Robert Raskind

Avoiding the Slippery Knot Syndrome

To the Editor.— The problem of coated and impregnated monofilament suture material becoming untied is not a new one; it has been experienced by the undersigned on two occasions. Since these two misadventures, we have been tying three knots, the last two of which are square, and applying a 3-mm Weck clipped firmly across the ends of the suture adjacent to the knot. The suture is then cut distal to the clip (Fig 2). An alternative method of keeping the knot from becoming untied is to coagulate the suture above the knot with an electrasurgical unit. There are no instances of the knot slipping or coming untied since we have adopted these practices.

Cardiac Arrest: Part One. Scope of Current Problem

Milstein’ defines cardiac arrest as &dquo;failure of the heart action to maintain an adequate cerebral circulation, in the absence of a causative and irreversible disease.&dquo; In January of 1848, death from cardiac arrest occurred in Newcastle, England, in a 15-year-old girl undergoing removal of a toenail while under chloroform. This is believed to be the first record of cardiac arrest brought on by administration of general anesthesia. Four additional deaths during use of