Gerontologic considerations : Catastrophic events in the OR

Gerontologic considerations : Catastrophic events in the OR 150 150 Tony Guo

Gerontologic considerations

  • Anesthetic drugs should be carefully titrated
  • Assess for poor communication
  • Risk from tape, electrodes, and warming/cooling blankets
  • Osteoporosis and osteoarthritis
  • Perioperative hypothermia

Catastrophic events in the OR

  • Anaphylactic reactions
    • Manifestation may be masked by anesthesia
    • Vigilance and rapid intervention are essential
    • Symptoms include hypotension, tachycardia, bronchospasm, pulmonary edema
  • Malignant hyperthermia
    • Rare metabolic disorder
    • Hyperthermia with rigidity of skeletal muscles
    • Often occurs with exposure to succinylcholine, especially in conjunction with inhalation agents
    • Usually occurs under general anesthesia but may also occur in recovery
    • Other triggers
      • Trauma
      • Heat
      • Stress
    • Autosomal dominant trait
      • Inherited hypermetabolism of skeletal muscle resulting in altered control of intracellular calcium
    • Tachycardia
    • Tachypnea
    • Hypercarbia
    • Ventricular dysrhythmias
    • Rise in body temperature NOT an early sign
    • Can result in cardiac arrest and death

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