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Although near-miss situations are relatively rare in anesthesiology, it is essential to know how to respond if the situation arises. This collection of actual cases, compiled from the author's 30+ years practice in major metropolitan hospitals in the US, Sweden and South Africa, is an excellent review of potential problems and solutions all anesthesiologists should be familiar with. The cases are succinct, with the problem and a solution described, then concluded by a retrospective analysis that examines whether the solution used was actually the best (or only) choice, or if other solutions might provide equally satisfactory outcomes. Also included in the analyses are tips to help avoid the problem altogether, when possible. This book is an excellent review for the ABA oral exam and is an easy and practical way to prepare for the unexpected in the daily practice of clinical anesthesia. TOC:No fiberoptic intubation system: a potential problem?.- Is the patient extubated?.- A strange computerized ECG interpretation.- Fractured neck of femur in an elderly patient.- Spinal anesthetic that wears off before surgery ends.- Understanding DNR/DNI orders.- Burn prevention in the operating room.- Inguinal hernia repair in a diabetic patient.- Case of the hidden IV.- Ideal pulse oximeter placement.- Awake craniotomy with language mapping.- Gum elastic bougie to facilitate intubation.- External vaporizer leak during anesthesia.- Manual ventilation by a single operator: Omar's slave for difficult positioning.- Life threatening arrhythmia in an infant.- Tongue ring: Anesthetic risks and potential complications.- Hasty C-arm positioning: A recipe for disaster.- Inability to remove a nasogastric tube.- An unusual cause of difficult tracheal intubation: Religious beliefs and customs.- Pulmonary edema following abdominal laparoscopy.- Difficult laryngeal mask airway placement: A possible solution.- Postoperative airway complication following sinus surgery.- Investigating an unusual capnograph tracing: Check your connections.- Endotracheal intubation for atransjugular intrahepatic porto-systemic shunt (TIPS) procedure.- Tracheostomy by an anesthesiologist: Be prepared.- General anesthesia for a patient with a difficult airway and a full stomach.- Jehovah's Witness and a potentially bloody operation.- Intraoperative insufflation of the stomach.- Sudden intraoperative hypotension.- Overestimation of blood pressure from an arterial pressure line.- Severe decrease in lung compliance during a code blue.- Shortening postoperative recovery time after an epidural: Is it possible? .- Difficult airway in an under-equipped setting.- Delayed cutaneous fluid leak following removal of an epidural catheter.- Traumatic hemothorax and same-side central venous access.- An apparent single abdominal knife wound: Check for other wounds.- A draw-over vaporizer with a non-rebreathing circuit.- Unexpected intraoperative "oozing".- Central venous access and the obese patient.- Taking over for a colleague: Check the facts and know the medications.- Intraoperative epidural catheter malfunction.- Breathing difficulties after an ECT.- White clumps in the blood sample from an arterial line: Beware of heparin-induced thrombocytopenia.- Anesthesia for a surgeon who has previously lost his privileges.- Airway obstruction in a prone patient.- Expected length of case: A question you should always ask.- Postoperative vocal cord paralysis.- Substance abuse by a colleague: a serious problem.- A leaking endotracheal tube in a prone patient.- Lessons from the field: Unusual problems require unusual solutions in impossible situations.- Avoiding air embolism during administration of albumin.- Trouble-shooting leaks: A loud "pop" intraoperatively and now you can't ventilate.- Postoperative median nerve injury.- Patient in a halo: Intraoperative adjustments change your view and access.- Now or never: Developing professional judgment.- General anesthesia in a patient with chronic amphetamine use.- What's wrong with this picture? Left-handed instrumentation.- The one eyed patient.- A near tragedy.- Robot assisted surgery: a word of caution.- An airway mergency in an out of hospital surgical office.- Another use for the nerve stimulator.
