John Doyle - Academia.edu (original) (raw)
Papers by John Doyle
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2007
Journal of Consciousness Exploration & Research, 2016
In this short essay, the following conjecture is offered: the phenomenon of consciousness is nece... more In this short essay, the following conjecture is offered: the phenomenon of consciousness is necessarily an energy consuming process. This conjecture, if true, implies that if a being is conscious, that being must have some form of physical existence.
Drug administration errors have been an increasing focus of concern in anesthesiology. These erro... more Drug administration errors have been an increasing focus of concern in anesthesiology. These errors usually pertain to the type of drug administered, the drug dosage, the rate of administration or the site of administration. Past studies have attempted to identify and understand the underlying etiology of these common forms of errors, so as to avert its often serious and sometimes fatal consequences. These studies have focused on errors relating to the administrator's theoretical knowledge, clinical experience, individual technique and other such related factors. This growing body of research has proven invaluable, not only by addressing the preventability of drug errors by clinicians, but also in leading constructive efforts to minimize their repeated occurrence. This article attempts to highlight the current understanding of drug administration error in clinical anesthesia and discusses the risk management techniques that may be of value in dealing with this problem.
![Research paper thumbnail of Editorial [Hot Topic Recent Advances in Anesthetic Management (Executive Guest Editors: Ehab Farag and D. John Doyle)]](https://attachments.academia-assets.com/80885151/thumbnails/1.jpg)
](Current Pharmaceutical Design, 2012
Purpose: To present a case where the Aintree intubation catheter was used in conjunction with the... more Purpose: To present a case where the Aintree intubation catheter was used in conjunction with the Laryngeal Mask Airway (LMA) and a fiberoptic bronchoscope (FOB) in a patient with an unexpected difficult airway. Clinical Features: A 38 year old 90 kg man scheduled for nasal endoscopy with ethmoidectomy under general anesthesia was found to be unexpectedly difficult to intubate using a both a MAC 4 laryngoscope and a GlideScope® video laryngoscope, despite having an airway exam that was unremarkable except for a slightly decreased mouth opening and a large tongue. Intubation was achieved by inserting a size 5 LMA into the patient, introducing a FOB into an Aintree intubation catheter, inserting the FOB / Aintree catheter assembly into the trachea via the LMA, removing the LMA, and then passing a regular size (7.5 mm) endotracheal tube into the trachea over the Aintree catheter. Conclusion: The Aintree intubation catheter provides an effective alternative to other methods for intubati...
What Does it Mean to be Human? Life, Death, Personhood and the Transhumanist Movement
This chapter is concerned with cryonics and suspended animation. Like the previous chapter, it co... more This chapter is concerned with cryonics and suspended animation. Like the previous chapter, it contributes substantially to the philosophical debate on where the line between life and death should be drawn. The ultimate aim of cryonics is to achieve nondestructive freezing (cryopreservation) of advanced organisms like humans so that they can be safely thawed in the future, usually with a view to obtaining advanced medical treatment not currently available. In this chapter number of scientific and philosophical questions presented by cryonics are discussed, such as whether cryonics is real science or simply a waste of money, the legal and moral status of cryonically suspended individuals, and how to deal with the possibility that the thawed individual might end up with some organs working but with severe neurological impairment.
What Does it Mean to be Human? Life, Death, Personhood and the Transhumanist Movement
This chapter is concerned with the technical, safety and bioethical issues associated with human ... more This chapter is concerned with the technical, safety and bioethical issues associated with human pharmacologic enhancement. Although neuroscientific advances are now providing valuable treatments for patients with neurological diseases, many of these treatments may also be applied to “normal” individuals free of disease as a means of achieving “quality of life” improvements, an enterprise sometimes called “cosmetic neurology”. Although such enhancements might variously make one happier, more serene, more intelligent, better at mental arithmetic, more personable, and so on, they also raise an important philosophical question—could such interventions lead to a mind-blunting effect that would diminish one’s capacity to appreciate life in all its dimensions, making us “unauthentic” humans living a banal, anesthetized existence as uncritical participants in the affairs of the world?
