Mediastinoscopy

 

Airway

·     Shared territory

·     Reinforced flexible ETT

·     Secured out of the way

Bleeding

·     Large PIVC

·     Group & hold

Vessel compression

(Right) brachiocephalic artery = innominate

·     Risk of stroke

·     -> A-line left upper limb (avoid fictitious reading)

·     -> SpO2 right upper limb (monitor compression)

Left brachiocephalic vein:

·     Impaired medication delivery

·     -> PIVC in right upper limb

Cancer

·     Mass effect – airway, great vessels, heart

·     Metastases

·     Metabolic

·     Medication

Surgical complications

·     Stroke

·     Haemorrhage (large artery, large vein)

·     Pneumothorax / pneumomediastinum / haemothorax

·     Tracheal injury

·     Oesophageal injury

·     Thoracic duct injury

·     Phrenic nerve injury

·     Recurrent laryngeal nerve injury

·     Venous air embolism

 

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