
Lecture Notes
Description
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Full-colour diagrams, photographs and key fact boxes supporteasy understanding of the theory of anaesthetics allowing confidenttransfer of information into clinical practice.
This fourth edition has been fully revised and updated toreflect recent developments within the anaesthetics specialty andis fully supported by a wide-range of self-assessments for studyand revision purposes together with a range of 'tips foranaesthesia attachments' that start each chapter.
Whether you need to develop your knowledge for clinicalpractice, or refresh that knowledge in the run-up to examinations,Lecture Notes Clinical Anaesthesia will help foster asystematic approach to the clinical situation for all medicalstudents and hospital doctors.
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Matthew Gwinnutt is a Core Trainee in Anaesthesia, MerseyDeanery, Liverpool
Content
Preface, vii
Acknowledgements, viii
List of abbreviations, ix
1 Anaesthetic assessment and preparation for surgery, 1
2 Anaesthetic equipment and monitoring, 18
3 Drugs and fluids used during anaesthesia, 39
4 The practice of general anaesthesia, 58
5 Local and regional anaesthesia, 79
6 Special circumstances, 88
7 Post-anaesthesia care, 100
8 The acutely ill adult patient on the ward, 121
Section 1: Recognition and assessment, 121
Section 2: Management of common emergencies, 131
Answers to short-answer questions, 159
Answers to true/false questions, 171
Index, 177
Abbreviations
AAGBI Association of Anaesthetists of Great Britain and Ireland ABG arterial blood gas ACE-I angiotensin converting enzyme inhibitors ACS acute coronary syndrome ADH antidiuretic hormone AKI acute kidney injury ALS advanced life support AMI acute myocardial infarction ANTT antiseptic no-touch technique ARDS acute respiratory distress syndrome ASA American Society of Anesthesiologists AT anaerobic threshold ATN acute tubular necrosis BIS bispectral index BMI body mass index BNF British National Formulary BiPAP bilevel positive airway pressure BP blood pressure BTS British Thoracic Society CAP community-acquired pneumonia CCU coronary care unit CEPOD Confidential Enquiry into Perioperative Death CNS central nervous system CO2 carbon dioxide COPD chronic obstructive pulmonary disease COX cyclo-oxygenase enzyme CPAP continuous positive airway pressure CPR cardiopulmonary resuscitation CPX cardiopulmonary exercise CRP c-reactive protein CRT capillary refill time CSF cerebrospinal fluid CT computerised tomography CTPA computerised tomography pulmonary angiography CVC central venous catheter CVP central venous pressure CVS cardiovascular system CXR chest X-ray DAS Difficult Airway Society DBP diastolic blood pressure DBS double-burst simulation DNAR do not attempt resuscitation DS degrees of substitution DVT deep vein thrombosis ECF extracellular fluid ECG electrocardiograph EEG electroencephalograph EMLA eutectic mixture of local anaesthetic ENT ear, nose, and throat ETT exercise tolerance test EWS early warning score FAST focused assessment with sonography in trauma FBC full blood count FEV1 forced expiratory volume in 1 second FFP fresh frozen plasma FiO2 fractional inspired oxygen concentration FRC functional residual capacity FVC forced vital capacity GCS Glasgow Coma Scale GFR glomerular filtration rate GI gastrointestinal GIFTASUP guidelines on IV fluid therapy for adult surgical patients GTN glyceryl trinitrate HAFOE high airflow oxygen enrichment HAP hospital acquited pneumonia Hb haemoglobin HbA1c glycosylated haemoglobin HDU high dependency unit HIV human immunodeficiency virus HR heart rate HRT hormone replacement therapy 5-HT 5-hydroxytryptamine HTLV human T-cell lymphotrophic virus ICF intracellular fluid ICP intracranial pressure I:E ratio inspiratory:expiratory ratio ILM intubating LMA INR international normalized ratio IPPV intermittent positive pressure ventilation IR immediate release IV intravenous IVC inferior vena cava IVRA intravenous regional anaesthesia JVP jugular venous pressure K+ potassium ions kPa kilopascals LBBB left bundle branch block LED light-emitting diode LFT liver function test LMA laryngeal mask airway LP lumbar puncture LSD lysergic acid diethylamide MAC minimum alveolar concentration MAP mean arterial pressure MET metabolic equivalent MH malignant hyperpyrexia MI myocardial infarction MR modified release MRI magnetic resonance imaging Na+ sodium ions NCEPOD National Confidential Enquiry into Patient Outcome and Death NIBP non-invasive blood pressure NICE National Institute for Health and Clinical Excellence N2O nitrous oxide NSAID non-steroidal anti-inflammatory drug NSTEMI non-ST-segment elevation myocardial infarction NYHA New York Heart Association OCP oral contraceptive pill OLV one lung ventilation OSAHS obstructive sleep apnoea and hypopnoea syndrome OTC over the counter PaCO2 arterial partial pressure of carbon dioxide PACU post-anaesthesia care unit PCA patient-controlled anaesthesia PCI percutaneous coronary intervention PCV pressure-controlled ventilation PE pulmonary embolism PEA pulseless electrical activity PEEP positive end expiratory pressure PEFR peak expiratory flow rate PMGV piped medical gas and vacuum system PaO2 arterial partial pressure of oxygen POCT point of care testing PONV postoperative nausea and vomiting psi pounds per square inch PT prothrombin time ROSC return of spontaneous circulation RRT renal replacement therapy RSI rapid-sequence induction SBP systolic blood pressure SpO2 peripheral oxygen saturation STEMI ST-segment elevation myocardial...System requirements
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