You are requested to attend to a 65-year-old male patient who has just returned from surgery in the high dependency unit. He underwent a left hemicolectomy to remove colon cancer. Your task is to prescribe the appropriate intravenous fluids for him.
What is the most effective way to determine the infusion rate for the fluids?
What is the preferred intravenous induction agent for anesthesia in day case procedures?
A 25-year-old woman presents with a sudden and severe headache. Upon examination, she is spontaneously opening her eyes and localising to painful stimuli, but is disoriented. What would be the most appropriate initial investigation?
What is the commonly used curved-blade laryngoscope in adult practice?
You are asked to take over a patient halfway through a case to relieve the consultant anaesthetist for a comfort break. The patient, who is 65 years old, has an endotracheal tube (ETT) in situ and is maintained on sevoflurane and ventilated at a rate of 14 breaths per minute, with a tidal volume of 600. You notice that the carbon dioxide (CO2) trace is high (ET 6.9) and increasing quite rapidly. The maxillofacial surgeon remarks that the patient’s jaw is quite tight and asks for more muscle relaxant. You check the patient’s temperature and find that it is high at 39.6 °C.
Which one of the following is your priority?
A 57-year-old woman has undergone a mitral valve repair and is experiencing a prolonged recovery in the cardiac intensive care unit. To aid in her management, a pulmonary artery catheter is inserted.
What is one of the calculated measurements provided by the pulmonary artery catheter?
A 60-year-old man has been resuscitated after a cardiac arrest and is now being treated for hypoxic brain injury in the Neuro-Intensive Care Unit. His family is concerned about his prognosis. What is the most reliable source of information regarding his potential outcome?
A patient in their 70s is anaesthetised for an exploratory laparotomy. They were found to have perforated from a septic appendix. This has resulted in part of their bowel being removed and a stoma formation. The patient has been on the table for two and a half hours. Their core temperature at the end of the operation is 35.1 °C.
Which mechanism accounts for most heat lost?
A 98-year-old gentleman is admitted for an incarcerated hernia. He has a past medical history of chronic kidney disease stage 3, secondary to hypertension, and a background of transient ischaemic attacks (TIAs) and osteoarthritis of both knees.
He has four good twitches on train of four testing (normal response), following which reversal of his muscle relaxant was given. Intraoperatively, he received a total of 100 micrograms of fentanyl, 20 mg of morphine and 1 g of paracetamol for pain. He has an arterial line in situ. Blood gas prior to finishing the procedure showed a pH of 7.35, PaCO2 of 5.4 kPa, HCO3− of 21 mmol/l, with a blood sugar of 7.2.
You attempt to wean him off ventilation, but 20 minutes later he still does not want to breathe unsupported or wake up.
What should your next course of action be?
A 42-year-old man was undergoing a routine appendectomy and was given general anaesthesia with succinylcholine and halothane. The patient was sedated and intubated during the procedure. After one hour, the anaesthetist observed that the patient had a temperature of 41 °C, blood pressure of 160/90 mmHg, and a pulse rate of 110 bpm. An arterial blood gas (ABG) test revealed a pH of 7.2 (normal value 7.35–7.45) and a PaCO2 of 6.6 kPa (normal value <4.5 kPa). What is the most likely diagnosis?