Anesthesia Emergencies comprises correct step by step info on easy methods to notice, deal with, and deal with problems and emergencies in the course of the perioperative interval. Concisely written, highlighted sections on rapid administration and chance elements strengthen crucial issues for simple memorization, whereas constant association and checklists offer ease of studying and readability. Anesthesia companies will locate this ebook an critical source, describing overview and therapy of life-threatening events, together with airway, thoracic, surgical, pediatric, and cardiovascular emergencies. the second one version encompasses a revised desk of contents which provides issues so as in their precedence in the course of emergencies, in addition to new chapters on challenge source administration and catastrophe medicine.
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Additional info for Anesthesia Emergencies (2nd Edition)
Immediate Management • Increase FiO2 to 00% and titrate PEEP to maintain adequate oxygenation. • Auscultate breath sounds. • Begin manual ventilation. • Suction the endotracheal tube. • Administer a bronchodilator if bronchospasm is suspected (albuterol 2–4 puffs into the ETT). • Administer a diuretic if pulmonary edema is present (furosemide 20 mg IV). • Exclude anesthesia gas machine or ventilator failure. • Increase the level of sedation and consider neuromuscular blockade if necessary. Diagnostic Studies • Measure peak airway pressures.
Diagnostic Studies • Coagulation tests (PT/INR/aPTT/platelet count) • Rigid/fiberoptic bronchoscopy • Chest X-ray • Computed tomography (CT) scan of the chest and neck as indicated • Bronchial arteriogram • Echocardiogram to rule out cardiac origin • Right heart catheterization Subsequent Management • Correct any coagulation defects (see Coagulopathy, c hapter 5). • Recombinant activated factor VII is sometimes used with diffuse alveolar bleeding. • Treat the primary cause of bleeding. • Bronchial artery embolization can be effective in the management of life-threatening massive hemoptysis.
It may also reflect increased dead space with a normal PaCO2. Sudden, catastrophic decrease in cardiac output will decrease the ETCO2 because of decreased perfusion (CO2 is not being carried to lungs). Immediate Management 40 • Assess cause of decreased ETCO2 • Send arterial blood to determine PaCO2 • Sudden: • Consider cardiovascular collapse. Assess perfusion by other means (blood pressure, presence of a pulse oximeter waveform). • Assess volume status. • Consider providing cardiovascular support using inotropes or vasopressors.