Modern Anaesthesia:

A Concise Guide to The Study And Practice Of Anaesthesia.

JOSHUA JATAUNAMO OSCAR • Boek • paperback

• Samenvatting
  This version has been thoroughly edited and updated to reflect the most recent methods and factors because anesthesia is a subject that is always developing. A must-have for anesthetists, this book is fully chaptered from chapters One to Fourteen and has full-color graphics and diagrams to help readers visualize the equipment used in anesthesia practice.
  An extremely comprehensive educational and practical textbook for anesthesia trainees, Modern Anaesthesia: A Concise Guide to the Study and Practice of Anaesthesia is a priceless resource for all those who work with anaesthetic equipment, including anaesthetic and intensive care nurses and operating department practitioners.
  The book should appeal to readers since it is well-organized and simple to read.
• Productinformatie
  Binding : Paperback
  Distributievorm : Boek (print, druk)
  Formaat : 152mm x 229mm
  Aantal pagina's : 236
  Uitgeverij : Noogul Publishing
  ISBN : 9781329879003
  Datum publicatie : 04-2025
  
• Inhoudsopgave
  TABLE OF CONTENTS
  ALL RIGHTS RESERVED i
  TABLE OF CONTENTS ii
  CHAPTER ONE 1
  INTRODUCTION TO ANAESTHESIA 1
  Introduction 1
  Historical Review 2
  Education 3
  Anaesthesia Practice 4
  History of Modern Medicine (BC-C 1500) 10
  Renaissance Period (C1500 – C 1750 11
  C 1800 – C 1842 11
  Mysterious Somnifera Spongia 11
  Age of Enlightenment 11
  Hypnosis 12
  First Era (1847 – 1897) 12
  Nurse Anaesthetist involvement in the First Era 13
  Second Era (1897 – 1947) 13
  Educational Programme 14
  Third Era (1947 – 2000) 15
  Summary 15
  References 17
  CHAPTER TWO 18
  INSTRUMENT USED IN ANAESTHESIOLOGY 18
  Introduction 18
  Medical Gas Supply 18
  Cylinders 18
  Pin index system 19
  Pressure in the cylinders 20
  Cylinder valve 20
  Piped gas supply 21
  Liquid oxygen 21
  Oxygen Concentrator 22
  Compressed Air 22
  Pressure Gauge 22
  Pressure regulator (Reducing valve) 23
  Flow restrictor 23
  Flowmeters 24
  Vapourizers 25
  Ideal vapourizers characteristics 25
  Boyle's bottle/glass-ether vapourizers 26
  Trichloroethylene vapourizer bottle 27
  Goldman halothane vapourizer 27
  Back bar 28
  Oxygen supply failure alarm 29
  Plenum vapourizers 29
  Common gas outlet 30
  Bag mount 30
  Rebreathing bag 31
  Corrugated Rubber Tube 32
  Adjustable pressure limiting valve (Expiratory valve) 33
  Face mask and angle piece 34
  Anaesthetic Breathing System 36
  Advantages: 37
  Disadvantages: 37
  Soda Lime 37
  Conical neutralization of CO2 37
  Baralyme 38
  Absorbers 38
  Water's 'to-and-fro' system 39
  Circle breathing system 40
  Vapourizer outside the circle breathing system 42
  Vapourizer inside the circle breathing system 42
  Mapleson Classification 42
  Criteria for an Ideal Breathing System 42
  Mapleson A System 43
  Mapleson B System 43
  Mapleson C System 44
  Mapleson D System 44
  Mapleson E System 45
  Mapleson F System 45
  Bain Circuit 46
  Endotracheal Tubes and Airways 47
  Endotracheal tubes 47
  Length of the tube: 48
  Type of cuff: 49
  Oxford endotracheal tube 49
  Armoured endotracheal tube 50
  RAE (Ring, Adair and Elwyn) endotracheal tube 50
  Laser resistant endotracheal tube 51
  Micro laryngeal endotracheal tube 51
  Tracheostomy tubes 51
  Metal Tracheostomy Tubes 53
  Double Lumen Endobronchial Tubes 54
  Oropharyngeal Airway 56
  Nasopharyngeal Airway 58
  Laryngeal Mask Airway 59
  Advantages: 59
  Disadvantages: 60
  Laryngoscopes 60
  Endotracheal Tube Connections 62
  Catheter Mount 63
