Trouble-shooting intra-op hypoxaemia:

 

Temporise

·      Announce problem

·      ±Stop surgery

·      ±Press emergency buzzer

·      FiO2 100%

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

Check airway

·      Everything connected? = look

·      In the right spot? = capno

Check breathing

·      Air moving in and out? = squeeze bag + auscultate both sides

Diagnosis

·      Low FiO2 (should be sorted by now)

·      Hypoventilation

o  Bronchospasm

o  Laryngeal spasm

o  Dyssynchrony

·      Shunt

o  Endobronchial intubation (should be sorted by now)

o  Collapse

o  Pulmonary oedema

o  Pneumothorax

·      Diffusion impairment: not likely