Ketofol Spritz

KEY POINTS: Presentation 24-72h post-injury - risk during major trauma and surgery (esp long bones) Pathophysiology: Fat from marrow into lungs = pulmonary hypertension, RV strain, hypoxia SIRS from fatty acids = myocardial depression, ARDS, DIC Prevention = early immobilisation/reduction and operative management Dx of exclusion but  classic triad of GURDS  = confusion, respiratory distress and pe...

Explain the cardiovascular effects of central neuraxial blockade 2019B08 62.6% 2013C12 56.0% 2013A12 38.0%

Explain the effects of intermittent positive pressure ventilation on cardiac output 2021B01 56.5% 2019A01 54.7% 2014A05 37.6% 2013B01 19.7%

What is the normal value for PVR? Outline physiological factors influencing PVR.

Discuss the potential adverse effects of suxamethonium. Describe how suxamethonium and non-depolarising neuromuscular blocking agents produce their adverse cardiovascular effects. Outline the possible reasons for prolonged paralysis induced by an intravenous dose of 1 mg/kg of suxamethonium.

Pharmacology - Dose, Onset (Mechanism of Action - Accommodation, Phase II Block), Offset, Side Effect (Summary) Describe how suxamethonium produces neuromuscular blockade. What is the mechanism of recovery of neuromuscular function and what mechanisms may be involved in Phase II block?

Describe the factors influencing CO2 tension in blood.

Outline the central nervous system effects of an awake person breathing air containing CO2.

Explain the difference between perfusion limitation and diffusion imitation in the transfer of gas between alveolus and pulmonary capillary. Outline the factors that determine whether a gas is perfusion or diffusion limited.

Briefly outline the differences between the pulmonary circulation and the systemic circulation.

Describe the response to hypoxaemia in both the awake and anaesthetised patient.

Describe the ways in which CO2 is carried in the blood

Discuss possible causes for the PaCO2 differing from the ETCO2 in an anaesthetised, intubated patient on IPPV.

Define “Venous Admixture”. Briefly explain how venous admixture influences arterial oxygen tension and how an increase in inspired oxygen concentration may affect this.

Explain the concept of time constants and relate these to “fast” and “slow ” alveoli