Mr. Soprano is a 52 year old entrepreneur in the waste management industry. He weighs 119 kg, is ... more Mr. Soprano is a 52 year old entrepreneur in the waste management industry. He weighs 119 kg, is 175 cm tall, and is being investigated for “dizzy spells” that appear to be panic attacks. His medical problem list includes obesity, untreated hypertension, and possible obstructive sleep apnea (based on his wife’s nocturnal observation that “sometimes he just stops breathing”). When questioned, he admits to extreme claustrophobia, possibly the result of a protracted period of time spent in a car trunk. A previous attempt at a magnetic resonance imaging (MRI) scan was unsuccessful because Mr. S, startled by the onset of the load noises made by the MRI machine, panicked and tried to get out of the MRI scanner, pulling out his IV in the process.
New Emirates Medical Journal
Background: Cardiac auscultation is a frequent first step in diagnosing heart disorders. However,... more Background: Cardiac auscultation is a frequent first step in diagnosing heart disorders. However, the lack of dependability of ordinary auscultation in the hands of inexperienced clinicians remains a problem. Objective: We sought to develop an inexpensive system for digital cardiac auscultation (digital phonocardiography) using a Windows laptop computer, freely downloadable software and an inexpensive USB microphone. Description: The system, based on the free open source Audacity software package, offers advanced features such as phonocardiogram storage and retrieval, low-pass and high-pass waveform filtering and variable-speed signal playback with pitch preservation. Results: Sample results for both raw and digitally filtered phonocardiograms are provided. Conclusion: An innovative laptop-based phonocardiogram system offering advanced features can be easily produced at minimal cost.
The Open Anesthesia Journal
Clinical Early Warning Scores are tools intended to alert clinical staff to possible future clini... more Clinical Early Warning Scores are tools intended to alert clinical staff to possible future clinical deterioration, often related to the onset of sepsis. Since their introduction, they have increased greatly in popularity. Their operation is conceptually simple: an elevated early warning score triggers a formal assessment by the responsible clinician. While the best-known system is the Royal College of Physicians National Early Warning Score (NEWS), a number of other scores are in use, such as an adaptation known as the Modified Early Warning System (MEWS) or warning systems for pediatric patients (PEWS). However, while promising, such instruments need to be studied in more detail to better characterize their eventual role in monitoring hospital patients. In particular, a central question concerns the identification of the best system (NEWS, MEWS, PEWS etc.) for a given clinical population (pediatric, trauma, prehospital etc.).
Ethics in Biology, Engineering and Medicine: An International Journal
In this essay I discuss the impact of postmodern thinking on the practice of contemporary medicin... more In this essay I discuss the impact of postmodern thinking on the practice of contemporary medicine, focusing on "alternative medicine" and its origins (at least in part) in a postmodern world view. I take the position that postmodern thinking has led to a belief in some circles that the current evidence-based, positivist approach to clinical management should be abandoned. I suggest that such thinking is not without its attendant dangers.
The Open Anesthesiology Journal
The GlideScope video laryngoscope has had a profound impact on clinical airway management by virt... more The GlideScope video laryngoscope has had a profound impact on clinical airway management by virtue of providing a glottic view superior to direct laryngoscopy. Since its introduction circa 2003, hundreds of studies have attested to its value in making clinical airway management easier and safer. This review will update the reader on the art and science of using the GlideScope videolaryngoscope in a variety of clinical settings and its relation to other airway management products. Topics covered include GlideScope design considerations, general usage tips, use in obese patients, use in pediatric patients, use as an adjunct to fiberoptic intubation, and other matters. Complications associated with the GlideScope are also discussed.
This report describes a simple interactive HTML/JavaScript-based educational resource aimed at ed... more This report describes a simple interactive HTML/JavaScript-based educational resource aimed at educating physiology students, medical students and physicians on the field of oxygen transport physiology. It can be run on almost all personal computers with a web browser that supports JavaScript.
Military robots are gradually entering the theater of war in many guises. As the capabilities of ... more Military robots are gradually entering the theater of war in many guises. As the capabilities of these robots move toward increased autonomous operation, a number of difficult ethical and legal issues must be considered, such as appropriate rules of engagement and even notions of robot ethics. In the distant future, as military "artificial beings" that draw on expected advances in cyborg and android technologies are developed, further issues of conscience, consciousness, personhood, and moral responsibility also arise.
Ethics in Biology Engineering and Medicine an International Journal, 2013
In this essay I discuss the impact of postmodern thinking on the practice of contemporary medicin... more In this essay I discuss the impact of postmodern thinking on the practice of contemporary medicine, focusing on "alternative medicine" and its origins (at least in part) in a postmodern world view. I take the position that postmodern thinking has led to a belief in some circles that the current evidence-based, positivist approach to clinical management should be abandoned. I suggest that such thinking is not without its attendant dangers.
