Peri Operative Complications

Question 1

Cause of severe hypotension in theater

Answer 1

Hypovolemia
Obstructed venous return
Intrathoracic pressure
Anaphylaxis
Embolus
Cardiac failure
Days rythmas
Severe sepsis
Shock
Anaesthetic

Question 2

Management of severe hypotension

Answer 2

O2
Look for cause ABCD
Tredenlenburg
IV fluid challenge
Vasoconstrictors or inotropes
Treat underlying cause
Investigation - ECG, ABGs, echo, troponin, CXR

Question 3

Causes of hypertension in theatre

Answer 3

Inadequate depth of anaesthesia
Pain
Anaesthestics
Hypoxia
Pre eclampsia
Raised ICP
Thyroid storm
Carcinoidsyndrom
Phaechromocytoma

Question 4

Management of hypertension in theatre

Answer 4

Stop surgery until controlled
Confirm readings
Increase depth of anaesthesia
Vasodilators - BBlockers, calcium channel b
Investigations - ECG, troponin, echo, CXR, thyroid function test, 24h urine catecholamines,

Question 5

Causes of severe hypoxia in theatre

Answer 5

Incorrect flow meter settings
Machine or 02 failure
Hypoventilation
Misplaced ETT
Airway obstruction
Atelectasis
Pulmonary edema
Aspiration
Pre existing pathology
Embolus

Question 6

Severe hypoxia management

Answer 6

100% o2
Call for help
Check airway and ventilation
Check cardio
Investigation - spo2, capnography,, temperature, CXR, abg

Question 7

Severe bronchospams with wheeze, silent chest , increased airway pressure and HR, management

Answer 7

100% o2
Salbutamol 250microgIV or 250gaminophylline slow IV
Hydrocortisone 200mg
Cxr, ABG, comsider circuit obstruction, ett patency, foreign body , anaphylaxis pneumothorax

Question 8

Presentation of pulmonary edema

Answer 8

Increased HR, RR, CVP, PAOP, decreased spo 2
Pink frothy sputum

Question 9

Management pulmonary edema

Answer 9

100% o2
Sit up or reverse trendelenburg
Opioids
Diuretics
Vasodilators
Investigate - cxr, abg, echo,

Question 10

Aspiration management

Answer 10

Secure airway
Suction
100% o2
Empty stomach
Cxr, brochonscooy,

Question 11

Air or gas embolism ménagement

Answer 11

Stop gaopen wound lower than heart
Flood wound and compress drainage veins
Increase venous pressure
ECG, cxr,

Question 12

Anaphylaxis presentation

Answer 12

Wartime and skin flushing
Itching urticaria
Angioedema
Tingling of lips, tongue
Edema of lips tongue and uvula
Sneezing congestion
Throat tightness, hoarseness stridor
Dyspnea , chest tightness, wheezing, cyanosis
Nausea vomiting
Syncope
Palpitation, tachycardia, cardiac arrest
Anxiety, seizures, headache confusion, behavioral change in babies
Period obit Al itching and edema

Question 13

Anaphylaxis management

Answer 13

Remove trigger
100% o2
Elevate legs and fluid resuscitation
Iv adrenaline 20-50 microg
Chlorphenamine 10-20mg

Question 14

Intra-arterial injection management

Answer 14

Stop injection
Label cannula
Flush Normal saline
Maintain tissue perfusion
Consider anticoagulant therapy

Question 15

Local anesthetic toxicity management

Answer 15

Stop administration
Resuscitate, and support
Treat seizures benzodiazepine
Lipid emulsion therapy ( 100 ml bolus ig 2-3mins infusion 250ml over 20mins
Airway management Hundred percent oxygen