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ABC of Anaesthesia Overview

Elisa Bertoja. Consultant in Anaesthesia, UCLH. ABC of Anaesthesia Overview . When does an anaesthesia start ?. Far before theatre. PRE OPERATIVE. INTRA OPERATIVE. POST OPERATIVE. ANAESTHESIA. Mr Ed Burdett. Pre-assessment. PRE OPERATIVE. PMH. CVS: MI 2004 ↑ BP angioplasty 2004

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ABC of Anaesthesia Overview

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  1. Elisa Bertoja Consultant in Anaesthesia, UCLH ABC of Anaesthesia Overview

  2. When does an anaesthesia start ? Far before theatre

  3. PRE OPERATIVE INTRA OPERATIVE POST OPERATIVE ANAESTHESIA

  4. Mr Ed Burdett

  5. Pre-assessment PRE OPERATIVE

  6. PMH CVS: MI 2004 ↑ BP angioplasty 2004 since then asymptomatic RS: COPD CNS: -- GUT: -- GIT: -- Mr Ed Burdett 77 ♂ elective TKR

  7. Mr Ed Burdett Th: Aspirin 75mg od Simvastatin 10 mg od Lansoprazole 15 mg od Atenolol 25 mg od Paracetamol prn Ibuprofen prn NKDA

  8. Pre-assessment Further investigation Proceed PRE OPERATIVE

  9. √ Pre-assessment Operating list Liaise with surgeon Pre-operative visit PRE OPERATIVE

  10. TAILORED ANAESTHESIA Intubation TIVA GA Sedation Oral Nasal Gas Fibreoptic LMA CSE Awake RA RSI Asleep Epidural Block Spinal

  11. √ Pre-assessment √ Operating list √ Liaise with surgeon √ Pre-operative visit Anaesthetic room PRE OPERATIVE

  12. PRE OPERATIVE INTRA OPERATIVE POST OPERATIVE ANAESTHESIA

  13. GA REGIONAL

  14. Induction Maintenance Emergence GA

  15. Induction Maintenance Emergence GA

  16. Temporary unsafe A: airway B: breathing C: cardiovascular INDUCTION From a safe condition

  17. C B A Depth of anaesthesia Pain management Liaise with surgeon MANTENANCE

  18. MANTENANCE

  19. C B A Depth of anaesthesia Pain management Liaise with surgeon MANTENANCE

  20. MANTENANCE

  21. From a controlled condition A: airway B: breathing Temporary unsafe C: cardiovascular EMERGENCE

  22. Pain management Patient safety High standard quality care POST OP PLAN

  23. Skills Pt Knowledge Conditions Surgery Pre-op Post-op Assess Plan CHOICES

  24. Adequacy Pt consent (informed) Feasibility REGIONAL

  25. C B A Achieved block Liaise with surgeon MANTENANCE

  26. Pain management Patient safety High standard quality care POST OP PLAN

  27. Skills Pt Knowledge Conditions Surgery Pre-op Post-op Assess Plan CHOICES

  28. Mr Ed Burdett Th: Aspirin 75mg od Simvastatin 10 mg od Lansoprazole 15 mg od Atenolol 25 mg od Paracetamol prn Ibuprofen prn nbm> 6hrs NKDA

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