By Gandhi, Manju N.

Kinds of emergency instances divided into 9 sections to hide majority of the emergencies that you could come upon and all of the perioperative facets of emergency anesthesia are lined in nice aspect besides treatment plans. common issues for adults, obstetric and pediatric sections were written individually to prevent duplication . part on basic ideas for emergency anesthesia and  Read more...

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Intensive Care Medicine Critical Care 2004;8:503-7. 5. Mythen MG, Webb AR. Perioperative plasma volume expansion reduces the incidence of gut mucosal hypoperfusion during cardiac surgery. Arch Surg 1995; 130:423-9. 6. Guest JF, Boyd O, Hart WM, Grounds RM, Bennett ED. A cost analysis of a treatment policy of a deliberate perioperative increase in oxygen delivery in high-risk surgical patients. Intensive Care Med 1997;23:85-90. 7. Denny Z, Levvett H. et al. The effects of fluid optimization on outcome following major surgery.

No specific anesthetic is inherently safer than any other. g. wound washing, redo surgery, etc. Is there a best approach to induction of anesthesia in emergent situation? Anesthetic agent/or sedative agents should be used judiciously with careful titration. Patients in shock have increased sensitivity to these agents. Sympathetic drive is at its maximum in patient with shock or hemodynamically compromised patient, therefore these patients tend to decompensate at the time of induction. Direct depressant effect of sedative and hypnotic agents may lead to vasodilatation and in addition positive pressure ventilation may reduce cardiac filling, as a result severe hypotension and sometimes cardiac arrest may occur since protection due to sympathetic drive is lost.

Need for reintubation: Some patients may need reintubation following the extubation. This may be either immediate or within few hours postoperatively. Patient’s need to be monitored for adequacy of breathing very closely and emergency intubation tray must be kept ready next to patient in order to prevent hypoxia and its consequences. • Inadequate neuromuscular block reversal: One must monitor the neuromuscular blockade following reversal of non-depolarizing muscle relaxants. The peripheral nerve stimulator helps in guiding the reversal of neuromuscular blockade and should be used whenever available.

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