Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anesthesia > Anesthesia for Emergency Surgery > Flashcards

Anesthesia for Emergency Surgery Flashcards

1
Q

What is an Emergency?

A

This is where there is an imminent threat to life or limb exists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is an emergency surgery?

A

This is when an operation has to be done as soon as possible in a response to a sudden condition that threatens patient’s life and its considered life – saving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When should an urgent surgery be done?

A

Within 24hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the aim of emergency surgery?

A

The aim of emergency surgery is to allow correction of the surgical pathology with minimum risk to the patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List 7 orthopedic emergencies?

A

Open fractures
Dislocations
Multiple long bone #s and Unstable pelvic #s
Compartment syndrome
Wet gangrene
Septic joint
Osteomyelitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List 7 general surgery emergencies?

A

Penetrating abdominal injury
Perforated viscus
Generalized peritonitis
Intestinal obstruction
Acute appendicitis
Massive upper G.I. Bleeding
Massive lower G.I bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

List 6 obstetric Emergencies?

A

Obstetric hemorrhages
Ruptured uterus
Prolonged obstructed labor
Ruptured ectopic pregnancy
Twisted ovarian cyst
Some C/S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the difference between an elective surgery and emergency surgery in terms of risks?

A

Patients undergoing emergency surgery have 10 fold increased risk of adverse events compared to those having planned or elective surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

List 8 factors that increase perioperative risk?

A

Limited time to asses and prepare patient
Uncertain diagnoses
Risk of aspiration
Body fluid, electrolyte and acid base derangements
Anemia and coagulation abnormalities
Coexisting diseases and poorly controlled chronic medical problems
Pain ands its physiological effects
After hours surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the approach to an emergency patient?

A

1.Pre-OP assessment
2.Preop preparations
3.Intraop management
4.Post Anesthetic Care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the parameters of Pre-op assessment?

A

History taking
Physical Exam
Lab investigations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the objective of preop assessment?

A

objective is to ascertain the indication, urgency, extent of the surgery and assess the risk of anesthesia which may dictate extent of pre operative preparation and choice of the anesthetic technique.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does the pre-op History taking component involve?

A

History taking; (AMPLE HISTORY)
Indication for the surgery
Traumatic
Non traumatic
History of cardiopulmonary symptoms
History of intercurrent medical illness
Previous history of anesthesia
Drug history
Social history
History of last meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does the physical exam aspect of preop assessment in Emergency cases invovle?

A

Depending upon the urgency of surgery, physical examination may be selective to identify significant cardiopulmonary dysfunction or any abnormalities that might lead to technical difficulties during anesthesia .

1.General examination:
features of painful/respiratory distress, dehydration, pallor,
presence or absence of tubes (N.G tube, urethral catheter)
2.Airways
3.Cardiopulmonary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What investigations are done in Preop assessment?

A

1.FBC - Hb
2.U&Es
3.Clotting profile
4.Chest x-ray and cardiac echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the objective of pre-op preparations?

A

The objectives is to optimize the patient, make him relatively fit for surgery, organize appropriate staffing and equipment in the theatre and make a provision for an ICU/HDU.

17
Q

what are the parameters for Pre-Op preparations?

A

1.Two large bore cannulas
2.Oxygen should be made available
3.Correction of fluid and electrolyte
4.Provision of blood/blood products
5.Monitoring of tissue perfusion
6Treatment of medical conditions:

18
Q

What is the most common and devastating complication in emergency anesthesia?

A

Full stomach which are vomiting/regurgitation followed by aspiration.

19
Q

What are the anesthetic techniques considered Intra-OP?

A

GA+ETT
Spinal Anesthesia
Epidural
P.N.B
L.A

20
Q

For GA and ETT what preparations are done intra-op and what form of induction is used?

A

Preparations:
1. Checking machines and monitors
2. Various sizes of ETT
3. Suction catheter
4. Drugs drawn up in to labelled syringes
5.Pre induction base line vital signs
Induction:
RSI

21
Q

What does rapid Sequence Induction invovle?

A

1.Preoxygenation
2. Cricoid Pressure
3.Intubation

22
Q

For how long do we pre-oxygenate and what is the purpose? How much oxygen do we give?

A

1.Breathing 100% oxygen for at least 3 minutes before induction
2. In breathing oxygen only, the lungs de-nitrogenate rapidly and after 3 minutes contains only oxygen and carbon dioxide

23
Q

What is the point of cricoid pressure and when is it done?

A

To obstruct the esophagus preventing from regurgitation

Opinions differs on when to apply the pressure
Just before induction agent vs As soon as pt lost consciousness

24
Q

What drug is used to intubate?

A

Succinylcholine

25
Q

When is the cricoid pressure released?

A

Only when :
The trachea is intubated
The cuff inflated
The correct position of the tube is confirmed

26
Q

Why are lungs not ventilated suring RSI?

A

Because it will further reduces barrier pressure and predisposes patient to risk of regurgitation and aspiration

27
Q

What do you do when RSI fails?

A

L.A
Awake intubation under local anesthesia

28
Q

What is the intra-op management done?

A

1.Maintenance of anesthesia
2. Fluid therapy
3.Blood transfusion
4.Intra operative monitoring
-Blood pressure
-Pulse rate
-Central venous pressure
monitoring
-Urine out put
-Capnograph
Reversal and emergence from anesthesia

29
Q

What is the treatment for aspiration?

A

1.Suction
2.Oxygen
3.Antibiotics

30
Q

What are the principles of post anesthetic care?

A

1.Extubation
2.ICU /HDU care depending on the condition
3.Continued resuscitation and medical care.

31
Q

When should extubation be done?

A

When protective airway reflexes are intact

Anesthesia (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions