Anaesthesiajournal.co.uk
Shock: causes, assessment and investigation
WebShock is a life-threatening clinical state in which cellular hypoxia develops due to an imbalance between oxygen supply and demand resulting in end organ dysfunction. It is the end result of a number of pathophysiological processes, and multiple processes may coexist. Shock may be reversible in early stages; however, if appropriate …
Actived: 5 days ago
URL: https://www.anaesthesiajournal.co.uk/article/S1472-0299(22)00298-3/fulltext
Critical care management of adult traumatic brain injury
WebSevere traumatic brain injury (TBI) is associated with significant morbidity and mortality. The critical care management of TBI requires a coordinated and comprehensive approach to treatment, including strategies to prevent secondary brain injury and maintenance of adequate cerebral perfusion and oxygenation. Management protocols …
Anatomy of the larynx, trachea and bronchi
WebThe anatomy of the airway is a core topic in anaesthesia, and a detailed knowledge is expected for examinations as well as in everyday practice. This article presents the most important aspects of airway anatomy from the point of view of the anaesthetist, with particular emphasis on understanding the clinical implications of the relevant structures …
Systemic toxic effects of local anaesthetics
WebLocal anaesthetics are widely used in the provision of local/regional anaesthesia and the management of acute and chronic pain. Their mechanism of action temporarily inhibits voltage gated sodium channels in neuronal plasma membranes. Local anaesthetic systemic toxicity (LAST) is a serious yet largely preventable complication that can occur by any of …
Sepsis 2021: a review
WebSepsis is responsible for tremendous morbidity, mortality and health-care expenditure worldwide. Over the past decade, the conceptualization of sepsis has shifted from one based upon an inflammatory response to one defined by a dysregulated immune response to infection and resulting organ dysfunction. The definitions of sepsis and …
A clinical approach to coma: neurological assessment of the …
WebComa is a state marked by the absence of arousal (wakefulness, vigilance) and awareness of one's self and environment. Patients in coma do not respond to internal or external stimuli and cannot be roused. Coma results from diffuse dysfunction of neuronal systems that govern awareness and arousal, and is a neurological emergency. The three …
Health information and the importance of clinical coding
WebClinical coding is the process of converting health information, which may be a combination of free text language and a clinician's interpretation of this, into a computer-readable formal language. Well-known examples of clinical coding systems include the International Classification of Diseases (ICD-10) and Systematized Nomenclature of …
Physiology of human fluid balance
WebThe physiology of fluid balance in humans should be understood and applied in clinical practice. Fluid balance, when managed accurately and safely, can prevent significant morbidity and mortality. Anaesthesia and critical care patients are often fasted and under physiological stress. Therefore, homoeostatic regulation of fluid balance is …
Induction of anaesthesia
WebGeneral anaesthesia is a temporary state of unconsciousness which is induced to facilitate a therapeutic procedure. Induction is the first stage of a sequential process. It commences with patient preparation and assessment away from theatre then continues in the safe and monitored environment of the anaesthetic room or operating theatre where the …
Patient recovery and the post-anaesthesia care unit (PACU)
WebThe PACU, often referred to as the recovery room, is a specif-ically designed clinical area within the theatre complex in which patients receive ongoing care after surgery and anaesthesia. These areas are staffed by trained individuals who provide direct patient care until fitness for discharge to ward-based care or in some cases, transfer to
Malignant hyperthermia
WebMalignant hyperthermia (MH) is a life-threatening condition characterized by signs of hypermetabolism during general anaesthesia. There is a wide variability in the magnitude of these signs. Early recognition and immediate management are essential in preventing morbidity and mortality. A MH crisis is a rare reaction caused by abnormal …
Electrolyte disorders in the critically ill
WebElectrolyte disorders are ubiquitous in the critically ill patient. Abnormalities may provide clues to the diagnosis, severity and even prognosis of illnesses. Abnormal serum electrolytes can be a marker of total body electrolyte deficit or excess, or movement between compartments. Despite the morbidity and mortality associated with electrolyte …
Management of shock in trauma
WebShock is defined as failure of the circulatory system resulting in a level of perfusion to tissues, which is inadequate to meet the oxygen demands of cellular metabolism. Haemorrhagic shock is most commonly associated with trauma. Haemorrhage is a leading cause of preventable death in trauma and over the past two decades there …
Tracheal intubation
WebTracheal intubation is the act of placing a tube into the trachea thus enabling oxygen delivery and carbon dioxide removal. Intubation is the most reliable method of maintaining an airway under anaesthesia, and for protecting against aspiration of stomach contents. Traditionally, intubation is achieved by direct visualization of the glottis, but …
Patient recovery and the post-anaesthesia care unit
WebPatient recovery is a period of active patient monitoring and management during which time airway reflexes return and respiratory and cardiovascular stability should be achieved. The post-anaesthetic care unit (PACU) is the specially designed clinical area in which staff trained in the recognition and management of potential complications arising …
Shock: causes, assessment and investigation
WebShock is a life-threatening clinical state in which cellular hypoxia de-velops due to an imbalance between oxygen supply and demand resulting in end organ dysfunction. It is the end result of a number of pathophysiological processes, and multiple processes may coexist. Shock may be reversible in early stages; however, if appropriate treat-ment
Cleaning, disinfection and sterilization of equipment
WebDecontamination is a combination of processes, in which pathogens are removed, inactivated or destroyed, to render a reusable item safe for further use. It comprises cleaning and either disinfection or sterilization as appropriate. Cleaning physically removes infectious agents and the organic matter on which they thrive, but does not necessarily destroy them.
Clinical audit, quality improvement and data quality
WebClinical audit and quality improvement are essential processes that help to ensure that patients receive safe, effective, and high-quality care. By participating in clinical audit and quality improvement initiatives, anaesthetists can gain a deeper understanding of the care provided to patients and identify areas for improvement. Ensuring good data …
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