Anesthesiology Clinics, 2015
Awake tracheal intubation is commonly used when ordinary intubation (for example, attempting dire... more Awake tracheal intubation is commonly used when ordinary intubation (for example, attempting direct laryngoscopy after the induction of general anesthesia) is expected to be difficult or hazardous. 1-8 Possible examples include patients with large glottic tumors, patients with unstable cervical spines, patients known to be difficult to intubate by virtue of previous anesthetic misadventures, and numerous other conditions. 9-15 This is an updated, reorganized and expanded version of an earlier article published in the 7th Annual Anesthesiology News Guide to Airway Management. August 2014.
International Journal of Cardiology, 2011
Objective: This study explored the severity of central obesity and the attitude and knowledge abo... more Objective: This study explored the severity of central obesity and the attitude and knowledge about central obesity among cardiac patients. Methods: A telephone interview was conducted on community dwelling cardiac patients who were members of a patient group. A self-developed questionnaire regarding knowledge and attitude of central obesity was used. Results: A total of 342 (male = 161, 47%; female = 181, 53%) Hong Kong Chinese cardiac patients participated in the study. The body mass index (BMI) was 23.6 (SD±3.3) for man and 22.4 (SD±4.2) for women; however, the mean waistline was 75.5 cm (SD±9) for men and 84.8 cm (SD±7.6) for women. Female participants had normal BMI but with central obesity (normal ≤80 cm). 240 (70%) participants defined central obesity correctly. Participants had the knowledge that high waist circumference could lead to hypertension (n = 274, 80.1%) coronary artery disease (n = 271, 79.2%) and diabetes mellitus (n = 256, 74.9%). 120 (35%) were abdominally obese, and among these obese participants, 87 (73%) of them had tried to reduce their waistline. Only 31 (26%) have their waistline reduced but 58 (48%) of them had increased since first diagnosis of heart disease. Conclusion: Male participants were classified overweight according to their mean BMI, but their mean waist circumference was normal. Normal BMI does not reflect the distribution of a person's body fat. It could be misleading as a muscular patient might be categorized as 'overweight'. Therefore, waist circumference should also be included in assessments.
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2007
Medical Education Online, 2009
View related articles Citing articles: 12 View citing articles Doyle DJ. Simulation in medical ed... more View related articles Citing articles: 12 View citing articles Doyle DJ. Simulation in medical education: Focus on Anesthesiology.
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2007
Journal of Consciousness Exploration & Research, 2016
In this short essay, the following conjecture is offered: the phenomenon of consciousness is nece... more In this short essay, the following conjecture is offered: the phenomenon of consciousness is necessarily an energy consuming process. This conjecture, if true, implies that if a being is conscious, that being must have some form of physical existence.
Drug administration errors have been an increasing focus of concern in anesthesiology. These erro... more Drug administration errors have been an increasing focus of concern in anesthesiology. These errors usually pertain to the type of drug administered, the drug dosage, the rate of administration or the site of administration. Past studies have attempted to identify and understand the underlying etiology of these common forms of errors, so as to avert its often serious and sometimes fatal consequences. These studies have focused on errors relating to the administrator's theoretical knowledge, clinical experience, individual technique and other such related factors. This growing body of research has proven invaluable, not only by addressing the preventability of drug errors by clinicians, but also in leading constructive efforts to minimize their repeated occurrence. This article attempts to highlight the current understanding of drug administration error in clinical anesthesia and discusses the risk management techniques that may be of value in dealing with this problem.
Current Pharmaceutical Design, 2012
Purpose: To present a case where the Aintree intubation catheter was used in conjunction with the... more Purpose: To present a case where the Aintree intubation catheter was used in conjunction with the Laryngeal Mask Airway (LMA) and a fiberoptic bronchoscope (FOB) in a patient with an unexpected difficult airway. Clinical Features: A 38 year old 90 kg man scheduled for nasal endoscopy with ethmoidectomy under general anesthesia was found to be unexpectedly difficult to intubate using a both a MAC 4 laryngoscope and a GlideScope® video laryngoscope, despite having an airway exam that was unremarkable except for a slightly decreased mouth opening and a large tongue. Intubation was achieved by inserting a size 5 LMA into the patient, introducing a FOB into an Aintree intubation catheter, inserting the FOB / Aintree catheter assembly into the trachea via the LMA, removing the LMA, and then passing a regular size (7.5 mm) endotracheal tube into the trachea over the Aintree catheter. Conclusion: The Aintree intubation catheter provides an effective alternative to other methods for intubati...
