Common practice for common cases

Question 1

Describe anaesthetic plan for peanut aspiration

Answer 1

Highest risk for chemical pneumonitis from nut oils

Other complications ofFB aspiration
1. Laryngeal oedema
2. Bronchospasm
3. Hypoxia
4. Tracheobronchial laceration
5. Infection
6. Bleeding

Pre-op
NPO status should not delay bronchoscopy

Intra-op
Maintenance: volatile or TIVA
Spontaneous (better - ? less displacement of FB) or controlled ventilation)

Question 2

Key points for induction of anaesthesia in a patient with congenital diaphragmatic hernia

Answer 2

1. Minimize Paw (Spontaneous breathing) Intrathoracic gastric insufflation with BVM –> compression of intrathoracic structures: heart/lungs/great vessels
2. Optimize possible pulmonary hypertension –> fentanyl/propofol/volatile will decrease pulmonary pressures