emedicina How to Survive in Anaesthesia emedicina emedicina How to Survive in Anaesthesia A guide for trainees Second edition Neville Robinson Department of Anaesthesia, Northwick Park and St Mark’s Hospitals, Harrow, Middlesex and George Hall Department of Anaesthesia, St George’s Hospital Medical School, London emedicina [...]... secondary brain damage after trauma Indications for endotracheal intubation in the head-injured patient Guidelines for transferring head-injured patients Minimum requirements for conduct of anaesthesia Considerations for electroconvulsive therapy anaesthesia Anaesthetic considerations for patient transfer 15 5 15 5 15 6 15 6 15 8 15 9 16 1 16 2 16 3 16 5 16 6 16 6 16 7 16 8 17 1 17 2 17 4 17 5 17 6 17 7 emedicina List of... obtained before intubation An oesophageal detector A pressure-reducing valve Flow meter needle valve and rotameter Mapleson classification of rebreathing systems Coaxial systems of Bain (A) and Lack (B) Anatomy of the epidural space Tuohy needle, epidural catheter, and filter Application of cricoid pressure 5 6 9 10 11 16 30 30 39 40 11 0 11 2 12 3 xi emedicina emedicina List of tables Table 1. 1 Table 5 .1. .. of figures Figure 1. 1 Figure 1. 2 Figure 2 .1 Figure 2.2 Figure 2.3 Figure Figure Figure Figure 3 .1 7 .1 7.2 8 .1 Figure Figure Figure Figure 8.2 20 .1 20.2 21. 1 Structures seen on opening of mouth for Mallampati Grades 1 4 Line shows the thyromental distance from the thyroid cartilage to the tip of the chin Laryngeal mask correctly positioned before inflation, with the tip of the mask in the base of the... impossible, to intubate These patients cause anaesthetists unexpected 3 emedicina How to Survive in Anaesthesia problems and we have had the occasional experience of casually starting an apparently normal laryngoscopy, only to have the sinking feeling associated with complete failure to visualise the larynx It is much better to anticipate a difficulty than encounter one unexpectedly Some anatomical factors... anatomical landmarks Discharge scoring criteria Typical regimen for intravenous morphine PCA pump The Glasgow Coma Scale (GCS) Neurological assessment 6 21 26 27 63 79 10 8 11 7 15 9 16 8 17 3 xiii emedicina emedicina Preface to the second edition We are grateful for the many comments received about the contents and style of the first edition We have taken the opportunity to decrease the size of the book to. .. “pocket-book” and we have revised the text and added two new chapters Our main aim remains to provide a concise readable text that will introduce the new trainee in anaesthesia to safe clinical practice In addition, the contents of the book are applicable to many clinical aspects of the primary Fellowship examination of the Royal College of Anaesthetists Neville Robinson George Hall Preface to the... the first edition If you are a trained anaesthetist, you should not be reading this If you have just started anaesthesia, congratulations on your choice; you have joined the most interesting specialty in medicine which contains some of the most intelligent, well-adjusted consultants to be found in hospitals (we can think of at least two) In your first few weeks of anaesthesia you will be given much... 6 .1 Table Table Table Table Table 6.2 12 .1 15 .1 20 .1 20.2 Table 27 .1 Table 29 .1 Table 30 .1 Wilson risk factor scoring system for difficult intubation Flow rates through typical venous cannulae Electrolytic composition of intravenous solutions (mmol/l) Properties of colloid solutions Blood products in common use Syracuse croup assessment scoring system Characteristics of local anaesthetic drugs Dermatomal... • History Symptoms Examination • anatomy and variants • medical conditions • specific assessment • Mallampati scoring system • Wilson risk factor scoring system • thyromental distance • sternomental distance Other tests History Any previous anaesthetic history must be obtained Information about difficulties with endotracheal intubation may be found in old anaesthetic records Previous successful intubation... considerations for spinal surgery Selection guidelines for day case surgery Discharge criteria for day case surgery Main objectives of care in the recovery area Causes of early postoperative hypoxaemia Typical criteria for discharge from recovery Claimed advantages of good postoperative analgesia Factors influencing postoperative pain General plan of postoperative analgesia Main side effects of NSAIDs . emedicina How to Survive in Anaesthesia emedicina emedicina How to Survive in Anaesthesia A guide for trainees Second edition Neville Robinson Department of Anaesthesia, Northwick. and St Mark’s Hospitals, Harrow, Middlesex and George Hall Department of Anaesthesia, St George’s Hospital Medical School, London emedicina