Scleroderma

 

CREST:

·       Calcinosis

·       Raynaud’s

·       Esophageal dysmotility

·       Sclerodactyly

·       Telangiectasia

 

Systemic scleroderma:

Airway

·     Very small mouth

·     Reduced neck ROM

·     Nasal/oral telangiectasia

·     Oesophageal dysmotility

Breathing

·     Interstitial lung disease

Circulation

·     Pulmonary hypertension

o  Myocardial fibrosis

o  Cor pulmonale

o  Arrhythmias

·     Ischaemic heart disease

·     Hypertension

External

·     Difficult IV access (dermal thickening and contractures)

·     Difficult positioning (contractures, nerve entrapment)

·     Raynaud’s (hypothermia, SNS stimulation / pain, beware radial A-line)

Medications

·     Immunosuppressants

o  Cushing’s syndrome

o  Insufficiency when sick

·     Pulmonary vasodilators

 

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