ANAESTHESIA - PowerPoint PPT Presentation

Loading...

PPT – ANAESTHESIA PowerPoint presentation | free to view - id: 41e400-MjM4Y



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

ANAESTHESIA

Description:

... adverse physiologic responses to endotracheal intubation. ABC s Preparation Monitor Preoxygenate Premedicate Sedate Rapid sequence intubation (RSI) ... – PowerPoint PPT presentation

Number of Views:64
Avg rating:3.0/5.0
Slides: 29
Provided by: qehaeOrgf
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: ANAESTHESIA


1
ANAESTHESIA ANALGESIA in AE
  • Joanne Bradford

2
Anaesthesia in AE
  • Local anaesthesia
  • Local infiltration
  • Regional anaesthesia
  • Conscious sedation
  • Dissociative anaesthesia
  • Rapid sequence intubation

3
Local anaesthesia
  • Indications
  • Uses
  • Contraindications
  • Toxic effects/Complications
  • BE PREPARED FOR RESUSCITATION

4
Local anaesthesia
  • Agents
  • Lignocaine
  • Bupivacaine
  • Dose
  • Adjuncts additives
  • Topical anaesthesia
  • Regional anaesthesia

5
Regional anaesthesia
  • Peripheral nerve blocks
  • Haematoma blocks
  • Intravenous arm block (Biers block)

6
Some common nerve blocks
  • Orofacial blocks
  • Wrist block
  • Ring (digital) block
  • Intercostal block
  • Femoral nerve block
  • Ankle block
  • Penile block

7
Wrist block
8
Wrist block
9
Digital block
10
Digital block - Toes
11
Femoral block
12
Ankle block - the sole
13
Ankle block - dorsum
14
Intercostal block
15
Penile block
16
Conscious sedation
  • minimal depression in the level of consciousness
    while maintaining a patent airway responding
    appropriately to stimulation or commands.
  • Indications
  • Agents
  • Benzodiazepines
  • Narcotics
  • Route i.v. commonly
  • Side effects

17
Rapid sequence intubation (RSI)
  • a technique for emergency airway control
    designed to minimize the adverse physiologic
    responses to endotracheal intubation.
  • ABCs
  • Preparation
  • Monitor
  • Preoxygenate
  • Premedicate
  • Sedate

18
Rapid sequence intubation (RSI)
  • Cricoid pressure
  • Intubate
  • ETT placement
  • Maintenance of sedation paralysis
  • Monitor
  • Appropriate disposal of patient

19
Dissociative anaesthesia
  • ..is characterized by amnesia, analgesia,
    sedation with maintenance of protective reflexes.
  • Agent Ketamine
  • Routes of administration
  • Side effects
  • Advantages
  • Contraindications/Special precautions

20
Management of anaesthetized patient
  • Patient selection
  • Informed consent
  • Preparation
  • Patient
  • Personnel
  • Equipment
  • Medication
  • Monitoring
  • Disposition

21
Management - Monitoring
  • O2 sat
  • Respiration depth, rate
  • HR
  • BP
  • Patient responsiveness/ awareness
  • Done before, during and after the procedure by
    both nursing and medical personnel.

22
Management - Disposition
  • Discharge criteria conscious sedation
  • Normal vital signs for ½ hr
  • Minimal or no nausea, vomiting or dizziness
  • Able to retain oral fluids
  • Able to void
  • Receives,comprehends retains discharge
    instructions
  • Responsible person available to accompany patient
  • Appropriate transportation from hospital

23
Analgesia in AE
  • Physical modalities
  • Explanation
  • Splintage
  • Dressings
  • Definitive Rx
  • Pharmacological modalities
  • Systemic
  • Nonsystemic
  • Others

24
Pharmacological Agents
  • SYSTEMIC
  • Oral parenteral medication
  • Non-opioids
  • NSAIDs
  • Acetaminophen
  • Ketamine
  • Opioids
  • Codeine
  • Pethidine
  • Morphine
  • Fentanyl

25
Pharmacological agents
  • NONSYSTEMIC
  • Local anaesthetics
  • Lignocaine
  • Bupivacaine
  • Others
  • Topical agents (NSAIDs, ethyl chloride spray,
    EMLA)
  • Alternative/allopathic
  • Adjuncts

26

Management of patient with pain
  • ABCs
  • ? Acute or chronic
  • Appropriate modality
  • ? Physical /or Pharmacologic
  • Pharmacological
  • Route of administration
  • Dose
  • Side/toxic effects
  • Adjuncts

27
Analgesia in special situations
  • Head injury
  • Migraine
  • Abdominal pain ( acute abd., renal colic)
  • SCD
  • Special Groups (children, elderly,pregnancy)
  • Asthma
  • Chronic pain
  • Drug addiction

28
Suggested reading
  • Tintinalli et al Emergency Medicine. A
    comprehensive study guide 5th Ed. Chap. 33
  • Rosen et al Emergency Medicine. Concepts
    Clinical Practice 4th Ed. Chap. 21
  • Roberts et al Clinical Procedures in Emergency
    Medicine 3rd Ed. Chaps. 31 - 35
  • Annals Emerg Med. 2855-74, 1996
  • Emerg Med Clin North Am 15399-415, 1997
About PowerShow.com