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Category: Anaesthetic Emergencies

Posted in: UIA > General Topics > Anaesthetic Emergencies 2020 Language: english

Laryngospasm is a well-known entity occurring during the perioperative period, most commonly during intubation or extubation. Clinical signs are the consequence of patient effort to breath against a closed glottis. Risk factors can be related to patient, surgery or anesthesia. They should be managed pre-operatively in order to prevent this occurrence, together with preventative drugs such as iv (intravenous) lidocaine and magnesium sulphate, iv propofol induction instead of the inhalational route in children and laryngeal aspiration before extubation. Prompt diagnosis and management is the key to success and includes Continuous Positive Airway Pressure (CPAP) with 100% oxygen, manual maneuvers (subluxation of the temporomandibular joint and Larson’s maneuver), increasing depth of anesthesia and muscle relaxation. If these measures do not succeed, forced orotracheal intubation or even cricothyroidectomy/tracheostomy are the emergency steps

Posted in: UIA > General Topics > Anaesthetic Emergencies 2011 Language: english

Bronchospasm is a relatively common event during general anaesthesia. Management begins with switching to 100% oxygen and calling for help early. Stop all potential precipitants and deepen anaesthesia. Exclude mechanical obstruction or occlusion of the breathing circuit. Aim to prevent/correct hypoxaemia and reverse bronchoconstriction. Consider a wide range of differential diagnoses including anaphylaxis, aspiration or acute pulmonary oedema.

Posted in: UIA > General Topics > Anaesthetic Emergencies 2009 Language: english

Children usually suffer cardiac arrest secondary to hypoxia or ischaemia due to respiratory or circulatory failure. Cardiac arrest is commonly reversed by simple interventions. Early recognition of a child at risk of deterioration is essential. Avoid interruptions in chest compressions.

Posted in: UIA > General Topics > Anaesthetic Emergencies 2009 Language: english

Resuscitation of a newborn infant at birth is straightforward and much more likely to be successful than resuscitation of a collapsed adult. The principles underlying the approach are simple and the issue is not complicated by a need to interpret ECGs or manage arrhythmias. Babies are well adapted to withstand the periods of intermittent hypoxia which are a feature of normal labour and delivery.

Posted in: UIA > General Topics > Anaesthetic Emergencies 2009 Language: english

Difficult intubation of the trachea is rare, but it can be encountered after routine induction of general anesthesia even if the airway examination did not provide any suspicion of a difficult airway. A difficult intubation may be defined as not being able to visualize any portion of the vocal cords after multiple attempts of conventional laryngoscopy by an experienced person.

Posted in: UIA > General Topics > Anaesthetic Emergencies 2009 Language: english

Magnesium sulphate administration is indicated to treat eclamptic seizures and prevent seizures in women with severe pre-eclampsia. Pharmacological strategies for control of blood pressure are described in detail. Intravenous regimes for magnesium administration are described with alternative intramuscular regimes for settings where infusion pumps are not available. Multidisciplinary input is essential.

Posted in: UIA > General Topics > Anaesthetic Emergencies 2009 Language: english

Obstetric haemorrhage remains one of the leading causes of preventable maternal morbidity and mortality worldwide. Life-threatening haemorrhage occurs in around 1 in every 1000 deliveries. Prompt recognition and management of obstetric haemorrhage is essential.

Posted in: UIA > General Topics > Anaesthetic Emergencies 2009 Language: english

Malignant hyperthermia (MH) is a rare pharmacogenetic autosomal dominant disease. This is generally unmasked when a susceptible individual is exposed to general anaesthesia and it can present during or after delivery of anaesthesia. The common precipitants are volatile anaesthetic agents and succinylcholine (suxamethonium).

Posted in: UIA > General Topics > Anaesthetic Emergencies 2009 Language: english

Local anesthetic (LA) agents are widely used, not just by anesthesiologists but by medical staff from all specialties. It is important to be aware of their toxic potential so that any toxic reactions can be detected and treated early. Whilst it is important to be able to treat LA toxicity effectively, it is clearly desirable to avoid LA toxicity whenever possible. For this reason the first section in this article outlines strategies for minimizing the risk of LA toxicity.

Posted in: UIA > General Topics > Anaesthetic Emergencies 2009 Language: english

Hypoxia during anaesthesia is common and is easily detected by a pulse oximeter. This article will describe how to respond to falling SpO2.

Posted in: UIA > General Topics > Anaesthetic Emergencies 2009 Language: english

Emergency management of maternal collapse and arrest (BLS. Modified Basic Life Support algorithm for in-hospital obstetric emergencies at more than 22-24 weeks gestation.

Posted in: UIA > General Topics > Anaesthetic Emergencies 2009 Language: english

Ensure all staff on the maternity unit are aware of the risk. Early recognition and treatment will prevent harm to mother and baby. Communicate with the rest of the team, the patient and partner. Be prepared – have a plan and practice a drill regularly.

Posted in: UIA > General Topics > Anaesthetic Emergencies 2009 Language: english

Assess the airway before induction of anaesthesia. Check all intubation equipment daily and be familiar with its use. Position the patient correctly before induction. Remember that oxygenation is more important than intubation. Call for help early. Maternal welfare is paramount and takes priority over foetal considerations.

Posted in: UIA > General Topics > Anaesthetic Emergencies 2009 Language: english

Even when a patient proves to be unexpectedly difficult to intubate, it is usually not a problem to adequately oxygenate and ventilate the patient using bag-mask ventilation (BMV). Occasionally, and fortunately very rarely, we encounter a patient who is impossible to intubate AND who also cannot be adequately oxygenated. This is the feared ‘can’t intubate, can’t ventilate’ situation.

Posted in: UIA > General Topics > Anaesthetic Emergencies 2009 Language: english

If anaphylaxis during anaesthesia is recognized promptly and managed optimally, severe adverse reactions are avoidable. Follow basic life support with the ABC approach (Airway, Breathing, and Circulation), epinephrine (adrenaline) is the most effective drug in anaphylaxis during anaesthesia and should be given as early as possible.