ISSUES & EVENT DISCLOSURE
• Advance directive → instructions given by an individual specifying what should be done for his or her health should he or she no longer be able to make decisions…
DRUGS RELEVANT TO PRACTICE OF ANESTHESIA
Dolasetron (Anzemet): See 5HT3 Antagonists. Droperidol (Inapsine) Indication: (1) Prevention/treatment of postoperative nausea and vomiting. Also used for (2) sedation, GA adjunct, treatment of delirium although alternate drugs are preferred…
INTERPRETATION
ATRIOVENTRICULAR CONDUCTION SYSTEM • 1st-degree AV block—PR interval increased >0.2 sec • 2nd-degree AV block • Mobitz type I (Wenckebach)—AV delay (PR interval) increases with each beat, until QRS is…
Management of Malignant Hyperthermia
APPENDIX C: MANAGEMENT OF MALIGNANT HYPERTHERMIA EMERGENCY THERAPY FOR MALIGNANT HYPERTHERMIA MH Hotline 1-800-644-9737; website: WWW.MHAUS.ORG Outside the US: 1-315-464-7079 DIAGNOSIS VS. ASSOCIATED PROBLEMS Signs of MH • Increasing ETCO2…
Anesthesia Machine Checkout & Setting Up the Or
APPENDIX B: ANESTHESIA MACHINE CHECKOUT & SETTING UP THE OR ANESTHESIA MACHINE CHECKOUT Checkout only valid for an anesthesia system that conforms to current standards and includes an ascending bellows…
FOR AESTHETIC SURGERY & SURGERY OUTSIDE OF THE OPERATING ROOM
ANESTHESIA OUTSIDE THE OPERATING ROOM General Considerations/Safety • Thorough preoperative evaluation of every pt is essential • All patients receiving any form of anesthesia must have ASA monitors during anesthesia…
FOR THE ELDERLY
• Take into account longer duration of action in elderly • Neuromuscular blocking agents • Duration prolonged by ↑ age (if steroid based), mild hypothermia, increased density of block (train-of-four…
FOR VASCULAR SURGERY
(lower should remain OFF until after reperfusion & stabilization) • Foley catheter: Goal urine output >0.5 mL/kg/hr • PRBC in the OR; may also need FFP • Management before clamping…
INHALED ANESTHETICS
MAJOR FACTORS AFFECTING UPTAKE Solubility • Partition coefficients express relative solubility of anesthetic gas at equilibrium • Lower partition coefficients imply ↓ solubility, faster equilibration of partial pressure (alveolus ↔…
INTRAOPERATIVE PROBLEMS
• Consider bronchoscopy • Consider bag ventilation • Treat underlying problem BRONCHOSPASM Causes • Preexisting reactive airway disease (asthma) • Manipulation of upper airway (oral endoscopy) • ETT with inadequate…