What Does it Mean to be Human? Life, Death, Personhood and the Transhumanist Movement
This chapter is concerned with cryonics and suspended animation. Like the previous chapter, it co... more This chapter is concerned with cryonics and suspended animation. Like the previous chapter, it contributes substantially to the philosophical debate on where the line between life and death should be drawn. The ultimate aim of cryonics is to achieve nondestructive freezing (cryopreservation) of advanced organisms like humans so that they can be safely thawed in the future, usually with a view to obtaining advanced medical treatment not currently available. In this chapter number of scientific and philosophical questions presented by cryonics are discussed, such as whether cryonics is real science or simply a waste of money, the legal and moral status of cryonically suspended individuals, and how to deal with the possibility that the thawed individual might end up with some organs working but with severe neurological impairment.
What Does it Mean to be Human? Life, Death, Personhood and the Transhumanist Movement
This chapter is concerned with the technical, safety and bioethical issues associated with human ... more This chapter is concerned with the technical, safety and bioethical issues associated with human pharmacologic enhancement. Although neuroscientific advances are now providing valuable treatments for patients with neurological diseases, many of these treatments may also be applied to “normal” individuals free of disease as a means of achieving “quality of life” improvements, an enterprise sometimes called “cosmetic neurology”. Although such enhancements might variously make one happier, more serene, more intelligent, better at mental arithmetic, more personable, and so on, they also raise an important philosophical question—could such interventions lead to a mind-blunting effect that would diminish one’s capacity to appreciate life in all its dimensions, making us “unauthentic” humans living a banal, anesthetized existence as uncritical participants in the affairs of the world?
Mr. Soprano is a 52 year old entrepreneur in the waste management industry. He weighs 119 kg, is ... more Mr. Soprano is a 52 year old entrepreneur in the waste management industry. He weighs 119 kg, is 175 cm tall, and is being investigated for “dizzy spells” that appear to be panic attacks. His medical problem list includes obesity, untreated hypertension, and possible obstructive sleep apnea (based on his wife’s nocturnal observation that “sometimes he just stops breathing”). When questioned, he admits to extreme claustrophobia, possibly the result of a protracted period of time spent in a car trunk. A previous attempt at a magnetic resonance imaging (MRI) scan was unsuccessful because Mr. S, startled by the onset of the load noises made by the MRI machine, panicked and tried to get out of the MRI scanner, pulling out his IV in the process.
New Emirates Medical Journal
Background: Cardiac auscultation is a frequent first step in diagnosing heart disorders. However,... more Background: Cardiac auscultation is a frequent first step in diagnosing heart disorders. However, the lack of dependability of ordinary auscultation in the hands of inexperienced clinicians remains a problem. Objective: We sought to develop an inexpensive system for digital cardiac auscultation (digital phonocardiography) using a Windows laptop computer, freely downloadable software and an inexpensive USB microphone. Description: The system, based on the free open source Audacity software package, offers advanced features such as phonocardiogram storage and retrieval, low-pass and high-pass waveform filtering and variable-speed signal playback with pitch preservation. Results: Sample results for both raw and digitally filtered phonocardiograms are provided. Conclusion: An innovative laptop-based phonocardiogram system offering advanced features can be easily produced at minimal cost.
The Open Anesthesia Journal
Clinical Early Warning Scores are tools intended to alert clinical staff to possible future clini... more Clinical Early Warning Scores are tools intended to alert clinical staff to possible future clinical deterioration, often related to the onset of sepsis. Since their introduction, they have increased greatly in popularity. Their operation is conceptually simple: an elevated early warning score triggers a formal assessment by the responsible clinician. While the best-known system is the Royal College of Physicians National Early Warning Score (NEWS), a number of other scores are in use, such as an adaptation known as the Modified Early Warning System (MEWS) or warning systems for pediatric patients (PEWS). However, while promising, such instruments need to be studied in more detail to better characterize their eventual role in monitoring hospital patients. In particular, a central question concerns the identification of the best system (NEWS, MEWS, PEWS etc.) for a given clinical population (pediatric, trauma, prehospital etc.).
Ethics in Biology, Engineering and Medicine: An International Journal
In this essay I discuss the impact of postmodern thinking on the practice of contemporary medicin... more In this essay I discuss the impact of postmodern thinking on the practice of contemporary medicine, focusing on "alternative medicine" and its origins (at least in part) in a postmodern world view. I take the position that postmodern thinking has led to a belief in some circles that the current evidence-based, positivist approach to clinical management should be abandoned. I suggest that such thinking is not without its attendant dangers.
