Perioperative Complications and Emergency Management
What you must understand
Know the common perioperative emergencies: hypoxia, hypotension, arrhythmias, anaphylaxis, malignant hyperthermia, aspiration, laryngospasm, bronchospasm, and cardiac arrest. Understand the ABCDE approach to a deteriorating patient. Master basic and advanced life support principles: high-quality chest compressions, early defibrillation, and appropriate drugs. Know anaphylaxis management (epinephrine, fluids, airway support) and the difference between anaphylaxis and vasovagal reactions. Understand the causes of hypotension under anesthesia (hypovolemia, vasodilation, cardiac depression, anaphylaxis, pneumothorax) and how to distinguish them. Recognize the signs of local anesthetic systemic toxicity and its treatment.
Traps in questions
A common trap is treating hypotension with fluids alone when the cause is vasodilation or anaphylaxis. Another is delaying epinephrine in anaphylaxis. Watch for questions that ask for the first action in a crisis-usually it is to call for help, oxygenate, and assess, not to reach for a drug immediately.
Rule of thumb
In any crisis, follow ABCDE and treat the most life-threatening problem first. If the patient is unstable, stop and reassess before continuing the procedure.