To the Editor

I wish to comment on the letter of Karen Shea, M.D., regarding clinically recognizing adequate patient sedation.

I enthusiastically endorse her bid for immortality by describing the phenomenon of a well sedated patient’s lips going ‘poof.’ I have used this clinical finding for years, but never knew what to call it. One of my own refinements at times is to administer small amounts of anesthetic gasses until the poofing occurs. Not wanting to detract from widespread recognition of the ‘Shea Sign,’ I propose that my described use of it be known as the “whiff ‘n poof” technique.

John Mumma, M.D. Medical Director

Bellingham Surgery Center, Inc. Bellingham, WA