Trouble-shooting intra-op hypoxaemia:

 

Temporise

·      Announce problem

·      ±Stop surgery

·      ±Press emergency buzzer

·      FiO2 100%

·      Man-spont, APL 20cmH2O, hand-ventilate

·      If in doubt: switch to manual resuscitator

Check delivery

·      Wall / cylinder: connected, turned on, running

·      Ventilator: FiO2, PEEP, VT

·      Tubing: connected, no kink

·      ETT: connected, enlocated

Check patient

·      Airways: laryngospasm? Bronchospasm? Dyssynchrony?

·      Parenchyma: APO? Collapse?

·      Pleura: pneumothorax?

DDx if unsure

·      Low FiO2

·      Hypoventilation

·      V/Q mismatch or shunt

·      Diffusion impairment

 

 

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