Bibliographic record
Abstract
The recent tragic death of a patient following intravenous rather than epidural administration of a local anaesthetic should serve to stimulate more interest in safety design. The undoubted benefit of epidural infusion analgesia for postoperative pain relief has significantly increased its popularity. We can therefore expect even such extremely rare tragedies to become more frequent. Indeed, we are aware of three cases of cross-connected epidural and intravenous central lines in the past five years in the South East alone – despite procedures and policies designed to minimise risk. Is it not time that we re-assessed the safety of having a common luer-lock connection for both intravenous and epidural drug administration? Perhaps the easiest design modification would be to reverse the current female port at the end of epidural and spinal catheters into a male ending. This would then physically prevent connection of a standard intravenous syringe to a spinal or epidural catheter. A specific ‘spinal syringe’ with a female connection would be required to enable epidural or spinal drug administration. A second stage in the development of this approach would be to re-design the epidural and spinal needles themselves with male ports, so that the initial epidural or spinal injection would again require a ‘spinal syringe’. The manufacturing technology is there to produce such ports – but do we as a profession dedicated to safety have the will to require a change? The profession has insisted on, and got, high standards of safety in anaesthetic machines and patient monitoring when the patient is asleep. Why not aim for similar safety when the patient is awake with an epidural or spinal?
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.038 | 0.022 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".