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diagnosis anesthesia anesthesiology intraoperative workup cardiology differential treatment algorithm anaphylaxis avrt cico clinical difficult ekg electrocardiogram embolism embolus hyperkalemia hypotension
Supraventricular Tachycardia EKG Here’s a great ECG case of a 50-year-old lady who presented with palpitations Her heart
Supraventricular Tachycardia ... great ECG case of ... Is it wide or narrow ... computer thinks it’s wide ... @EM_RESUS #AVRT
Treatment of Stable Narrow-Complex Tachycardia Regular Rhythm: • Attempt vagal maneuvers • Give adenosine 6 milligrams IV
Converts - Probably AVnRT ... Control rate (e.g ... Treat underlying cause ... Treat underlying cause ... #Treatment #management
Palpitations - Differential Diagnosis Framework What? • It is an unpleasant awareness or sensation that the heart is
exam • 12-lead ECG ... Valvular disease (e.g ... maneuvers: SVT-AVNRT ... bending over: AVNRT ... Red Flag Symptoms
Hypotension - Guidelines for Crises in Anaesthesia Hypotension is commonly due to unnecessarily deep anaesthesia, the autonomic
and positioning (e.g ... non-sinus → 2-7 Tachycardia ... (eg steroid dependency ... Intraoperative #Checklist ... #Diagnosis #Management
Intraoperative Tachycardia - Guidelines for Crises in Anaesthesia Tachycardia in theatre is often due to inadequate depth
Guidelines for Crises ... obtain 12-lead ECG ... : central line/wire ... Intraoperative #Checklist ... #Diagnosis #Management
Intraoperative Circulatory Embolus - Guidelines for Crises in Anaesthesia Causes: thrombus, fat, amniotic fluid, air/gas. Signs: hypotension, tachycardia,
in Anaesthesia Causes ... : hypotension, tachycardia ... Consider thrombolysis e.g ... Intraoperative #Checklist ... #Diagnosis #Management
Intraoperative Anaphylaxis - Guidelines for Crises in Anaesthesia • Unexplained hypotension • Unexplained bronchospasm (wheeze may be absent
• Unexplained tachycardia ... arrest where other causes ... alternate vasopressor (e.g ... Intraoperative #Checklist ... #Diagnosis #Management
Can’t Intubate, Can’t Oxygenate (CICO) - Guidelines for Crises in Anaesthesia This is the last resort when
Guidelines for Crises ... optimal airway management ... airway expertise e.g ... Intraoperative #Checklist ... #Diagnosis #Management
Hyperkalemia - Diagnosis and Management - GrepMed Handbook S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
Diagnosis and Management ... heparinized tube) • ECG ... badness): Peak T, flat ... only if no clear cause ... Monitor for tachycardia
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