Word: millers
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...policy: refusing to criticize Israel's strategy or tactics in Lebanon or call for an immediate cease-fire. Blair's transformation today into official lame duck means all the European leaders who backed the Iraq war - Spain's Jose Maria Aznar, Italy's Silvio Berlusconi and Poland's Leszek Miller - have paid the ultimate political price...
Last year Dr. Ron Miller was in a hospital pre-op unit doing what he has done every week for more than three decades: administering an anesthetic to a patient headed for surgery. Miller served as an anesthesiologist in the Vietnam War and now chairs the department of anesthesia at the University of California, San Francisco, School of Medicine; it's hard to imagine someone with more experience or better credentials. Even so, he was taken by surprise when he gave a low dose of a moderate sedative called midazolam, designed to put the patient into a semiconscious state, somewhere...
...just imagine, says Miller, what might have happened if that had taken place outside a hospital, without a trained anesthesiologist present. A decade or two ago, such a scenario would have been farfetched because most surgery was done in hospital O.R.s...
There is simply no way trained anesthesiologists can meet the demand--especially since the increase in surgeries has been accompanied by a simultaneous increase in what anesthesiologists are asked to do. "At UCSF," says Miller, "we manage all of the post-op pain, we run all of the recovery rooms, and we man all of the preoperative evaluative clinics...
Since each patient's response to anesthesia can be different, as San Francisco's Miller was reminded last summer, the guidelines are intended to ensure that whoever administers the drugs should be able to rescue a patient from one level of sedation deeper than the level intended (see chart). "Our job is flying in bad weather," says Zapol. "A fair number of hearts stop in operating rooms, or people stop breathing. The key thing in training is to make people confident at resuscitation...