Clinical Anesthesiology. Lessons Learned from Morbidity and Mortality Conferences

Description

• Based on flagship teaching activity of the Department of Anesthesiology, University of California, San Diego School of Medicine
• Each case concludes with “Lessons Learned”
• Questions accompanying the cases designed to develop the reader’s clinical acumen
• More than 60 real-life cases covering the broad range of anesthesia practice

The book presents more than 60 real-life cases which together memorably and succinctly convey the depth and breadth of clinical anesthesiology. Each chapter includes a case summary, questions, lessons learned, and selected references. Tables and distinctive visual synopses of key teaching points enhance many chapters.

The cases have been selected by Dr. Benumof from the Morbidity and Mortality (M & M) conferences of the Department of Anesthesiology, University of California, San Diego, which he has moderated the last several years, and residents and junior faculty have crafted them into the chapters of this book. Structured in a novel way, the UCSD Anesthesiology M&Ms maximize teaching and learning, and these cases bring that experience right to the reader’s finger tips.

• Case coverage of respiration- and circulation-related problems, obstetrics, neurology, pain and regional anesthesia, pediatrics, outpatient surgery, and special topics
• Resource for anesthesiology and critical care medicine trainees
• Review tool for board certification or recertification
• Fun reading – valuable lessons!

Table of contents

I. Respiration-Related Cases.- 1. Cannot Ventilate, Cannot Intubate Due to Airway Hemorrhage.- 2. Pulmonary Edema Following Attempted Nasal Intubation for Mandibular Fracture Repair.- 3. Loss of Critical Airway.- 4. Anterior Mediastinal Mass.- 5. Awake Intubation with a NIM Tube: How is it done?.- 6. Hemodynamic Collapse Following a Mainstem Intubation.- 7. Hypoxemia During Tracheostomy.- 8. Anesthetic Depth and Mask Ventilation in the Prone Position.- 9. Jet Ventilation through a Cookgas Airway Exchange Catheter.- 10. End of Case Evaluation and Management of a Patient Post Airway Mass Excision.- 11. Possible Recurrent Laryngeal Nerve Injury.- 12. Obstructive Sleep Apnea, and Dead in Bed.- 13. Bilevel Positive Air Pressure, Decreased Sensorium, Aspiration and Capnography.- 14. Perioperative Management of a Patient Previously Treated with Bleomycin Undergoing Thoracic Surgery.- 15. Intra-Operative Airway Fire.- 16. Obesity Hypoventilation Syndrome.

II. Circulation-Related Cases.- 17. Hemorrhage During Endovascular Repair of Thoracic Aorta.- 18. Pacemakers and Automatic Implantable Cardioverter Defibrillators.- 19. Acute Myocardial Infarction during Laparoscopic Surgery.- 20. Sickle Cell and Preeclampsia.- 21. Dysrhythmias in a Patient with Crohn’s Disease.- 22. Hematologic Disorders: Hemophilia and Disseminated Intravascular Coagulation.- 23. Blood Transfusion and the Jehovah’s Witness Patient.- 24. Cardiac and Pulmonary Contusions.- 25. Intraoperative Coagulopathy.- 26. Hypotension in Chronic Methamphetamine User.- 27. Venous Air Embolism During Arteriovenous Malformation Repair.- 28. Cardiac Tamponade.- 29. Case of Intraoperative New-Onset Atrial Fibrillation.- 30. Valvular Disease.

III. Obstetrics-Related Cases.- 31. Labor Epidural with Unrecognized Dural Puncture, Causing High Sensory Block, Hypotension, Fetal Bradycardia and Post Dural Puncture Headache.- 32. Acute Pulmonary Dysfunction Immediately After Cesarean Delivery Under General Anesthesia.- 33. Jehovah’s Witness With Placenta Previa and Increta for Cesarean Hysterectomy.- 34. A Pregnant Patient With Mitral Stenosis.- 35. Unrecognized Uterine Hyperstimulation Due to Oxytocin and Combined Spinal-Epidural Analgesia.- 36. Super Morbidly Obese Patient for Elective Repeat Cesarean Section.- 37. Probable Amniotic Fluid Embolus.- 38. Emergent Cesarean Section.- 39. Pregnancy Plus Atrial Septal Defect vs Eisenmenger Syndrome.- 40. Uterine Abruption.

IV. Pediatric-Related Cases.- 41. Neonatal Resuscitation Following Spontaneous Vaginal Delivery.- 42. Anxious, Coughing and Bound to Obstruct.

V. Special Diseases/Conditions/Situations.- 43. Hypothermia During Laparoscopic Nephrectomy.- 44. Operating Room Management Case Scenarios.- 45. Anaphylaxis Reactions.- 46. Autonomic Dysreflexia.- 47. Porphyrias.- 48. Monitored Anesthesia Care: Medical Implications; and Wrong-Sided Operations: Legal Implications.- 49. Diabetic Ketoacidosis in the Urgent Anesthesia Setting.- 50. Fever, Altered Mental Status, and Rigidity in the Perioperative Course.

VI. Neuro/Neuromuscular-Related Cases.- 51. Emergent Craniotomy for Evacuation of Epidural Hematoma.- 52. Hyperkalemia and Residual Neuromuscular Blockade after Kidney Transplantation.- 53. A Defasciculating Dose of Nondepolarizing Neuromuscular Blocker.- 54. Postoperative Monocular Vision Loss.- 55. Delayed Emergence After Aneurysm Clipping.

VII. Pain and Regional Anesthesia Related Cases.- 56. Unintentional Dural Puncture in a Patient with Severe Preeclampsia.- 57. Complex Regional Pain Syndrome.- 58. Vascular Absorption of Local Anesthetic Producing Systemic Toxicity.- 59. Inadvertent High Spinal in Parturient.

VIII. Outpatient Surgery–Related Cases.- 60. Plastic Surgery in a Surgeon’s Office.- 61. Orthopedic Surgery in an Ambulatory Surgicenter.- 62. Eye Surgery at an Outpatient Surgicenter.- 63. Endoscopic Sinus Surgery at an Outpatient Sugicenter.