Anaesthetic emergencies

2021 ◽  
pp. 1051-1098
Author(s):  
Andrew Kane ◽  
Richard Armstrong ◽  
Jerry P Nolan ◽  
Jasmeet Soar ◽  
Sorcha Evans ◽  
...  
Keyword(s):  
Malignant Hyperthermia ◽  
Pulmonary Oedema ◽  
Neuromuscular Blockade ◽  
Local Anaesthetic ◽  
Life Support ◽  
Advanced Life Support ◽  
Latex Allergy ◽  
Gas Embolism ◽  
Failed Intubation ◽  
Gastric Aspiration

This chapter discusses anaesthetic emergencies. It begins with a description of adult basic life support (BLS) and advanced life support (ALS). It goes on to describe post resuscitation care; severe bradycardia; tachycardia; severe hypo- or hypertension; severe hypoxia; laryngospasm; air/ gas embolism; gastric aspiration; severe bronchospasm; pulmonary oedema; anaphylaxis; latex allergy; intra-arterial injection; incomplete reversal of neuromuscular blockade; local anaesthetic toxicity; failed intubation; the can’t-intubate-can’t-oxygenate (CICO) scenario and malignant hyperthermia (MH).

Anaesthetic emergencies

2016 ◽  
Author(s):  
Andrew McIndoe
Keyword(s):  
Major Trauma ◽  
Status Asthmaticus ◽  
Basic Life Support ◽  
Life Support ◽  
Neonatal Resuscitation ◽  
Advanced Life Support ◽  
Gas Embolism ◽  
Gastric Aspiration ◽  
Drug Doses ◽  
Broad Complex

This chapter discusses anaesthetic emergencies. It begins with a description of adult basic life support and advanced life support. It goes on to describe the management of acute problems, including narrow and broad complex tachycardia, severe hypo- or hypertension, severe hypoxia, laryngospasm, air/gas embolism, gastric aspiration, status asthmaticus, pulmonary oedema, failed intubation, the cannot-intubate-cannot-ventilate scenario, malignant hyperthermia anaphylaxis, intra-arterial injection, and unsuccessful reversal of neuromuscular blockade. It concludes with the management of paediatric emergencies, including paediatric advanced life support, ventricular fibrillation or tachycardia, neonatal resuscitation, the collapsed septic child, paediatric major trauma, acute severe asthma, and anaphylaxis, as well as with a discussion of paediatric drug doses and equipment.

Anaesthetic emergencies

2018 ◽  
Author(s):  
Andrew McIndoe
Keyword(s):  
Major Trauma ◽  
Status Asthmaticus ◽  
Basic Life Support ◽  
Life Support ◽  
Neonatal Resuscitation ◽  
Advanced Life Support ◽  
Gas Embolism ◽  
Gastric Aspiration ◽  
Drug Doses ◽  
Broad Complex

This chapter discusses anaesthetic emergencies. It begins with a description of adult basic life support and advanced life support. It goes on to describe the management of acute problems, including narrow and broad complex tachycardia, severe hypo- or hypertension, severe hypoxia, laryngospasm, air/gas embolism, gastric aspiration, status asthmaticus, pulmonary oedema, failed intubation, the cannot-intubate-cannot-ventilate scenario, malignant hyperthermia anaphylaxis, intra-arterial injection, and unsuccessful reversal of neuromuscular blockade. It concludes with the management of paediatric emergencies, including paediatric advanced life support, ventricular fibrillation or tachycardia, neonatal resuscitation, the collapsed septic child, paediatric major trauma, acute severe asthma, and anaphylaxis, as well as with a discussion of paediatric drug doses and equipment.

Recommended Guidelines for Uniform Reporting of Pediatric Advanced Life Support: The Pediatric Utstein Style

Circulation ◽  
1995 ◽  
Vol 92 (7) ◽  
pp. 2006-2020 ◽  
Author(s):  
Arno Zaritsky ◽  
Vinay Nadkarni ◽  
Mary Fran Hazinski ◽  
George Foltin ◽  
Linda Quan ◽  
...  
Keyword(s):  
Life Support ◽  
Advanced Life Support ◽  
Recommended Guidelines ◽  
Utstein Style

Code Blue Events in the Neonatal and Pediatric Intensive Care Units at a Tertiary Care Children's Hospital

