• When respiratory difficulties develop in a hospital patient, the anesthesiologist should be called promptly. Emergency kits should be kept ready at all times in a central location. This report analyzes 100 consecutive cases in which anesthesiologists were called for help in emergency rooms, the nursery, the radiology department, and the medical and surgical wards of a 600-bed university hospital. The cause of the respiratory difficulty was neurological disease in 54 cases, poisoning or drug reactions in 17, cardiac disease in 11, and metabolic disturbances in 6. Among the neurological cases the most frequent trouble was cerebrovascular accident (21 cases) and head injury (10 cases). The insertion of an endotracheal tube was the most important method of treatment, and was carried out in 80 patients; positive pressure assistance of respiration with oxygen was required in 28. No reliance was placed on drugs as analeptics or respiratory stimulants; it is believed that this type of treatment is less than useless. Of the 100 patients in this series, 4 were dead when the anesthesiologist arrived, 14 died during the initial treatment, and 45 improved but died later as a result of their basic disease. Thirty-seven patients who had been in serious difficulty were saved by prompt calls for assistance and by the efficient use of emergency equipment.
Ziegler CH, Jacoby J. EMERGENCY SERVICE WITHIN THE HOSPITAL. JAMA. 1957;164(13):1432–1434. doi:10.1001/jama.1957.02980130008002
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