By Keith J. Ruskin, Stanley H. Rosenbaum
Anesthesia Emergencies comprises suitable step by step details on the right way to notice, deal with, and deal with issues and emergencies through the perioperative interval. Concisely written, highlighted sections on speedy administration and hazard elements toughen crucial issues for simple memorization, whereas constant association and checklists supply ease of studying and readability. Anesthesia services will locate this booklet an necessary source, describing overview and therapy of life-threatening events, together with airway, thoracic, surgical, pediatric, and cardiovascular emergencies. the second one variation includes a revised desk of contents which offers issues so as in their precedence in the course of emergencies, in addition to new chapters on drawback source administration and catastrophe medicine.
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Additional resources for Anesthesia Emergencies
Pass a suction catheter down ETT to rule out kinking or the presence of blood or secretions. • To rule out a problem with the anesthesia machine and patient breathing circuit, check that ventilation with a self-inﬂating bag (“Ambu bag”) is satisfactory. ). Diagnostic Studies • Auscultation of lung ﬁelds • CXR • FOB Subsequent Management Will depend on the nature of the underlying problem. Further Reading Henderson J. Airway Management in the Adult. In: Miller RD, ed. Miller’s Anesthesia. 7th ed.
American Heart Association. Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. 3: Management of symptomatic bradycardia and tachycardia. Circulation. 2005;112:IV-67–IV-77). 37 Dysrhythmias: Narrow Complex Tachycardia Deﬁnition Heart rate > 100 beats per minute (may be regular or irregular) with a narrow QRS complex (<120 msec) Presentation • Hypotension • Palpitations • Altered mental status • Chest pain • Pulmonary edema Pathophysiology A narrow QRS complex implies a rapid activation of the ventricles via the normal His-Purkinje system.
Wolff-Parkinson-White syndrome) Junctional tachycardia Atrial ﬁbrillation Atrial ﬂutter Immediate Management • Administer adenosine (6 mg rapid IV push, repeat 12 mg × 2). ). • Stable, irregular, narrow complex tachycardias: control heart rate with diltiazem (15 mg IV over 20 minutes) or metoprolol (5 mg IV q 5 minutes). • Consider DC cardioversion if hemodynamically unstable. • Treat unstable arrhythmias with immediate electrical cardioversion. 38 Diagnostic Studies • ECG • Electrophysiology testing • Echocardiography Subsequent Management • If adenosine fails, initiate rate control with either intravenous calcium-channel blockers or beta-blockers.