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- Verlag: Springer-Verlag GmbH
- Erscheinungstermin: 11.01.2008
- ISBN-13: 9780387725253
- Artikelnr.: 37288537
Table of Contents 1 Case 1: No Fibro-Optic Intubation System - A Potential Problem 2 Case 2: Is the Patient Extubated? 3 Case 3: A Strange Computerized ECG Interpretation 4 Case 4: An Elderly Lady with a Fractured Neck of Femur 5 Case 5: A Spinal Anesthetic That Wears Off Before Surgery Ends. What to Do? 6 Case 6: Just a Simple Monitored Anesthesia Care (MAC) Case 7 Case 7: Smell of Burning in the Operating Room 8 Case 8: A Diabetic Patient for Inguinal Hernia Repair 9 Case 9: The Case of the "Hidden" IV 10 Case 10: Postoperative Painful Eye 11 Case 11: Awake Craniotomy 12 Case 12: Gum Elastic Bougie 13 Case 13: You Smell Anesthesia Vapor. Where Is It Coming From? 14 Case 14: Manual Ventilation of a Patient Turned 180 Degrees Away From the Anesthesia Machine by a Single Operator. Is It Possible? 15 Case 15: Life Threatening Arrhythmia in a 5 Month Old 16 Case 16: Tongue Ring 17 Case 17: Hasty C-Arm Positioning. A Recipe for Disaster. 18 Case 18: Inability to Remove a Nasogastric Tube 19 Case 19: An Unusual Cause of Difficult Tracheal Intubation 20 Case 20: Pulmonary Edema Following Abdominal Laparoscopy 21 Case 21: A Possible Solution to a Difficult Laryngeal Mask Airway Placement 22 Case 22: Postoperative Airway Complication Following Sinus Surgery 23 Case 23: An Unusual Capnograph Tracing 24 Case 24: A Respiratory Dilemma during a Transjugular Intrahepatic Porto-Systemic Shunt Procedure (TIPSS) 25 Case 25: A Tracheotomy is Urgently Needed and You Have Never Done One 26 Case 26: General Anesthesia for a Patient with a Difficult Airway and Full Stomach 27 Case 27: A Jehovah's Witness Patient and a Potentially Bloody Operation 28 Case 28: Laparoscopic Achalasia Surgery 29 Case 29: Sudden Intraoperative Hypotension 30 Case 30: Blood Pressure Difference between a Non-Invasive and an Invasive Blood Pressure Measurement 31 Case 31: Severe Decrease in Lung Compliance during a Code Blue 32 Case 32: Shortening Post-Anesthesia Recovery Time after an Epidural. Is It Possible? 33 Case 33: At Times You Need To Be a MacGyver 34 Case 34: Delayed Cutaneous Fluid Leak from a Puncture Hole after Removal of an Epidural Catheter 35 Case 35: Traumatic Hemothorax and Same Side Central Venous Access 36 Case 36: A Single Abdominal Knife Wound. Easy Case? 37 Case 37: A Draw-Over Vaporizer with a Non-Rebreathing Circuit 38 Case 38: Unexpected Intraoperative "Oozing" 39 Case 39: Central Venous Access and the Obese Patient 40 Case 40: Check Your Facts 41 Case 41: Intraoperative Epidural Catheter Malfunction 42 Case 42: Breathing Difficulties after an ECT 43 Case 43: White "Clumps" in the Blood Sample from an Arterial Line 44 Case 44: Anesthesia for a Surgeon Who Has Previously Lost His Privileges 45 Case 45: Airway Obstruction in an Anesthetized Prone Patient 46 Case 46: A Question You Should Always Ask 47 Case 47: Postoperative Vocal Cord Paralysis 48 Case 48: This Is a Serious Problem 49 Case 49: A Leaking Endotracheal Tube in a Prone Patient 50 Case 50: An Impossible Situation? 51 Case 51: An "Old Trick" But a Potential Serious Problem 52 Case 52: A Loud "Pop" Intra-Operatively and Now You Can't Ventilate 53 Case 53: Postoperative Median Nerve Injury 54 Case 54: A Patient in a Halo 55 Case 55: It Is Now or Never 56 Case 56: General Anesthesia in a Patient with Daily Use of Prescribed Amphetamine 57 Case 57: What Is Wrong With This Picture? 58 Case 58: The One-Eyed Patient 59 Case 59: A Near Tragedy 60 Case 60: Robot Assisted Surgery. A Word of Caution. 61 Case 61: An Airway Emergency in an Out of Hospital Surgical Office 62 Case 62: A Case of Recent Hip Replacement Coming For a Cystoscopy 63 Case 63: A High Glucose Concentration in an Epidural Catheter Aspirate. Should One Be Concerned? 64 Case 64: A General Anesthesia in a Patient Who Has Had a Recent Eye Operation
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