Difficult Airway Algorithm 1. Assess the likelihood and clinical impact of basic management problems: • Difficulty with patient cooperation or consent • Difficult mask ventilation • Difficult supraglottic airway placement • Difficult laryngoscopy • Difficult intubation • Difficult surgical airway access 2. Actively pursue opportunities to deliver supplemental oxygen throughout the process of difficult airway management. 3. Consider the relative merits and feasibility of basic management choices: • Awake intubation vs. intubation after induction of general anesthesia • Non-invasive technique vs. invasive techniques for the initial approach to intubation • Video-assisted laryngoscopy as an initial approach to intubation • Preservation vs. ablation of spontaneous ventilation 4. Develop primary and alternative strategies #Difficult #airway #algorithm #Anesthesiology #Anesthesia #CriticalCare #Management

Effect of different head positions on upper airway dimensions - Atlanto-occipital Extension - Neutral - Head forward positioning ...there's a reason everyone in respiratory distress positions their head forward relative to their chest Image by Dr. Richard Levitan @airwaycam #Airway #Positioning #Head #Cervical #Anesthesia #CriticalCare #XRay #Neck #Comparison

Fascia Iliaca Regional Nerve Block Regional nerve blockade for early analgesic management of elderly patients with hip fracture #Fascia #Iliaca #Regional #NerveBlock #Anesthesia #Local #Pain #Management

Ultrasound Guided Thoracic Interfascial Plane Blocks - Sergi Boada Pie @Sebopi #Thoracic #Interfascial #Plane #NerveBlock #Blocks #POCUS #Ultrasound #Anesthesia #Pain #Management

Cervical Paramedial Translaminar Peridural Block - POCUS Assisted Instructions - Sergi Boada Pie @Sebopi #Cervical #Paramedial #Translaminar #Peridural #Block #POCUS #Anesthesia #Pain #Management #Ultrasound

Transverse Abdominis Plane (TAP) Block CT confirmed appendicitis gets a TAP block by the ED for multimodal pain management. Surgeons are supportive and excited about better pain control. Break down the artificial silos in medicine and improve patient care. Review Article: https://www.ajemjournal.com/article/S0735-6757(19)30017-8/fulltext - Dr. Arun Nagdev @NagdevArun #Transverse #Abdominis #Plane #TAP #Block #Regional #Anesthesia #Management #POCUS #Ultrasound

Anesthesia for the Obese Patient: Preoperative Evaluation, Intraoperative Management, and Postoperative Management #Anesthesia #Obese #Obesity #Management #Preoperative

Anaesthesia and peri-operative care for Jehovah's Witnesses and patients who refuse blood 1. Patients should be given a clear explanation of the blood products that the medical team looking after them consider might be required during or after surgery, and the risks involved if they refuse. Discussion of alternative treatments should be undertaken if available. 2. It should be clearly documented in the medical record which treatments and/or procedures the patient consents to and which they do not. 3. At least 6 weeks before elective surgery likely to be associated with significant blood loss, the patient's Hb should be checked and if < 130 g.l—l, optimisation by treatment with iron and/or erythropoietin should be considered. 4. All relevant issues should be highlighted at the time of the team briefing and during the surgical safety checklist before induction of anaesthesia. A specific checklist recording which components/products/procedures the patient will or will not accept should be available. 5. The majority of Jehovah's Witnesses will accept intra-operative cell salvage - this should be discussed before surgery and if agreed set up from the start of surgery. Consent should be obtained. 6. The interventions promoted as part of a 'patient blood management' approach should be rigorously applied, including tranexamic acid administration for major surgery. 7. After surgery, a comprehensive verbal and written handover of the patient is essential. Staff should be made aware of any adverse intra-operative events and should understand and respect the wishes of the patient that will have been discussed before the procedure. #Jehovahs #Witnesses #Anesthesia #perioperative #preoperative #Management #Checklist

Practice Guidelines for Preoperative Fasting Infographic by Dr. Jesse Burk-Rafel @jbrafel > 8 hours - Heavy foods (fried/fatty) and meats > 6 hours - Light meal (e.g., toast + clear liquid), Cow's milk (in moderation), Infant formula > 4 hours - Breast milk > 2 hours - Non-alcoholic clear liquids (e.g., water, fruit juice without pulp, nutritional drinks, clear tea, black coffee) 0-2 hours - NPO Benefits of Clear Liquids up to 2 hours Pre-Op - LESS patient thirst and hunger - LOWER risk of aspiration Source: American Society of Anesthesiologists. practice Guidelines for Preoperative Fasting and the Use Of pharmacologic Agents to Reduce the Risk Of pulmonary Aspiration: Application to Healthy Patients undergoing Elective Procedures. Anesthesiology. 2017: 126376-393. http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2596245 #NPO #Preoperative #Fasting #Guidelines #Anesthesia #Hours #Timeline #EBM #VisualAbstract #Times #Preprocedural

Impact of Anesthesia on Intraoperative Fluid Administration Infographic by Dr. Catherine Beni @totalbodydolor #Anesthesia #Intraoperative #Fluid #Administration #Guide #Management