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

·      Cor pulmonale

·      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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