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An anesthesia machine, with the vitalsigns monitor screen on the left, and the electronic medical records computer screen on the right. His vitalsigns are heart rate = 100, BP = 150/80, respiratory rate = 20 breaths/minute, oxygen saturation 95% on room air, and temperature 100.2 The BP is 100/50.
Your station in the operating room consists of an anesthesia machine; a bevy of vitalsigns monitors; a computerized pharmacy cart; a cart full of syringes and equipment; and the computer which handles the hospital’s electronic medical record (EMR). You may have nausea after generalanesthesia.
On physical exam, her vitalsigns are normal, her lungs are clear, and her heart exam is positive for the clicking sound of a mechanical valve and a 2/6 systolic murmur. The surgeon injects 2% lidocaine at the skin incision site, and the surgery begins. Vitalsigns remain normal with BP=110/70, P=80, and oxygen saturation=99%.
Even though the patient was brain dead, it was imperative to maintain his or her vitalsigns and oxygenation at optimal levels to preserve the cardiac function for the eventual recipient. I also had to fill out a written anesthesia medical record to document what I was doing to the patient. At this point my work began.
Prior to the pulse oximeter, anesthesiologists had only unreliable measures of tissue oxygenation, such as observing how red the blood seemed when the surgeon made the initial incision into the patient. Anesthesia was a more dangerous undertaking without true second-to-second knowledge of the patient’s oxygenation.
Prior to surgery your patient tells you, “I always get a hangover after generalanesthesia. Hangover after generalanesthesia (HAGA) describes a patient who has a safe general anesthetic, but who then feels hungover, sedated, and wasted for a time period exceeding two hours afterwards. The patient is always right.
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