Hypothermia

Question 1

Patient had abdominoperineal resection Under epidural anesthesia then develop Tachycardia and hypotension He was ASA 3

Q1. What is your finding from the chart ?

Answer 1

Hypothermia

Question 2

Q3: How to asses core temperature ?

Answer 2

By oral / Axillary / Recatal / Esophageal

Question 3

Q2: What is definition of hypothermia ?

Answer 3

Core body temp < 35 or <36 in pre-op Pt

Question 3

Q5: What is the meaning of ASA ?

Answer 3

American Society of Anesthesiology ‘Classify pt fitness before surgery”

Question 4

Q4. What is the complications of Hypothermia regarding the body systems?

Answer 4

Heart – > HF / Arrythmia
Respiratory – > Incr. Pulm. Vascular resistance.
Kidney – > Dec. Renal blood flow
Blood – > coagulopathy
GIT– > Dec. Motility
CNS – > Dec. cerebral blood flow

Question 5

Q7: Mechanism of heat loss ?

Answer 5

Conduction (loss to table)
Convection (loss to surroundings)
Radiation
Evaporation
Anathetic agents gases

Question 5

Q6: What is the relation between ASA 3 And hypothermia in the patient ?

Answer 5

Due co-morbidities of this pt it’s more likely to have hypothermia and other complications during surgery

Question 6

Q8. Give potential complications that may arise intraoperative in patient with hypothermia ?

Answer 6

Coagulopathy , Arrythmia , MI

Question 7

Q9. How to prevent hypothermia ?

Answer 7

Nice Guidelines:
“Read From Book”

Question 8

Q10. Types of blankets used in hypothermia ?

Answer 8

Space blanket – blizzerds – wool – heat pockets

Question 9

Q11: What is definition of DIC ?

Answer 9

Pathological Consumptive Coagulopathy due to activation of coagulation and fibrinolytic system leading to forming microthrombi with consmpution of clotting Fx and platlets.

Question 10

Q12: Treatment of DIC ?

Answer 10

FFP and platlet and cryoprecipitate

Question 11

Q13: what is massive blood transfusion ?

Answer 11

Replacement of 1 blood volume in 24 hrs or 50% of blood in 4 hrs

Question 12

Q14. what is its complications ?

Answer 12

Fluid overload – hypothermia – electrolyte dis. Hyper K / Hypo Ca – Coagulopathy - ARDS

Question 13

Q15. What are the measures that can be done to reduce the need for transfusion ?

Answer 13

Cell savers / Hypotensive technique / Hemostasis / Autologous tansfusion