Anaesthesia by Garrioch, Magnus

By Garrioch, Magnus

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Sample text

What is the name of this alternative regional block? ii. Name each of the nerves labelled. iii. Which of these nerves is commonly missed with the axillary block? iv. Describe the movements you would anticipate on stimulation of each of these nerves. indd 43 15/10/14 11:37 AM Answer 31 31i. An anti-siphon valve, or anti-flowback valve. ii. If a syringe pump with standard giving set is placed above the level of the patient’s right heart, a siphoning effect can develop, leading to potential rapid emptying of the syringe contents into the patient’s intravenous line.

Urine output is reduced. This is a potentially serious blood loss and a fluid challenge of 1,000–2,000 ml of Hartmann’s solution should be given through two large bore (16 gauge) IV catheters. A surgical opinion is essential as further blood loss is likely and surgical or radiological/angiographic intervention may be required to stem bleeding. The patient must be observed for further evidence of haemorrhage, as he may only transiently respond to fluids. • Class 3 (30–40% 1,500–2,000 ml blood loss).

Should surgery proceed without any further action? iii. If emergency surgery was required, how would anaesthetic management be modified to minimise risk, and how would the arrhythmia be managed? indd 33 15/10/14 11:37 AM Answer 24 24i. Features of Wolf–Parkinson–White (WPW) syndrome. e. a paroxysmal supraventricular tachycardia). Paroxysmal atrial flutter/fibrillation (PAF) is the commonest presentation of WPW but exceptionally, syncope and even death may result if the tachycardia is so rapid that ventricular filling fails.

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