![]() ![]() In the veterinary literature there has been little research into estimating blood loss. Recent medical studies have focused on development of pictorial guides to aid in the estimation of blood loss, generally with findings of improved accuracy ( 9– 11). Visual estimation has been found to be both the most common method of estimation and inaccurate, with both over- and underestimation and with wide ranges ( 5, 8). In the medical literature, research has been particularly focused around obstetrics, where hemorrhage is common. Estimating blood loss volume, together with systemic indicators such as digital pulse pressure (dPP) and MAP, provides important information for making appropriate fluid therapy decisions including whole blood transfusion ( 6, 7). Accurate estimation of intraoperative blood loss is an important component of circulatory competency assessment and management ( 4, 5). Traditional systemic parameters alone, including mean arterial pressure (MAP) and heart rate (HR), have been shown to have poor correlation with accurate hemorrhage assessment ( 3). In small animals, with low total blood volumes, small amounts of blood loss can logically have significant deleterious effects. A pictorial guide improves the accuracy generally, and specifically for more complex scenarios which are likely to reflect the clinical situation.Īcute hemorrhage impairs oxygen delivery and rapid management improves outcomes ( 1, 2). Visual blood loss estimation is inaccurate amongst veterinary anesthetists and associated staff, showing decreasing accuracy with increasing complexity. The overall median raw estimation error for the WGD phase was 13 mL (range −80 ml to 143 mL) ( p = 0.0128). There were no differences between role, gender, experience, or country of origin. ![]() The PGD raw median error increased with scenario complexity. The overall raw PGD phase median estimation error was−27 mL (range −99 to 248 mL). Data was analyzed for normality with the Shapiro-Wilks test, corrected to absolute error and compared for statistical significance using the Wilcoxon signed-ranks test or the Kruskal-Wallis test as appropriate. The pictorial guide used similar images labeled with corresponding volumes. Each participant estimated the blood volume (in mL) for each scenario twice, initially (Pre-Guide ) and then with the aid of a pictorial guide (With-Guide ). The survey consisted of visual and brief descriptive depictions of blood loss scenarios involving small animals, principally including images of common surgical items and receptacles containing a blood-like substance. A voluntary, two-part, online, anonymous survey was distributed to members of two email databases with an interest in anesthesia, including students, nurses, interns, residents, general practitioners, and specialists. This study investigated the visual estimation accuracy of a global population of anesthesia staff and students as an initial estimation and also with the assistance of a pictorial guide. Visual estimation of blood loss is the most common form of evaluating intraoperative hemorrhage, and is also the most inaccurate. Anaesthesia Department, The Veterinary Teaching Hospital Sydney, The University of Sydney, Camperdown, NSW, Australia.Assistant viewer similar to Lightroom’s new “reference view,” but fully functional with edits and tabs.Scott H.Native browsing of Aperture libraries with no conversion needed.Catalog-free Image handling that automatically monitors the content of referenced folders, enabling instant editing with no slow import process needed.Smart extension for macOS Photos, the first of its kind to offer non-destructive pro-level editing while recalling positions of sliders and masks, even after closing Photos.Edge-aware brush to enable more precise selections. ![]() Skin smoothing brush utilizing Frequency Separation in a single brush with the ability to control the separation radius.Advanced selective tonal adjustments including HSL, Curves, Split Toning, and more, operating on specific parts of the image defined with advanced masking tools.Adaptable single-space workflow, from camera-to-edit within a single window without slow switching between the library and develop modules.Unique color and luminosity masks making fine-art results easier….Versatile and responsive patch tool, up to 30x faster than Lightroom’s equivalent Spot-Removal tool (tested on a modern 15” MacBook Pro).With carefully designed workflow and innovative technology, Picktorial is the ultimate photo editing tool for every photographer to intuitively organize and enhance photos. Picktorial makes pro-level photo editing tool available in a minimalist, streamlined workflow. ![]()
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