surgery week 9 Flashcards
What s the aneurysm screening program
US from65 years
When do you need to operate on a patient with abdominal aortic aneurysm
5.5 cm
what is the risk of rupture for an aneurysm below 5cm
1%
What is the risk of rupture of an aneurysm that is above 5cm
20-30%
What is the national average risk for surgery on an abdominal aortic aneurysm
below 5%nationally and0.5 at st. mary’s
Is a stent or a surgical graft (open repair) better for abdominal aortic aneurysm
EVAR and a surgical graft
short term EVAR
At 8 years there is a higher rate of endoleak
tachycardic
hypotension
clamy and sweaty
back pain
abdominal aortic anyrism
Patient is hypotensive what do you do immidiatly
shocked- O- blood, colloid (don’tgive dextrose)
if speaking leave him alone
Why do you not give fluid to someone who has a ruptured aortic aneurysm
permissive hypotension
they have a clot stoping to much blood leaving ifyou increase the pressure
bring straight to theatre, or CT to theatre
What would have presented with retroperotonnal pain
acute pancreatitis- amylase
perforated viscus- erect chest X ray
MI- troponin
cross match blood
catherise
analgesia
ABG- see a high lactate, low FBC, acidosis
do a CT on the to theatre to determine the extent, if it is ok for endovascular repair
What symptoms of acute limb ischaemia
- Pain
- pulseless
- paresthesia
- paralyisis
- pale
- cold
What happens when people are revascualrised and the tissue has been dead for a while?
MI due to high potassium
also get lactate
how do manage patients with acute limb ischaemia
IV heparin - prevent propagation
thrombectomy OR do thrombolysis (patient wwith previous by pass surgery)
What are the 2 p that mean that you can’t revive the foot
