In medicine, there are innumerous amounts of tests and procedures performed every day. These procedures irrespective of how invasive or noninvasive they are require patients to be ‘Nil per Oral’ (NPO) for several hours prior to the procedure. Traditionally fasting preoperatively has been mandatory to prevent any risks related to aspiration during anesthesia. When anesthesia is induced in patients, it inhibits the patients cough and swallow reflex posing a higher risk for the patient to aspirate any gastric contents. The gastric contents which are highly acidic can cause irritation and inflammation in the lungs which can hinder the gas exchange leading to imminent death of the patient (Andrew-Romit & Mortel, 2011). Therefore long fasting periods were always implemented to enable stomach emptying during the induction of anesthesia. However, current studies display a lot of information and evidence showing that pulmonary aspiration arises very rarely as a complication of modern general anesthesia (Gunawardhana, 2012).
Cardiac catheterization or coronary angiogram is one of the most common and minimally invasive procedures performed by a cardiology intensivist. Pre-procedure fasting or NPO has been the standard protocol of care since beginning due to the vomiting very commonly caused by the first generation of radio contrast materials which were nearly toxic in nature (Kern, 2010). However, the modern contrast media which is approved Food and Drug Administration (FDA) is much safer as various studies show very rare incidences of any adverse effects like vomiting, contrast related hypotension or arrhythmias (Kern, 2010). For a patient cardiac cath can be a nerve racking experience as it reveals any blockages in the coronary arteries ...
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...ilization. Journal of Clinical Anesthesia, 12(1), 48-51. Retrieved from http://www.jcafulltextonline.com/article/S0952-8180(99)00139-7/abstract
Polit, D. F. & Beck, C. T. (2012). Nursing research: generating and assessing evidence for nursing practice (9thed.) Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Rosengarten, J., Ozkor, M., & Knight, C. (2007). Fasting and cardiac catheterisation - should we be following the evidence? Controversies and Consensus in Imaging and Intervention, 5(2), 21-23. Retrieved from http://c2i2.digithalamus.com/vol_v_issue_2/Fasting_and_cardiac_catheterisation.asp
Salman, O. H., Asida, S. M., & Ali, H. S. (2013). Current knowledge, practice and attitude of preoperative fasting: A limited survey among Upper Egypt anesthetists. Egyptian Journal of Anaesthesia , 29(2), 125–130.doi:10.1016/j.egja.2012.10.007.
Patients that come in in cardiogenic shock during there echocardiogram need to be evaluated in a whole looking for any abnormalities. Diastole dysfunction, systolic dysfunction, any possible shunting issues, aortic stenosis, coarctation of the aorta or
Smith, C., Sidhu, R., Lucas, L., Mehta, D., & Pinchak, A. (2007, March 13). Should patients undergoing ambulatory surgery with general anesthesia be actively warmed? Internet Journal of Anesthesiology, 12(1).
Anesthesia, “We take it for granted that we can sleep through operations without feeling any pain. But until about 150 years ago, the operating room was a virtual torture chamber because surgeons had no way to prevent the pain caused by their healing knives.”
In a healthy individual receiving a general anaesthetic, the anaesthetist must be aware of the causes and treatment of acute onset AF, both intra-operatively and peri-operatively. Patients with AF often develop a decline in left ventricular performance and other hemodynamic instabilities including reduced diastolic filling and tachycardia mediated cardiomyopathy1, all of which can reduce cardiac output and pose difficulties for the anaesthetist.