The Open Anesthesiology Journal
The GlideScope video laryngoscope has had a profound impact on clinical airway management by virt... more The GlideScope video laryngoscope has had a profound impact on clinical airway management by virtue of providing a glottic view superior to direct laryngoscopy. Since its introduction circa 2003, hundreds of studies have attested to its value in making clinical airway management easier and safer. This review will update the reader on the art and science of using the GlideScope videolaryngoscope in a variety of clinical settings and its relation to other airway management products. Topics covered include GlideScope design considerations, general usage tips, use in obese patients, use in pediatric patients, use as an adjunct to fiberoptic intubation, and other matters. Complications associated with the GlideScope are also discussed.
This report describes a simple interactive HTML/JavaScript-based educational resource aimed at ed... more This report describes a simple interactive HTML/JavaScript-based educational resource aimed at educating physiology students, medical students and physicians on the field of oxygen transport physiology. It can be run on almost all personal computers with a web browser that supports JavaScript.
Military robots are gradually entering the theater of war in many guises. As the capabilities of ... more Military robots are gradually entering the theater of war in many guises. As the capabilities of these robots move toward increased autonomous operation, a number of difficult ethical and legal issues must be considered, such as appropriate rules of engagement and even notions of robot ethics. In the distant future, as military "artificial beings" that draw on expected advances in cyborg and android technologies are developed, further issues of conscience, consciousness, personhood, and moral responsibility also arise.
Ethics in Biology Engineering and Medicine an International Journal, 2013
In this essay I discuss the impact of postmodern thinking on the practice of contemporary medicin... more In this essay I discuss the impact of postmodern thinking on the practice of contemporary medicine, focusing on "alternative medicine" and its origins (at least in part) in a postmodern world view. I take the position that postmodern thinking has led to a belief in some circles that the current evidence-based, positivist approach to clinical management should be abandoned. I suggest that such thinking is not without its attendant dangers.
Anesthesiology Clinics, 2015
Awake tracheal intubation is commonly used when ordinary intubation (for example, attempting dire... more Awake tracheal intubation is commonly used when ordinary intubation (for example, attempting direct laryngoscopy after the induction of general anesthesia) is expected to be difficult or hazardous. 1-8 Possible examples include patients with large glottic tumors, patients with unstable cervical spines, patients known to be difficult to intubate by virtue of previous anesthetic misadventures, and numerous other conditions. 9-15 This is an updated, reorganized and expanded version of an earlier article published in the 7th Annual Anesthesiology News Guide to Airway Management. August 2014.
International Journal of Cardiology, 2011
Objective: This study explored the severity of central obesity and the attitude and knowledge abo... more Objective: This study explored the severity of central obesity and the attitude and knowledge about central obesity among cardiac patients. Methods: A telephone interview was conducted on community dwelling cardiac patients who were members of a patient group. A self-developed questionnaire regarding knowledge and attitude of central obesity was used. Results: A total of 342 (male = 161, 47%; female = 181, 53%) Hong Kong Chinese cardiac patients participated in the study. The body mass index (BMI) was 23.6 (SD±3.3) for man and 22.4 (SD±4.2) for women; however, the mean waistline was 75.5 cm (SD±9) for men and 84.8 cm (SD±7.6) for women. Female participants had normal BMI but with central obesity (normal ≤80 cm). 240 (70%) participants defined central obesity correctly. Participants had the knowledge that high waist circumference could lead to hypertension (n = 274, 80.1%) coronary artery disease (n = 271, 79.2%) and diabetes mellitus (n = 256, 74.9%). 120 (35%) were abdominally obese, and among these obese participants, 87 (73%) of them had tried to reduce their waistline. Only 31 (26%) have their waistline reduced but 58 (48%) of them had increased since first diagnosis of heart disease. Conclusion: Male participants were classified overweight according to their mean BMI, but their mean waist circumference was normal. Normal BMI does not reflect the distribution of a person's body fat. It could be misleading as a muscular patient might be categorized as 'overweight'. Therefore, waist circumference should also be included in assessments.
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2007
Medical Education Online, 2009
View related articles Citing articles: 12 View citing articles Doyle DJ. Simulation in medical ed... more View related articles Citing articles: 12 View citing articles Doyle DJ. Simulation in medical education: Focus on Anesthesiology.