Anesthetic Considerations

Question 1

If patient is likely to have difficult airway management

Answer 1

• Consider AFO intubation
• Ensure the availability of difficult airway cart, different blades, LMA, video laryngoscope, FOB in the room
• Have another anesthesiologist on standby for assistance
• Have surgeon at bedside for tracheostomy
• Maintain SV with ketamine or inhaled induction if AFOI is not elected

Question 2

Trauma Bay

Answer 2

• Consider long bone fracture (fat embolus), facial injuries (difficult airway), altered mental status (intracranial bleed, increased ICP), SCI (spinal shock, difficult airway), hemorrhage, pneumothorax, abdominal compartment syndrome
• Always consider patients to have a FULL STOMACH
• If concerned about brain injury, avoid glucose-containing fluids

Question 3

Post-Cardiac Surgery Complications?

Answer 3

• LV failure
• Cardiac tamponade

Question 4

Hemodynamic Goals/Considerations with Cardiac Valvular Abnormalities

Answer 4

Question 5

Obstetric patient for emergent or conversion to GA

Answer 5

• Patients should always be considered difficult airway and full stomach
• Pt should be prepped, draped, and OB ready to cut PRIOR to induction
• Give appropriate aspiration ppx medicine
• Place pt in LUD position

Question 6

When is SCh Contraindicated?

Answer 6

• Burns > 24h
• Spinal cord injury
• Hyperkalemia
• Sepsis
• Prolonged immobility
• Multiple sclerosis, ALS
• MH history
• Myotonic dystrophy / muscular dystrophy