ABCs of Anaesthesia

Part 2 Final Exam Viva Demonstration - Parkinson's Disease and Fractured NOF with Faith


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Great work with this viva and especially after doing a hectic night shift! seriously well done!

Here are some of the resources mentioned:

GUIDELINES ON PERIOPERATIVE MANAGEMENT OF ANTICOAGULANT AND ANTIPLATELET AGENTS December 2018
https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0006/458988/Guidelines-on-perioperative-management-of-anticoagulant-and-antiplatelet-agents.pdf

Management of Proximal Femoral Fractures 2011
https://anaesthetists.org/Portals/0/PDFs/Guidelines%20PDFs/Guideline_management_proximal_femoral_fractures_2011_final.pdf?ver=2018-07-11-163755-037&ver=2018-07-11-163755-037

Do Not Attempt Resuscitation (DNAR) Decisions in the Perioperative Period
https://anaesthetists.org/Portals/0/PDFs/Guidelines%20PDFs/New%20archived/Guidelines_DNAR_decisions_perioperative_period_2009_final_.pdf?ver=2020-12-01-093913-800×tamp=1606819367259

Camptocormia (Bent Spine Syndrome)
https://en.wikipedia.org/wiki/Camptocormia

The optimal effect site concentration of remifentanil in combination with intravenous midazolam and topical lidocaine for awake fibreoptic nasotracheal intubation in patients undergoing cervical spine surgery

https://pubmed.ncbi.nlm.nih.gov/22240620/
Conclusion: The estimated EC(95) of remifentanil Ce for smooth nasotracheal fibreoptic intubation with conscious sedation was 3.38 (95% CI 2.90-3.46) ng·mL-1 when used in combination with midazolam and topical lidocaine. Remifentanil TCI may provide a tolerable experience of awake fibreoptic intubation despite the high incidence of recall.

Crisis Resource Management in Anaesthesia
https://youtu.be/i-rRipHMZ5Q
https://youtu.be/3DC8onloQ38
https://vimeo.com/461283262

Fat embolism syndrome:
Distinct pattern of clinical symptoms and signs following fat emboli,
-        more frequent in closed fractures
-        mostly associated with fractures of long bones. (1-3% single long bone or 33% bilateral femoral)
-        overall mortality 5 – 15%
-        typically presents 24 – 72 hours post injury (rarely 12 hrs to 2 weeks)
-        classic triad: respiratory changes, neurological abnormalities, petechial rash (not always present)
-        other clinical features include pyrexia, tachycardia, right heart strain, myocardial depression coagulopathy & renal changes

 Bone cement implantation syndrome:
·       No agreed definition. 
·       Characterised by hypoxia, hypotension, arrhythmias, increased PVR & cardiac arrest. 
·       Usually occurs at one of 5 stages: 
Femoral reaming
Acetabular and femoral cement implantation, insertion of prosthesis,  or joint reduction
·       Fat embolism seems to be the most likely aetiology

Disclaimer:
The information contained in this podcast is for medical practitioner education only. It is not and will not be relevant for the general public.
This contains general information about medical conditions and treatments. The information is not advice and should not be treated as such. 
The presenter makes no representations or warranties in relation to the medical information on this episode. 
You must not rely on the information as an alternative to assessing and managing your patient with your treating team and consultant.
You should seek your own advice from your medical practitioner in relation to any of the topics discussed in this episode’
Medical information can change rapidly, and the author/s make all reasonable attempts to provide accurate information at the time of filming. There is no guarantee that the information will be accurate at the time of viewing

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ABCs of AnaesthesiaBy Lahiru Amaratunge

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