contingencies

• SCC+TDM: Scan, Confirm, Call for Help + Temporize -> Diagnose & Manage
Actions for Scan, Confirm, Call for Help + Temporize? (2)
• 1. Turn up FiO2 to 100% with high flows. This will buy you time until you figure out the problem.
• 2. Scan from the machine to the patient to confirm the reading
What are common problems with the pulse oximeter? (2)
• Poor connection at X3 monitor
• Poor connection with patient
What are common problems with the circuit? (2)
• Disconnected at anesthesia machine
• Disconnected from airway device
What are common problems with the endotracheal tube? (2)
• Tube is kinked
• Tube is plugged with secretions
Actions for Diagnose & Manage? (3)
• 3. Switch ventilator setting to spontaneous ventilation and hand ventilate. This will allow you to assess compliance.
• 4. Auscultate lungs
• 5. Suction endotracheal tube
What could a tight rebreathing reservoir bag imply? (many)
• Obstructive Process (pubmed)
What could a collapsing rebreathing reservoir bag imply? (many)
• ??? (science direct)
What could lung auscultation revealing wheezing imply? Management? (3)
• Bronchospasm
• Management: Albuterol, deepen anesthesia, epinephrine 10-100 mcg
What could lung auscultation revealing decreased left-sided but normal right-sided breath sounds imply? Management? (1)
• Endobronchial intubation (e.g. likely right mainstem)
• Management: Reposition endotracheal tube
• Last Updated: 7/9/23, UpToDate

Acute Coronary Syndrome

#ACS

ACS more likely due to [***history],[***physical], and [***diagnostics]. DDx less likely due to no [***history], [***physical], and [***diagnostics].

Diagnostics

• - F/u EKG. May see t wave changes, ST ele, ST dep. Here are even more words and more words and even more words to see what happens.
• - Trend troponin q3h. May see elevations in MI. Infarction results in myocytes releasing cardiac enzymes. More words to see what happens.

Last Updated: 7/14/22, UpToDate

Aortic Dissection

Cardiac Tamponade

Pulmonary Embolism

Tension Pneumothorax