Clinical Practice

Question 1

1.Which pacemakers/ defibrillators need to be turned off for surgery?
2.why?
3. How?

Answer 1

1. defibrillators
2. Risk of microshock to the heart
3. How? Acute-> magnet. Or what should have is cardiophysiologists attend to turn it off and return to turn back on at the end of surgery. defib should be available in theatre

Question 2

1.What is adult fluid requirement per day
2. Daily calorie requirement
3. Daily sodium requirement
4. Daily potassium requirement

Answer 2

1. Fluid Around 30ml/kg/day
2. 35kcal/ kg/day
3. 2mmol/kg/day Na
4. 1mmol/kg/day K

Each gram of glucose I. IV fluid provides about 4kcal. Of energy

Question 3

which mapleson breathing circuit is most efficient in spont breathing?

which is best in controlled?

Answer 3

Mapleson A is most efficient in spontAneous breathing patients

Mapleson D is best in controlleD breathing

Question 4

indications for hypertonic saline

Answer 4

Indications for use of hypertonic saline include:

Osmotherapeutic agent for treatment of cerebral oedema and raised intracranial pressure
Treatment of symptomatic hyponatraemic seizures
Small volume resuscitation for shock (especially associated with traumatic head injury), and
Renoprotective agent (e.g prevention of radiocontrast and cytotoxic nephropathy, and rhabdomyolysis induced acute kidney injury).