Anaesthesia

 

“Describe how you would anaesthetize this patient”

 

I am most concerned about the risk of

·      A: CICO, aspiration

·      B: respiratory failure

·      C: cardiovascular collapse, AMI

·      D: stroke, awareness

Anaesthetic

·      e.g. relaxant GA with mRSI

o   Induction with propofol/alfentanil/sux + suction/cricoid/apnoea

o   Maintenance with sevo/nitrous

·      e.g. TIVA -propofol / remifentanil / metaraminol infusions

·      e.g. adrenaline 10mcg/mL drawn up

Airway

·      ETT + video laryngoscope + ramping + good pre-oxygenation

·      Extubate awake on remifentanil

Access

·      Large PIVC + pumpset + rapid infuser

·      A-line

·      CVC

Probes

·      Temp (with forced air warming)

·      BIS

·      A-line

·      CVC

·      IDC

People

·      Paeds: parent for child, escort for parent, nurse for me

·      Airway: second anaesthetist, ENT surgeon scrubbed and ready

·      MTP: second anaesthetist, extra nurses

Pain

·      Regional/neuraxial

·      Infusions/PCA

·      Pain service

 

 

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