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Lifebox: give a little, help a lot

BMJ 2012; 344 doi: (Published 17 January 2012) Cite this as: BMJ 2012;344:e313
  1. Iain H Wilson, president1,
  2. Isabeau A Walker, consultant anaesthetist2
  1. 1Association of Anaesthetists of Great Britain and Ireland, London, UK
  2. 2Great Ormond Street Hospital for Children, London, UK

In the 1980s pulse oximetry transformed the safety of anaesthesia in UK. For the first time anaesthetists in operating theatres could determine the oxygenation of unconscious patients accurately, rather than trying to estimate skin colour under green drapes with artificial light. Since most preventable deaths under anaesthesia involve hypoxia or hypotension, all UK hospitals purchased oximeters, and they rapidly became a universal standard. Initially oximeters were used in theatre, the anaesthetic room, and recovery but they rapidly spread to all areas of the hospital. Today arterial oxyhaemaglobin saturation (SpO2) is recorded almost as routinely as heart rate and blood pressure.

Anaesthesia in the UK is well resourced and safe, with mortality directly attributable to anaesthesia of around 1 in 200 000. The situation is completely different in poorer settings, where the mortality directly attributable to anaesthesia has …

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