1 / 14

Anesthetic Management of The Trauma Patient

Anesthetic Management of The Trauma Patient. Baseline Prior To OR. BP 90/40 | HR 130s | Intubated CV Left chest ant & post wounds/ left calf wound Right CT with 400cc blood returned Decreased right breath sounds Aggressive Resuscitation Underway.

krikor
Download Presentation

Anesthetic Management of The Trauma Patient

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Anesthetic Management of The Trauma Patient

  2. Baseline Prior To OR • BP 90/40 | HR 130s | Intubated CV • Left chest ant & post wounds/ left calf wound • Right CT with 400cc blood returned • Decreased right breath sounds • Aggressive Resuscitation Underway

  3. Initial Status After OR Arrivalfor Thoracotomy and Ex-Lap • BP 30/15 | HR 106 | SaO2 98 % • Resuscitation continuing • Multiple IV Access attained • Right rad A- line • Right 16g and 18g iv • Left 16g iv • Right 16g IJ with CVP monitoring

  4. Monitors & Equipment • Arterial and NIBP Blood Pressure • Central Venous Pressure (CVP) • ECG a.k.a. EKG with ST analysis (standard) • SaO2 | FiO2 | Anes. gas monitor • Vent monitors (RR/PIP/Vt/I:E) • Altan Dean Rapid Infuser

  5. Anesthetic Agents • Initially: • 100% Oxygen and Midzolam (Versed) with Cisatracurium (Nimbex) for muscle relaxation. • ** Patient’s vital signs would not tolerate any additional anesthetics.

  6. Course of Events

  7. Fluid Resuscitated

  8. Blood Gas Analysis

  9. Blood Gas AnalysisPost-OP

  10. Hemoglobin and Hematocrit • Hemoglobin: -protein that carries oxygen in blood -normally saturated 95-100% -Normal 10-14g/dl • Hematocrit: -measures red cell mass, anemia, hydration. -normal 42-52%

  11. Hemoglobin & Hematocrit Trend

  12. Coagulation • PT: used to monitor coumadin, Vit. K def, Factor def., DIC • PTT: used to monitor heparin therapy. • Fibrinogen: protein that converts to fibrin to make clot • INR: for monitoring oral anticoagulants, interantional standard value.

  13. Coagulopathy

  14. Immediate Post-Op Course • Vitals (HR 143* BP 85mmHg(mean) Pox 98% • H/H (9.7/27.2) • ABG: 7.43/38/54 • Critical Cond. Continuous vigorous volume replacement • Pt. on ventilator in SICU

More Related