Anesthesia Student Survival Guide.pdf - Index of

404 ● AnesthesiA student survivAl Guide
Table 25.3 Trauma blood protocol.
• O-neg×2 units, then
• O-pos if
o Male
o obviously non-child bearing age
• Continue with O-neg
Table 25.4 Massive transfusion protocol.
• Thaw 4 units FFP and 1 unit Cryoprecipitate
• Crossmatch 6 units PRBC and 1unit Platelets
• Deliver to OR
– Cooler #1:4 units PrBC
– Cooler #2:2 units PrBC + 3 units FFP
– Bucket: Cryoprecipitate + Platelets
• Continue to replenish coolers/bucket until told to stop
Orthopedic Surgery
Not all trauma is orthopedic, and not all orthopedic procedures result from
trauma. Here we shall focus on the special challenges in care of the routine,
scheduled, elective orthopedic patient.
Choice of Anesthetic
Orthopedic procedures lend themselves to a wide variety of regional techniques,
many of which are detailed in Chap. 13. The question that patients frequently
ask is “Are blocks better and safer than general anesthesia?” Unfortunately, the
answer is far from clear. A good general anesthetic is always better than a bad
regional anesthetic. Does regional anesthesia reduce patient morbidity or
improve patient satisfaction?
The answer is an unequivocal “it depends.” Patients with less pain are obviously
more satisfied, but again a poorly functioning block (or regional/epidural
catheter) will increase pain and aggravation, as well as patient and surgeon dissatisfaction.
Ultrasound-guided catheter techniques are revolutionizing ambulatory
orthopedic procedures in some hospitals, while others are abandoning