Surgical Care at the District Hospital
Part 1 2 3 4 5 6 Primary Trauma Care Manual
Resusciation and Anaesthesia
Resuscitation and Preparation for Anaesthesia and Surgery
Management of emergencies and cardiopulmonary resuscitation
Other conditions requiring urgent attention
Intravenous access
Fluids and drugs
Drugs and resuscitation
Preoperative assessment and investigations
Anaesthetic issues in the emergency situation
Important medical conditions for the anaesthetist
Practical Anaesthesia
General anaesthesia
Anaesthesia during pregnancy and for operative  delivery
Pediatric anaesthesia
Conduction anaesthesia
Specimen anaesthetic techniques
Monitoring the anaesthetized patient
Postoperative management
Anaesthetic infrastructure and supplies
Equipment and supplies for different level hospitals
Anaesthesia and oxygen
Fires, explosions and other risks
Care and maintenance of equipment
Hypertension
 


> PREPARATION FOR GENERAL ANAESTHESIA
> INTRAVENOUS INDUCTION
> INTRAMUSCULAR INDUCTION
> INHALATIONAL INDUCTION
> MAINTENANCE OF ANESTHESIA
> FAILED INTUBATION



MAINTENANCE OF ANAESTHESIA

All anaesthetics are constantly being eliminated from the body, either by being breathed out, metabolized or excreted by the kidney, so it is necessary to continue to give more drug throughout anaesthesia. There is no formula for
calculating the amount you need to give. Only by monitoring the patient’s physiology and responses can you decide if you need to increase, reduce or maintain the rate of administration

Anaesthesia too light


Check the patient is breathing adequately; retained carbon dioxide may be the cause. Signs that anaesthesia may be too light include:

:: Patient moves
:: Rising pulse and blood pressure
:: Sweating, tears.

Anaesthesia too deep

:: Falling pulse and blood pressure
:: Depressed breathing.

In addition to monitoring the cardiovascular, respiratory and nervous systems, make regular checks of your equipment. The commonest cause of awareness during anaesthesia is the vaporizer running dry.

Waking the patient up

There is no antidote for anaesthesia:

:: Whenever you give a drug, you must have an idea of how long its effect will last
:: Different drugs wear off at different rates; be prepared to continue to support the patient’s breathing and airway for as long as necessary at the end of the case
:: Remove the tracheal tube only if the patient is either deeply anaesthetized (to avoid laryngeal spasm) or is awake.


Give extra oxygen before and after the end of the anaesthetic. Continue to monitor the patient just as carefully after you have turned the anaesthetic off until he or she is fully awake.

> PREPARATION FOR GENERAL ANAESTHESIA
> INTRAVENOUS INDUCTION
> INTRAMUSCULAR INDUCTION
> INHALATIONAL INDUCTION
> MAINTENANCE OF ANESTHESIA
> FAILED INTUBATION



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