10. General anesthesia - general anesthesia stages. Intensive care in maxillofacial surgery. Flashcards
(46 cards)
Four stages of general anesthesia
- Minimal Sedation (Anxiolysis):
* Normal response to verbal stimulation
* No impact on airway, ventilation, or cardiovascular function - Moderate Sedation (Conscious Sedation):
* Purposeful response to verbal or tactile stimulation
* Airway and ventilation not compromised
* Cardiovascular function maintained - Deep Sedation/Analgesia:
* Responce after repeated or painful stimulation
* Possible need for assistance in maintaining airway and ventilation
* Cardiovascular function is maintained - General Anesthesia:
* Unarousable even with painful stimulation.
* Airway intervention is required
* Possible support needed for ventilation and potential impairment of cardiovascular function.
Role of an Intensive Care Unit (ICU) in a hospital setting
- Patients with severe and life-threatening illnesses and injuries
- Constant, close monitoring and support from specialist equipment and medications
- Staffed by highly trained doctors and nurses
- Higher staff-to-patient ratio
- Access to advanced medical resources and equipment
Types of conditions commonly treated in ICUs
- Acute respiratory distress syndrome (ARDS),
- Trauma, multiple organ failure, and sepsis
Different types of ICUs based on medical specialties
- Neonatal Intensive Care Unit (NICU):
- Pediatric Intensive Care Unit (PICU):
- Psychiatric Intensive Care Unit (PICU):
- Coronary Care Unit (CCU):
- Neurological Intensive Care Unit (NeuroICU):
- (Trauma ICU):
- Post-Anesthesia Care Unit (PACU):
- High Dependency Unit (HDU): A transitional unit for patients requiring close observation and care not critical enough for ICU.
- Surgical Intensive Care Unit (SICU): Provides care for critically ill surgical patients, managed by surgeons trained in critical care
Mobile Intensive Care Unit (MICU) and how it functions
- Specialized ambulance equipped to provide on-scene advanced life support=>
- Resuscitation and intensive care during transport
Types of equipment and systems commonly found in an ICU
- Mechanical ventilators
- Cardiac monitors, equipment for constant monitoring of bodily functions
- Intravenous lines, feeding tubes, nasogastric tubes
- Suction pumps, drains, catheters
- Wide array of drugs
What is covered in the personal history of a patient
- Habits like chewing tobacco
- Alcohol consumption
- Smoking, drug abuse, and exposure to commercial sex workers
Purpose of routine haematological investigations in oral and maxillofacial surgery
- Overall health status
- Detect infections
- Assess nutritional status
- Identify bleeding disorders and evaluate the immune response to facilitate postoperative recovery
What haemoglobin (Hb) indicates in a blood test
Indicates the oxygen-carrying capacity of the blood
Normal haemoglobin values for males and females
- Females: 12 to 16 g/dL
- Males: 14 to 18 g/dL
g/dL- grams per decilitre
Decreased haemoglobin value suggests
- Anaemia=>iron deficiency
- Decreased absorption of vitamins and minerals
- Bone marrow depression, increased blood loss
What should be done if a patient has low haemoglobin
Referred to specialists
What a complete blood count (CBC) includes
- Red blood cell count
- White blood cell count
- Differential white blood cell count
- Platelet number estimation, and a blood smear description
Benefits of performing a CBC
- Helps to determine nutritional status
- Detect infections
- Identify bleeding disorders
- Evaluate the patient’s immune response
Normal values for red blood cell count in males and females
- Females: 4.5 to 5.5 million cells per cu mm
- Males: 4.5 to 6.2 million cells per cu mm
cu= cubic millimetres (mm3)
Conditions are associated with decrease in red blood cell count
- Anaemia, pellagra
- Haemorrhage, and liver disease
Conditions associated with an increase in red blood cell count
- Polycythaemia and extreme dehydration
Normal values for white blood cell count in adults and children
- Adults: 5000 to 10000 cells per cu mm
- Children below 7 years: 6000 to 15000 cells per cu mm
Conditions that cause an increased white blood cell count (leucocytosis)
- Acute infections
- Uraemia, leukaemia, and steroid therapy
Conditions that cause a decreased white blood cell count (leukopenia)
- Aplastic anaemia, radiation therapy
- Infectious mononucleosis, malaria, AIDS
Physiological factors can cause an increase in WBC count
- Pregnancy, exposure to heat and cold
- Muscular exercise, and emotional stress
Normal distribution of polymorphonuclear leukocytes (neutrophils) in a differential white blood cell count
Neutrophils: 50 to 70 percent
Conditions that cause an increase in neutrophils
- Infections, granulocytic leukaemia
- Post-surgery, severe exercise
Conditions that cause a decrease in neutrophils
Aplastic anaemia, viral infections, and patients undergoing radiation
