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Imagine this scenario: You’ve just finished anesthetizing a patient in a hospital setting, and the patient now requires transport from the operating room (OR) to the post-anesthesiacare unit (PACU). It’s common for zero monitoring equipment to be attached to the patient. We need pulse oximetry monitoring.
Let’s look at a case study which highlights a specific risk of generalanesthesia at a freestanding surgery center or a surgeon’s office operating room, when the anesthesiologist departs soon after the case is finished. I’ve personally performed over 7,000 general anesthetics in freestanding surgery centers and office operating rooms.
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.
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.
An anesthesia emergency occurs without warning. Your patient’s vitalsigns are dropping. You need the ultimate anesthesia emergency guidebook. That ultimate guidebook is the S tanford Emergency Manual of Cognitive Aids for Perioperative Critical Events S , written by the Stanford Anesthesia Cognitive Aid Group.
Propofol infusions are typically used to make our patients sleep, and most propofol infusions cross the American Society of Anesthesiologists line into generalanesthesia. You may make the surgeon happy, and you may continue to have a safe airway under generalanesthesia in the absence of the endotracheal tube, but what if you don’t?
Alerts or abnormal vitalsigns and laboratory results are represented by squares and triangles, respectively. The Tower Mode view looks like this (Figure 1): Figure 1 Census View, Anesthesia Tower The Tower Mode includes a display for each individual patient (Figure 2 below). Will I Have a Breathing Tube During Anesthesia?
When you want to accelerate the heart rate in the operating room or the postanesthesiacare unit, use the first drug recommended in the ACLS and American Heart Association bradycardia algorithms—and that drug is atropine. Why Did Take Me So Long To Wake From GeneralAnesthesia? Do this while your memory is fresh.
Prior to surgery your patient tells you, “I always get a hangover after generalanesthesia. Listen to them and adjust your care. 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.
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