Practical Procedures in Anaesthesia and Critical Care

by Jackson, Guy; Whiten, Christopher J.; Soni, Neil

• ISBN13: 9780199573028
• ISBN10: 0199573026
• Edition: 1st
• Format: Paperback
• Copyright: 2011-01-11
• Publisher: Oxford University Press

Summary

The ability to perform a wide variety of practical procedures safely and competently is essential for any doctor involved in the practice of anesthesia and intensive care. Junior doctors especially are now called upon to gain competence in many invasive practical procedures in an increasingly short space of time, whilst also understanding the theory behind them. This highly practical book is the only guide needed to the procedures and techniques commonly used in anesthesia and critical care medicine. Step-by-step, it clearly explains each technique and procedure, enabling the reader to fully understand how and why they are performed. Full colour photographs illustrate each technique, and every chapter covers the same essential information: definition, indications, contraindications, complications, equipment, sites, and technique, for ease of use. This book will be used by all junior trainees in anesthesia, along with junior doctors from other specialities working in intensive care units. It will also be useful to any senior anesthetist who wishes to update or refresh their knowledge, as well as anyone working in the emergency ward who performs any of these procedures.

Table of Contents

Abbreviations	p. xi
Introduction	p. xiii
Basic Principles	p. 1
Hand washing	p. 2
Aseptic technique	p. 7
Consent	p. 11
Environment, safety and additional equipment	p. 12
Ultrasound in anaesthesia and intensive care	p. 13
Cardiopulmonary resuscitation	p. 14
Intravascular Access	p. 21
Peripheral venous cannulation	p. 22
Central venous access	p. 26
Ultrasound guidance for intravenous central line insertion	p. 30
Seldinger technique	p. 33
Railroading	p. 36
Internal jugular vein CVC insertion	p. 38
Subclavian vein CVC insertion	p. 42
Femoral vein CVC insertion	p. 45
External jugular vein cannulation	p. 48
Tunnelled central venous lines	p. 50
Peripheral sites for central venous access: peripherally inserted central catheter (PICC) lines	p. 52
'Special' lines	p. 56
Pulmonary artery catheter	p. 56
Intraosseous needle insertion	p. 59
Lines for haemofiltration/dialysis	p. 62
Dialysis	p. 64
Arterial line insertion	p. 66
Rapid infusion devices	p. 68
Transducers	p. 70
Monitoring	p. 71
'Routine' anaesthetic monitoring	p. 72
12-lead ECG	p. 73
Cardiac output monitoring	p. 75
Intra-abdominal pressure measurement	p. 77
Arterial blood gas sampling	p. 78
Airway Procedures	p. 81
Airway maintenance	p. 82
Positioning	p. 82
Oropharyngeal airway (aka Guedel Airway)	p. 84
Nasopharyngeal airway	p. 86
Facemasks	p. 88
Laryngeal mask airways	p. 90
Tracheal intubation	p. 95
Oral tracheal intubation	p. 95
Nasal intubation	p. 101
Bougies and other intubation aids	p. 104
Rapid sequence induction (RSI)	p. 106
Double lumen tube insertion	p. 111
Airway devices and 'special' airways	p. 117
Video-laryngoscopes	p. 118
Difficult intubation	p. 120
Retrograde tracheal intubation	p. 125
Emergency airway access	p. 129
Cricothyroidotomy	p. 129
Fibreoptic intubation	p. 135
Percutaneous tracheostomy	p. 142
Insertion of a tracheostomy	p. 144
Changing a tracheostomy	p. 149
Bronchoscopy	p. 151
Ventilation	p. 156
Mechanical ventilation	p. 156
Thoracic Procedures	p. 163
Needle thoracostomy for chest aspiration	p. 164
Aspiration of tension pneumothorax	p. 164
Aspiration of pleural effusion/haemothorax	p. 166
Intercostal drain insertion	p. 169
Surgical chest drain insertion	p. 169
Seldinger chest drain insertion	p. 173
Removal of a chest drain	p. 175
Pericardiocentesis	p. 177
Temporary cardiac pacing	p. 179
External temporary cardiac pacing: percussion pacing	p. 179
External temporary cardiac pacing: transcutaneous pacing	p. 181
Internal temporary cardiac pacing	p. 182
Abdominal Procedures	p. 185
Nasogastric and nasojejunal tube placement	p. 186
Nasogastric tubes	p. 186
Nasojejunal tubes	p. 192
Sengstaken-Blakemore and Minnesota tube placement	p. 194
Urethral catheterization	p. 198
Abdominal paracentesis	p. 202
Neurological and Related Procedures	p. 207
Local anaesthesia	p. 208
Lumbar puncture	p. 210
Spinal anaesthesia	p. 214
Epidural anaesthesia analgesia	p. 219
Epidural analgesia troubleshooting	p. 227
Intracranial pressure monitoring	p. 229
Index	p. 233
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