A Vasoplegic Syndrome Case

Medical involvement included pharmacological intervention. An infusion of Sotalol 40mg was administered intravenously at approx 0930 over thirty minutes with continuous cardiac monitoring. Sotalol, an antiarrhythmic drug, depresses the sinus heart rate, decreases atrioventricular conduction, decreases cardiac output and decreases systolic and diastolic blood pressure (Bryant, Knights, & Salerno, 2003). As the patient was already hemodynamically compromised, a bolus of fluid (Gelofusion 500mls) was administered prior to the Sotalol infusion. The aim was to increase the circulating volume and raise blood pressure. Vital signs remained stable during the infusion, however the heart rate was neither converted to sinus rhythm or reduced to a normal rate.

The patient is a 72-year-old female who arrived to the emergency department in cardiac arrest. Emergency medical services reports the patient was last seen eating breakfast at her nursing home and was found an hour later face down and unresponsive. After it was determined the patient was in asystole, an intravenous catheter was started and two rounds of Epinephrine was administered. Upon arrival to the emergency department the patient had pulseless electrical activity with sinus tachycardia on the monitor. Airway management was in process with a bag valve mask on 100% oxygen and chest compressions in progress. After intubation and stabilization the

Lack of enough trained staff in conscious sedation available at the time of the procedure

This Anaesthetic case study would describes and discussed the scenario of a patient through the anaesthetic role of their surgical procedure. It will include and discuss the anaesthetic safety procedures equipment and drug interventions used to ensure this particular patients maximum safety and comfort before and during the procedure. The case study will include pre and peri-operative assessment in order to describe the involvement contribution of various specialties in the holistic care of the critical care patient. This assignment will focus only on the anaesthetics side of the procedure but will also highlight the importance of the triad of anaesthesia and discuss the administration, maintenance and reversal of

On arrival to UKMC the patient received a Glasgow Coma Score of 3, which is an indication that intubation is needed. Bipap therapy was attempted but failed, due to respiratory failure. This was confirmed by arterial blood gases. After being assessed by the team at UKMC, the patient was intubated for respiratory failure, as well as shock of an unclear etiology. Rapid sequence intubation drugs, Etomidate and Succinylcholine where administered prior to intubation. A 7.5 endotracheal tube was used

Postoperative delirium (POD) is a pervasive complication in elderly surgical patients that is associated with increased morbidity and mortality. Depending on

(Medical Law and Ethics, 2009 Chap. 6 Pg. 216) No, there isn’t any legally recognizable injury to the patient. None of these accorded the patient suffered cardiac arrest and died. The patient would have to seek recovery or compensation but in this case the patients family has filed a wrongful death suit.

Patients can become hypertensive during induction, positioning, or tumor resection (12). Chronic catecholamine excess causes volume contraction and patients can become severely hypotensive, as in this case, if adequate volume resuscitation is not performed (12). It is prudent to evaluate for adverse events following hypertensive and hypotensive episodes. Serial neurological evaluations, CT brain, electrocardiograms, or serial cardiac enzymes may be warranted. Complications of surgery are primarily due to severe preoperative hypertension, high secretion tumors, or repeat intervention for recurrence (13). In one study, adverse perioperative events occurred in 32 percent of cases (14). The most common adverse event was sustained hypertension in 25 percent of the patients. There were no perioperative deaths, myocardial infarctions, or cerebrovascular events. Despite premedication of most patients with phenoxybenzamine and a beta-blocker, varying degrees of intraoperative hemodynamic lability occurred

As previously mentioned, the left ventricle is no longer as compliant and therefore cannot fill with blood without encountering resistance. The use of diuretics decreases overall volume, which as a result decreases overall pressure. This lost pressure may be needed in order for blood to pump with added pressure against the resistance into the ventricle. Once pressure is lost the patient is said to have hypotension and is at risk for blood not being able to perfuse to vital tissues (Burchum et al., 2016, pg.

These procedures are not reported alone but as add-on codes used to identify extraordinary conditions of patients and their unusual risk factors. There are four kinds of certain codes used for particular circumstances which are: 1) Anesthesia for the age younger than one year and over the age of seventy (99100), 2) Anesthesia complicated by the utilization of total body hypothermia (99116), 3) Anesthesia complicated by the utilization of controlled hypotension (99135) and 4)Anesthesia complicated by emergency circumstances

The patient had a medical history of hypertension, hyperlipidemia, coronary artery disease, myocardial infarction in 2010, COPD, pulmonary embolism, prostate cancer, gastro esophageal reflux disease, and small bowel adhesions. The patient had an echocardiogram six months ago with an ejection fraction of 45%. Individuals with “an EF of 25% to 50% have an intermediate risk for the development of postoperative low cardiac output

Propofol was administered to put the patient to sleep initially. The patient was kept asleep with anesthesia gases. These gases are fluorinated ethers combined with nitrous oxide. A paralytic was also administered to keep the patient’s muscles from moving during the procedure. During the procedure, the CRNA monitored the patient’s vitals, especially the blood pressure. The blood pressure decreases prior to the initial incision and will increase after the cut is made. The CRNA was monitoring that the patient’s blood pressure did not get too low before the incision was made. The CRNA also made sure the patient was positioned to prevent injury such as pulled muscles and pinched nerves.

Sharon presented with symptoms 2 hours after administration of inhaled Halothane. She had a temperature that elevated to 105 degrees, increased heart rate of 120 bpm and low blood pressure of 60/56. All of these symptoms are abnormal for this patient but can be signs of the condition MH. This condition can be triggered by exposure to volatile inhaled anesthesia drugs like Halothane and signs can be seen during surgery or shortly after surgery (library book, pg510).

The purpose of this paper is to analyze if there is any improvement, post-operative complications, mortality and related factors of elderly undergoing cardiac surgery. The debate whether or not we are pushing the limits is still questionable because of the complications associated with these invasive surgeries and whether or not if it’s a money game. The growing numbers of the elderly patients enjoy a prescription drug benefit, access to artificial knee and hip surgery, and life-saving cardiovascular interventions that were undreamed of a half-century ago.

Generally, before fully losing consciousness, presyncopal symptoms include feeling faint, dizzy, lightheaded, hearing ringing, darkened or faded vision, and decreased hearing ability. The victim is overpowered by unsteadiness and weakness before blacking out. Inevitably, symptoms of the episodes continue until the vertigo (dizziness) overwhelms the victim, literally sending them into a whirl. One can know when to worry if symptoms like chest pain, dyspnea (difficulty breathing), low back pain, heart palpitations, severe headache, ataxia (loss of body movement control), or slurred speech occur. After the victim wakes up from fully losing consciousness, he or she feels a sensation of warmth, nausea, lightheadedness, temporary visual changes,