Critical events Flashcards
1
Q
Anaphylaxis (what, signs, differential, management
A
Anaphylaxis is a type 1 hypersensitivity reaction. The antigen/drug binds to IgE on mast cells causing them to degranulate and release histamines, prostagladins and leukotrienes. This causes vasodilation, increase vessel permeability and smooth muscle contaction -> bronchospasm
Clinical signs are variable but ususally involved:
- CVS - hypotension, tachycardiac
- RESP - wheeze/bronchospasm & pulmonary oedema
- SKIN - oedema/rash
Management:
- Declare anaesthetic emergency and ask for help
- Stop giving likely drug
- Secure airway and give 100% oxygen
- IV/IM adrenaline
- IV crystalloid
- Assess response
Ongoing management:
- 10mg chlorphenamine 200mg Hydrocortisone
- Ongoing vasopressors & consider bicarbonate
- At 1 hour take mast cell tryptase
- Check for cuff leak prior to extubation
- HDU/ITU
Later management:
- refer to local allergy clinic
- yellow card
- document clearly and tell patient
2
Q
Aspiration
A
x
3
Q
Awareness
A
x
4
Q
Blood transfusion error
A
x
5
Q
Bradycardia
A
x
6
Q
Cyanosis
A
x
7
Q
Difficulty ventilating/high airway pressures
A
x
8
Q
Failed intubation (general patient)
A
x
9
Q
Failed intubation (obstetric patient)
A
x
10
Q
Failure to breath post general anaesthetic
A
x
11
Q
High spinal block
A
x
12
Q
Hypertension
A
x
13
Q
Hypotension
A
x
14
Q
Hypoxia
A
x
15
Q
Intra-arterial injection
A
x