Although there is meticulous effort by nurses and other health care professionals in ensuring patient recovery after surgical procedures, many patients experience complications. These post-operative complications include, but are not limited to, wound infection, atelectasis, postoperative ileus, embolism, and deep vein thrombosis. This paper will specifically look at atelectasis, the collapse of lung alveoli due to airway obstruction, and post-operative ileus, the cessation of gastrointestinal movement preventing passage of its contents (Lewis et al., 2014). The purpose of this paper is to provide a greater understanding of the experience of hospitalization for surgical patients by focusing on the two post-operative complications, atelectasis
Chamberlain, R., & Martindale, R. (2007, October 31). The role of the surgeon and the surgical care team: proactive strategies for preventing postoperative ileus. Evidence-based Management of Postoperative Ileus, 1-7. Retrieved from www.esng-meded.com/surgerynews/e-supplement_001.pdf
Anesthetic management for patients with dilated cardiomyopathy is challenging. It is imperative that there should be a complete preoperative assessment to tailor the anesthetic plan specifically for the patient. Ensure that the patient has an optimized cardiac status and does not have any symptoms of heart failure prior to elective surgeries because it increases morbidity and mortality. The anesthesia provider needs to be very vigilant throughout the perioperative period and prompt administration of inotropes or anti-arrhythmic medications may be required. Patients with dilated cardiomyopathy presents a challenge to anesthetic providers, thus, a good understanding of the disease, its affects, along with a thorough preoperative assessment, will be beneficial in formulating a customized anesthetic plan to prevent adverse outcomes.
Angina is pain felt in the chest area as a result of lack of inadequate supply to the myocardium (Better Health Channel, 2013) Atherosclerosis or the hardening and narrowing of arteries caused by the build-up of plaques, the insufficient supply of oxygen and its increasing demand are some of the factors that can cause ischemia in the myocardium (Lewis et al., 2012). When there is a total blockage of the coronary arteries for a few minutes, the myocardium cannot receive oxygen and glucose for aerobic metabolism thus anaerobic metabolism occurs (Lewis et al., 2012). The lactic acid builds up and stimulates the nerve fibres in the myocardium resulting to chest pain (Lewis et al., 2012). The cells are repaired and the aerobic metabolism and the contractility of the arteries are restored when there is return of blood flow (Lewis et al., 2012)
Burns, N., & Grove, S.K. (2009). The practice of nursing research: Appraisal, synthesis, and generation of evidence (6th ed.). St. Louis, MO: Saunders Elsevier.
Although the comorbidities and type of surgery dictate certain decisions in managing patient care, anesthesiologists maintain various modalities for the perioperative period. These consist of anything from local to regional anesthesia, including neuraxial techniques and peripheral nerve blocks, as well as monitored anesthesia care with sedation to general anesthesia. Overlapping of different anesthetic types and combinations of regional analgesics to supplement general anesthesia occur frequently.
Polit, D. F. & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice (9th ed.). Philadelphia: Lippincott.
The patient received general anesthesia. The CRNA monitored the patient 's heart rate, blood pressure, temperature, EKG, PaCO2, PaO2, pulse oximeter, and Bispectral index. The airway was maintained through intubation.
Firstly, Anesthesia made many surgical operations possible and saved millions of lives. As most people would have rather committed suicide than undergo surgery, Anesthetics allowed for patient’s to be operated on safely and without pain. Surgery is a very common practice in all parts of the world and can only be possible with the help of Anesthetics. According to the Massachusetts Academy of Mathematics and Science, ‘40 million people in North America are administered to Anesthesia every year’ (2010 p. 37). This statistic shows how Anesthesia influences many people lives every day.
Anesthesia is used in almost every single surgery. It is a numbing medicine that numbs the nerves and makes the body go unconscious. You can’t feel anything or move while under the sedative and are often delusional after being taken off of the anesthetic. Believe it or not, about roughly two hundred years ago doctors didn’t use anesthesia during surgery. It was rarely ever practiced. Patients could feel everything and were physically held down while being operated on. 2It wasn’t until 1846 that a dentist first used an anesthetic on a patient going into surgery and the practice spread and became popular (Anesthesia). To this day, advancements are still being made in anesthesiology. 7The more scientists learn about molecules and anesthetic side effects, the better ability to design agents that are more targeted, more effective and safer, with fewer side effects for the patients (Anesthesia). Technological advancements will make it easier to read vital life signs in a person and help better decide the specific dosages a person needs.
...., & Jr, L. H. (1992). Release of vasoactive substances during cardiopulmonary bypass. Annals of Thoracic Surgery. doi:10.1016/0003-4975(92)90113-I-6