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The LMA Classic (cLMA) generally provides an adequate airway, but certain problemsremain:

The device does not protect the airway from aspiration of gastric contents.

1. It does not provide an airtight seal around the larynx (the usual pressures causingleakage of gas being 15-20 cm H20). Consequently, the device may function poorly

during positive-pressure ventilation.

2. The esophagus is included within the rim of the LMA in 10-15% of patients, directlyexposing the esophagus to positive airway pressures. This often results in insufflation

of the stomach and postoperative discomfort.

I GEL

The i-gel is a cuffless, single-use supraglottic airway device designed to provide a more effective

seal than the LMA, thus eliminating problems above with the addition of a gastric drain. Made of a

gel-like thermoplastic elastomer, the i-gel has an anatomically-designed mask that allows quick, easy

insertion and can accurately position itself over the laryngeal framework to provide a reliable

perilaryngeal seal without the need for an inflatable cuff..

Benefits of i-gel

y Made from a unique, soft, gel-like material to allow ease of insertion and reducedtrauma.

y Gastric channel designed to improve and enhance patient safety.y Integral bite-block reduces the possibility of airway channel occlusion.y Virtually eliminates rotation.y Reduces the possibility of epiglottis downfolding and obstructing the airway.y Unique packaging protects the i-gel in transit and ensures that it maintains its

anatomical shape.

yyyyy JOHN SNOWy John Snow was one of the first physicians to study and calculate dosages for the use ofether

and chloroform as surgical anaesthetics, allowing patients to undergo surgical procedures

without the distress and pain they would otherwise experience. He personally administered

chloroform to Queen Victoria when she gave birth to the last two of her nine children,

Leopold in 1853 and Beatrice in 1857,[3]

leading to wider public acceptance ofobstetric

anaesthesia.

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Snow published an article on ether in 1847 entitled On the Inhalation of the Vapor of Ether.

A bigger, longer work was published posthumously in 1858 entitled On Chloroform and

Other Anaesthetics, and Their Action and Administration. He first publicized his theory in an

essay On the Mode of Communication of Cholera.

Macintosh designed equipment that now bears his name: a laryngoscope, an anaesthetic

vaporiser, spray and endobronchial tube. The laryngoscope he designed in 1941 remains themost-used today. It was developed from a Boyle-Davis mouth gag, used fortonsillectomy.

Macintosh noted that this mouth gag indirectly elevated the epiglottis and exposed thelaryngeal aperture.

[5]

Macintosh studied unexplained deaths that occurred under anaesthesia and established a

training programme. He travelled widely, giving demonstrations of "safe and simple"anaesthesia.[

The AirTraq Optical Laryngoscope is an intubation device that uses magnifying wide-angle

mirrors, a LED light source, and a tracheal tube guide channel to aid in rapid visualization

and passage of a endotracheal tube.

It is a designed for anticipated difficult tracheal intubations. It is a single use intubationdevice with an integrated light source and an anti-fog system that permits intubation without

hyperextension of the neck. Additionally, the device is simple to use and easy to learn.

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AirTraq Optical Laryngoscope

The AirTraq is particularly well suited for emergency airways both in the field and in

hospitals. It is a self-contained, single-use adult and pediatric intubation device that offers an

alternative intubation technique for every emergency airway where a laryngoscope might be

used. Because of its small size and light weight it can easily be placed and carried inside

portable airway boxes and kits. This allows the device to be at the right place in situations of

cardiac arrest, other emergency airways, and rapid sequence intubation cases. Since the

intubation technique does not require hyperextension of the neck, it is also appropriate for

emergency patients getting intubated who require cervical spine precautions.

NARCOANALYSIS

The controlled administration of intravenous hypnotic medications is called "narcosynthesis"

or "narcoanalysis." It may be used to procure diagnosticallyor therapeuticallyvital

information, and to provide patients with a functional respite from catatonia ormania.

Sedatives orhypnotics that alter higher cognitive function include ethanol, scopolamine, 3-

quinuclidinyl benzilate, temazepam, and variousbarbiturates including sodium thiopental

(commonly known as sodium pentothal) and sodium amytal (amobarbital) India's Central

Bureau of Investigation has used intravenous barbiturates for interrogation.

( Acording to prevailing medical thought, information obtained under the influence of

intravenously-administered sodium amytal can be unreliable; subjects may mix fact and

fantasy in that context.[7]

Skeptics imply that much of the claimed effect of the drug relies on

thebelief of the subject that he or she cannot tell a lie while under its influence.[8][9]

Some

observers also feel that amobarbital does not increase truth-telling, but merely increases

talking; hence, both truth and fabrication are more likely to be revealed in that construct.[10

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Euthanasia

Euthanasia refers to the practice of ending a life in a manner which relieves pain andsuffering., The precise definition of euthanasia is "a deliberate intervention undertaken with

the express intention of ending a life, to relieve intractable suffering."[

Classification of euthanasia

Euthanasia may be classified according to whether a person gives informed consent into three

types: voluntary, non-voluntary and involuntary.Voluntary euthanasia

Euthanasia conducted with the consent of the patient is termed voluntary euthanasia. Activevoluntary euthanasia is legal in Belgium, Luxembourg and the Netherlands. When the patient

brings about his or her own death with the assistance of a physician, the term assisted suicide

is often used instead.

Non-voluntary euthanasia

Euthanasia conducted where the consent of the patient is unavailable is termed non-voluntaryeuthanasia. Examples include child euthanasia, which is illegal worldwide but decriminalised

under certain specific circumstances in the Netherlands

Involuntary euthanasia

Euthanasia conducted against the will of the patient is termed involuntary euthanasia.

Procedural decision

Voluntary, non-voluntary and involuntary euthanasia can all be further divided into passiveor active variants.

Passive euthanasia-Passive euthanasia entails the withholding of common treatments, such asantibiotics, necessary for the continuance of life.

[1]

Active euthanasia-Active euthanasia entails the use of lethal substances or forces to kill

and is the most controversial means

METHODS There are many ways of initiating euthanasia, and each method can have

different outcomes, some very painful. Regulating methods will not deter users from using

plastic bags; it will merely legitimise their use.

y Withdrawn orWithheld Treatmenty Injections and Drugsy Carbon Monoxide, Helium, Plastic Bagsy Dehydrationy Nitschke's 'Peaceful' Suicide Pill(barbiturate-based 'peaceful pil)

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. Barbiturate Overdose/ Euthanasia Solution, Intraveneous (100 mg/kg) .Anesthesia and

Exsanguination, Anesthesia and Intraveneous KCl (1-2 meq/kg) Anesthesia and

Decapitation Anesthesia and Cervical Dislocation Decapitation of Awake

Animal,Cervical Dislocation of Awake Animal .

Arguments Against Euthanasia

1. Euthanasia would not only be for people who are "terminally ill" 2. Euthanasia can become a means of health care cost containment 3. Euthanasia will become non-voluntary4. Euthanasia is a rejection of the importance and value of human life .

People who support euthanasia often say that it is already considered permissable to take

human life under some circumstances such as self defense - but they miss the point that whenone kills for self defense they are saving innocent life - either their own or someone else's.

With euthanasia no one's life is being saved - life is only taken.