Stripp TK, Jorgensen MB, Olsen NV. Anaesthesia for electroconvulsive therapy – new tricks for old drugs: a systematic review. Acta Neuropsychiatr. 2018 Apr;30(2):61-69. doi: 10.1017/neu.2017.12. Epub 2017 May 2. PMID: 28462732. Physiology and Physical Effects Cardiovascular effects: Secondary to autonomic nervous system activation Initial parasympathetic discharge Bradycardia Hypotension Asystole Prominent sympathetic response follows. Systolic […]
By Victor Li Key Reference: Harding D, Marsh S, Lennie Y. Perioperative considerations for transgender and gender diverse adults. BJA Education. 2023;23(4):136-143. doi:https://doi.org/10.1016/j.bjae.2022.12.005 You are reviewing your patient list when you come across Ms Sue Doenim, a 23yo to be seen in the pre-admission clinic for an elective laparoscopic cholecystectomy. Upon meeting Sue, he informs you […]
What should I know? Basic Anatomy In the adult, the spinal cord ends at the level of L1-2 Spinal anaesthesia/lumbar puncture aims to insert the spinal needle into the subarachnoid space Spinal needles will have to go through several layers skin—subcutaneous tissue—supraspinous ligament—interspinous ligament—ligamentum flavum – epidural space—dura mater—subarachnoid space Spinal anaesthesia for caesarean sections […]
By Dr Garzarella Metabolic acidosis Expected pCO2 = 1.5 × [HCO3] +8 ±2 Metabolic alkalosis Expected pCO2 = 0.7 × [HCO3] +20 ±5 Mechanism In metabolic acid-base disturbances, chemoreceptors sense an abnormal pH and stimulate the respiratory centre to increase or decrease ventilation to compensate Example 1. 62F presents to the emergency department with peritonitis […]
Cardiac arrests are associated with significant mortality and are often unexpected and extremely stressful for the practitioners involved. Cardiopulmonary resuscitation is arguably one of the most important skills for medical practioners. Previous research has shown that the non-technical skills of the team leader is directly related to technical performance of the team, particularly under stressful […]
Definition of Tourniquet: a constricting or compressing device used to control venous and arterial circulation to an extremity for a particular duration. Tourniquets are commonly used during limb surgeries (particularly in plastic and orthopaedic surgery) to limit blood loss and optimise surgical conditions. The application of a tourniquet results in physiological changes which, although mostly […]
Bradycardia is defined as a heart rate below 60bpm and occurs commonly under anaesthesia. Although most bradycardias are benign, they have the potential to cause haemodynamic compromise and progress to asystole/cardiac arrest. Being able to predict when a bradycardia may occur, as well as understanding the underlying cause, is pivotal to early and successful treatment. […]
An 80kg 50yo male enters theatre directly from the emergency department for an urgent laparotomy. He has been involved in a motor vehicle accident and is thought to have lost up to 4L of blood. Despite valiant efforts at resuscitation, you know that he is still significantly unstable and under volume. […]
By Adam George Definition Hypercalcaemia indicates a total serum calcium (Ca) concentration corrected for albumin of >2.6 mmol/L. hypercalcaemia can loosely be stratified as follows: Mild/moderate (>2.6-2.9 mmol/L) Severe (>3.0 mmol/L) Approximately 99% of calcium in vivo is stored in bone as hydroxyapatite. […]
The PADDI trial by Dr. Matthew Vella @mjv.igee PADDI (The Perioperative ADministration of Dexamethasone and Infection Trial) Corcoran, T. B., Myles, P. S., Forbes, A. B., Cheng, A. C., Bach, L. A., O’Loughlin, E., Leslie, K., Chan, M. T. V., Story, D., Short, T. G., Martin, C., Coutts, P., Ho, K. M., PADDI Investigators, Australian […]