917
11
Q
WW1
X-rays
A
- X-rays discovered 1895 by Rontgen
- Marie Curie payed for mobile X ray machines with her own money
- More machines in Field Hospitals
- Limitations, could not detect clothing in wounds and required patients to be still
12
Q
WW1
Infection
A
- A-septic conditions were impossible
- Cut away infection and bathe in saline was preffered method
- This was the Carrel-Dakin method
- Injuries often still led to amputation
13
Q
WW1
Thomas Splint
A
- Held femur fractures open to prevent compounding of break
- 1914 80% of femur fractures died, 1916 80% survived
14
Q
WW1
Skin Grafts
A
- Shrapnel lead to terrible face injuries
- Harold Gillies assigned to solve issue of facial injuries
- Specific hospital in Sidcup, treated 2,000 patients after the Somme
- Facial reconstruction became a key part of rehabilitation
