Ketofol Spritz

KEY POINTS:

• Presentation 24-72h post-injury - risk during major trauma and surgery (esp long bones)
• Pathophysiology:
1. Fat from marrow into lungs = pulmonary hypertension, RV strain, hypoxia
2. SIRS from fatty acids = myocardial depression, ARDS, DIC
• Prevention = early immobilisation/reduction and operative management
• Dx of exclusion but classic triad of GURDS = confusion, respiratory distress and petechiae
• Petechiae only present in 50% but pathognomonic 
• Mx = exclude other Dx (PE, anaphylaxis) --> treat fracture (no cement)
• A) ETT (req in 40%)
• B) FiO2 1.0, ARDS-ventilation
• C) fluids, pressors, inotropes, coags correct (DIC)
• D/E) normal sugar/temp
• ICU post-op, resolves <7 days

Explain the cardiovascular effects of central neuraxial blockade

2019B08 62.6%

2013C12 56.0%

2013A12 38.0%

Explain the effects of intermittent positive pressure ventilation on cardiac output

2021B01 56.5%

2019A01 54.7%

2014A05 37.6%

2013B01 19.7%

Pharmacology - Dose, Onset (Mechanism of Action - Accommodation, Phase II Block), Offset, Side Effect (Summary)

Describe how suxamethonium produces neuromuscular blockade. What is the mechanism of recovery of neuromuscular function and what mechanisms may be involved in Phase II block?

Outline the central nervous system effects of an awake person breathing air containing CO2.