Surgery

Question 0

What is Nitrous oxide and when was it used?

Answer 0

Laughing gas used in 1844 by Humphry Davy and in dentistry with little success.

Question 1

What was used for pain relief pre 1800?

Answer 1

Alcohol and opium with little success

Question 2

What is ether and when was it used?

Answer 2

Ether was used from 1846, by John Collin Warren and Robert Liston.

Question 3

What is chloroform and when was it used?

Answer 3

Chloroform was used from 1847 by James Simpson and had minimal side effects. However, the wrong dose could kill patients.

Question 4

What is cocaine and when was it used?

Answer 4

The first local anaesthetic in 1884

Less addictive novocaine in 1905 used as GA

Question 5

Why did people oppose to anaesthetics?

Answer 5

Worried about long term use
Thought unconsciousness would cause death
More complex operations- more risks,deaths and infection
Victorian religion- God inflicted pain for a reason

Question 6

Advantages and disadvantages of chloroform?

Answer 6

Less quantity needed for same effect as ether
More rapid, complete and persistent
Far more agreeable and pleasant.
Wrong dose could easily stop heart.

Question 7

Advantages and disadvantages of ether?

Answer 7

Made patients unconscious but very sick.

Was hard to transport and flammable.

Question 8

What is the chloroform inhaler?

Answer 8

Invented by John Snow in 1853 to control the dose of chloroform administered.

Question 9

What was surgery like before anaesthetics?

Answer 9

Painful and patients died of shock
Surgeons worked fast to minimise pain and blood loss
Patients had to be held down
Operations close to body surface.

Question 10

What was surgery like after anaesthetics?

Answer 10

Surgery pain free
Take more time to focus on blood loss
Patients didn’t struggle
Deeper surgery possible so more infection

Question 11

Before antiseptics…

Answer 11

Patients died from infection
Environment/ equipment not sterile
Hands/ clothes unwashed

Question 12

Development of Antiseptics by Lister

Answer 12

1864 Lister read Germ Theory
Lister learned carbolic acid cleaned sewers
1865 Bandages soaked and environment cleaned with carbolic acid
1867 Invented carbolic spray. Ward free of sepsis 9 month

Question 13

What was the opposition to Lister and antiseptics?

Answer 13

Using carbolic acid hurt hands, slowed operations down, didn’t work
Lister altered his methods, others saw doubt
Some proffered to use soap and water.
Believed lowered immunity

Question 14

What is aseptic surgery?

Answer 14

1890 Germ-less environment
Theatres cleaned and sterilised.
Masks to stop breathing infection into wound.
1878 Koch steriliser invented.

Question 15

What methods were used to stop blood flow?

Answer 15

Clamps and tourniquets in amputation of limb
Using heat (cautery) to seal vessels painfully
Tying blood vessels with silk thread ligature (not sterilised)

Question 16

The development of Blood transfusion….

Answer 16

C17- animals to humans. Low success rate and banned
C19- demand for safe transfusion, more surgery
1818 Man to Man transfusion - Blundell
1861 Blood groups- Landsteiner
1914 Hustin Preservation
1932 Andre Bagadsorov 21 days at 4’
Now 35 day preservation

Question 17

What was Landsteiner’s role in blood transfusion?

Answer 17

1901 Landsteiner’s 4 blood groups. Transfusions wouldn’t work between different groups but testing and finding took too long.

Question 18

What was Robert Lewisohn’s role is blood transfusion?

Answer 18

1915 Lewisohn found adding sodium citrate to blood so it could be stored for longer
(Richard Weil used refrigerators)

Question 19

When was the first blood bank?

Answer 19

Before the battle of cambrai in 1917 the army asked the public to donate blood.

Question 20

Who performed the first blood transfusion?

Answer 20

Reuben Ottenburg in 1907. Patients were directly linked to the donor.

Question 22

List the influencing factors for this topic.

Answer 22

Technology- inhalers, sterilisers and refrigeration
War- prosthetics, deep bullet surgery, field surgeons
Individual Genius- Snow and Inhaler
Communication- The Royal Society, new publication methods
Science- Pasteur’s germ theory, chloroform chemistry

Question 24

How is blood stored today?

Answer 24

Blood is separated by using centrifuge into individual components. This separates blood by its density, allowing some components to be removed. This can be stored for 32 days. 17 year olds can now donate blood.