2020 ◽  
Author(s):  
Catherine M. Groden ◽  
Erwin T. Cabacungan ◽  
Ruby Gupta
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Support ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Neonatal Resuscitation ◽  
Advanced Life Support ◽  
Pediatric Intensive Care ◽  
Code Blue ◽  
Neonatal Resuscitation Program

Objective The authors aim to compare all code blue events, regardless of the need for chest compressions, in the neonatal intensive care unit (NICU) versus the pediatric intensive care unit (PICU). We hypothesize that code events in the two units differ, reflecting different disease processes. Study Design This is a retrospective analysis of 107 code events using the code narrator, which is an electronic medical record of real-time code documentation, from April 2018 to March 2019. Events were divided into two groups, NICU and PICU. Neonatal resuscitation program algorithm was used for NICU events and a pediatric advanced life-support algorithm was used for PICU events. Events and outcomes were compared using univariate analysis. The Mann–Whitney test and linear regressions were done to compare the total code duration, time from the start of code to airway insertion, and time from airway insertion to end of code event. Results In the PICU, there were almost four times more code blue events per month and more likely to involve patients with seizures and no chronic condition. NICU events more often involved ventilated patients and those under 2 months of age. The median code duration for NICU events was 2.5 times shorter than for PICU events (11.5 vs. 29 minutes), even when adjusted for patient characteristics. Survival to discharge was not different in the two groups. Conclusion Our study suggests that NICU code events as compared with PICU code events are more likely to be driven by airway problems, involve patients <2 months of age, and resolve quickly once airway is taken care of. This supports the use of a ventilation-focused neonatal resuscitation program for patients in the NICU. Key Points

scholarly journals European Resuscitation Council Guidelines 2021: Adult advanced life support

Resuscitation ◽  
2021 ◽  
Author(s):  
Jasmeet Soar ◽  
Bernd W. Böttiger ◽  
Pierre Carli ◽  
Keith Couper ◽  
Charles D. Deakin ◽  
...  
Keyword(s):  
Life Support ◽  
Advanced Life Support ◽  
European Resuscitation Council

Improving the Appropriateness of Advanced Life Support Teams’ Dispatch: A Before-After Study

2021 ◽  
pp. 1-7
Author(s):  
Lorenzo Gamberini ◽  
Cosimo Picoco ◽  
Donatella Del Giudice ◽  
Corrado Zenesini ◽  
Marco Tartaglione ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Life Support ◽  
Advanced Life Support ◽  
Emergency Operation ◽  
Support Teams ◽  
Global Sensitivity ◽  
Emergency Logistics ◽  
Prehospital Emergency ◽  
Task Time ◽  
Algorithm Implementation

Abstract Background and Importance: The dispatch of Advanced Life Support (ALS) teams in Emergency Medical Services (EMS) is still a hardly studied aspect of prehospital emergency logistics. In 2015, the dispatch algorithm of Emilia Est Emergency Operation Centre (EE-EOC) was implemented and the dispatch of ALS teams was changed from primary to secondary based on triage of dispatched vehicles for high-priority interventions when teams with Immediate Life Support (ILS) skills were dispatched. Objectives: This study aimed to evaluate the effects on the appropriateness of ALS teams’ intervention and their employment time, and to compare sensitivity and specificity of the algorithm implementation. Design: This was a retrospective before-after observational study. Settings and Participants: Primary dispatches managed by EE-EOC involving ambulances and/or ALS teams were included. Two groups were created on the basis of the years of intervention (2013-2014 versus 2017-2018). Intervention: A switch from primary to secondary dispatch of ALS teams in case of high-priority dispatches managed by ILS teams was implemented. Outcomes: Appropriateness of ALS team intervention, total task time of ALS vehicles, and sensitivity and specificity of the algorithm were reviewed. Results: The study included 242,501 emergency calls that generated 56,567 red code dispatches. The new algorithm significantly increased global sensitivity and specificity of the system in terms of recognition of potential need of ALS intervention and the specificity of primary ALS dispatch. The appropriateness of ALS intervention was significantly increased; total tasking time per day for ALS and the number of critical dispatches without ALS available were reduced. Conclusion: The revision of the dispatch criteria and the extension of the two-tiered dispatch for ALS teams significantly increased the appropriateness of ALS intervention and reduced both the global tasking time and the number of high-priority dispatches without ALS teams available.

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