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Thursday, June 20, 2013

A CHART FOR NEUROINTENSIVE CARE ROUNDS



A chart for taking rounds in Neuro intensive care setting by the anaesthesiologist / intensivist. Can also be used in other ICU settings. Click on the link below for downloading it.......

ITS A CHART FOR NEURO MEDICINE & SURGICAL I.C.U. ... PRINT PAGE 1 ON ONE SIDE OF A SINGLE SHEET AND WILL SUFFICE FOR 7 DAYS [ONE READING PER DAY ] AND PAGE 2 ON THE OTHER SIDE OF THE SAME SHEET FOR REGISTERING INFO AT TIME OF ADMISSION AS BASELINE  [BETTER TO TAKE BACK TO BACK PRINT ON A3 SIZE SHEET] ;  DAY 8 ONWARDS USE ANOTHER SHHEET; CAN KEEP PAGE 2 UNFILLED ON SUCH PAGES IF NOTHING TO WRITE

GCS.docx - 12.8 KB

                                              




Saturday, April 13, 2013

MNEMO (anaesthesia implications)>METHERGINE "METH"

MNEMO (anaesthesia implications)>METHERGINE "METH"

1.M=MS,HTN/PIH,Heart diseases are C/I
2.Ensure it is given over 1 mins if iv. Ensure breast feeding is delayed for 12h after last dose.
3.Together don't give any other vasopressor
4.HTN & CVA are the dreaded complications

MNEMO> PENTAZOCINE "HOT DRUG"

MNEMO> PENTAZOCINE "HOT DRUG"

H.Hallucination and psychotomimetic effects
O.Overt seizures rarely, with iv route
T.Typical Opioid side effects
D.Dose: 0.5 mg/kg i.v. or 30 mg i.v. Q4H. 30 mg iv= 10 mg morphine
R. Respiratory depression, Raised Pulmonary pressures(Pulmonary HTN), Raised BP, Raised ICP, Rare diseae:Porphyria ....are CONTRAINDICATIONS
U. Upward CVP, LVEDP,PULMONARY PRESSURES
G.Give LESSER doses more FREQUENTLY to reduce side effects

MNEMO(anaesthesia implications)>FrieDreich's Ataxia: "FDA"

FrieDreich's Ataxia: FDA

F. Failure of Heart and Respiration
[Needs detailed evaluation of CVS]
D.Diabetes
A.Atracurium safe,Arrhythmias

ANAESTHESIA MNEMO> PEMPHIGUS VULGARIS

 "VULGARIS"
V.Venous access is difficult
U.Use of small ETT may be better than LMA
L.Larynx: Anticipate scarring and narrowing
G.Get exacerbations with pregnancy, surgeries
A.Anticipate problems with mask application on induction
   Anticipate fluid and electrolyte imbalances
R.Risks of long term steroid therapy :
  [explain to patient and take   preventive measures like PPIs against ulcer, steroid supplimentation etc]
I.Infections
  Intubation can cause airway trauma --> bleeding ,scarring etc can occur
S.Skin is vulnerable: Avoid skin traction and friction

Saturday, March 23, 2013

ANAESTHESIA IMPLICATIONS OF COEXISTING DISEASES THROUGH MNEMONICS

MNEMO[anaesthesia implications]> Ehlers Danlos Syndrome "EDS"
E. ECG conduction anomalies
D.Difficult to maintain intravenous access
S.Spontaneous pneumo thorax
Severe tracheal bruising can happen on intubation
 MNEMO (anaesthesia implications)>SLE "CARD"
1.Cardiac and Renal involvement
2.Anemia
3.Raynaud's phenomenon: So avoid hypothermia
4.Determine clotting status
MNEMO[anaesthetic implications]> SARCOIDOSIS: "SARC"
'Sound box(=larynx)' involvement
Affect eyes, cranial nerves, LUNG
Renal impairement
Calcium increased
 
MNEMO> ITP(anaesthesia implications):
"ABCD"
1 Avoid aspirin/heparin
2 Bleeding from airway
3 Corticosteroid ( pt may be getting )
4 Develop Rebound Thrombosis after splenectomy