  Intubating Forceps (Magill) 64
  Laryngeal Spray 65
  Gum Elastic Bougie 65
  Stylet 65
  Ventilators 65
  Options: 66
  Summary 67
  Bibliography 69
  CHAPTER THREE 70
  ANAESTHETIC MACHINE 70
  Components of Anaesthetic Machine: 71
  Safety Devices incorporated in the anaesthetic machine 71
  Explain uses of O2 in the Anaesthetic machine 72
  Temperature Compensated Vaporizer 72
  Temperature uncompensated vapourizer (Not temperature compensated) 73
  Modern – Plenum Vapourizer Temperature compensated. 73
  Signs of Electrolyte Imbalance 74
  Peri Operative Embolism 74
  Management: - Vasopressors, inotopes 74
  Isoflurane 75
  Side effect – Respiratory depression, low blood pressure 75
  Uses: 75
  Adverse Effect 75
  Physical Properties: Molecular weight 184.5glmol 75
  Mechanism of Action: 76
  Premedication 76
  Specific Indications: 76
  Factors that Reduces Sedative Premedication 77
  Summary 77
  References 79
  CHAPTER FOUR 80
  ROLE OF THE NURSE ANAESTHETISTS IN HEALTH CARE DELIVERY 80
  Introduction 80
  Nurse Anaesthesia Scope of Practice 81
  Preoperative / Pre procedure 81
  Intraoperative / Intra procedure 82
  Postoperative / Post procedure 82
  Pain Management 82
  Other Services 82
  Pre-Operative Assessment & Patient Preparation 83
  Objectives of Pre-Anaesthetic Visit: 83
  Pre-Op Assessment 83
  History 84
  Physical Examination 84
  Pre-operative investigations 85
  Physical status assessment 85
  Preparation/Optimization of Patient 85
  Premedication 86
  Drugs for premedication 86
  Sedatives 87
  Narcotic analgesics eg pentazocine 87
  Neuroleptic agents e.g. droperidol 87
  Anticholinergics e.g. Atropine 88
  Disadvantages of premed 88
  References 91
  CHAPTER FIVE 92
  CONSENT FORM 92
  Introduction 92
  Consent 92
  Ethical Angle 93
  Legal Angle 93
  Consent 93
  Types of consent 93
  Reasons for signing informed consent 95
  Shared Decision-Making 95
  Disclosure of Information 96
  Pre-Requisites 97
  Exceptions to Disclosure 98
  Therapeutic privilege 98
  Placebo 98
  Blanket Consent 98
  Documentation 98
  Consent Validity 99
  Signing Informed Consent Means 99
  Informed Refusal 100
  Consent to Operation, 100
  Legal Implication 101
  Understanding the legal basis 101
  Ethical Angle 101
  Autonomy 101
  Right to decide 102
  Paternalistic approach 102
  Legal Angle 103
  Case Study 104
  A turning point: Montgomery 104
  Implications of the case 105
  Summary 107
  References 108
  CHAPTER SIX 109
  ROLES OF NURSE ANESTHETIST IN RESUSCITATION AND INTENSIVE CARE 109
  Introduction 109
  Admission of Patient 109
  Discharge of Patient from Intensive Care Unit (ICU) 110
  Professional Role 110
  Communicator Role 111
  Collaborator Role 111
  Manager Role 111
  Health Advocate Role 111
  Scholar / Researcher Role 112
  Postoperative Care and Pan Management Role 112
  Termination of Anesthesia Role 112
  Documentation Role 112
  Accountability Role 113
  Patient Information Role 113
  Patient Education Role 113
  Principles of Reporting and Recording 113
  Purpose of Client Records 114
  General Guidelines for Recording 114
  Record Keeping and Reporting (Documentation) in Anaesthesia 115
  Harold Randall Griffith Reasons for Documenting Anaesthetic Records 115
  Internationally the Characteristics of Anaesthetic Chart Include the following 115
  The design of anaesthetic chart should include the following: 116
  Advantages of AIMS 116
  Disadvantages of AIMS 117
  References 117
  CHAPTER SEVEN 120
  OXYGEN 120
  Introduction 120
  History of Oxygen 120
  General Uses of Oxygen 121
  Medical Oxygen (99-99.5% Pure) 122
  Oxygen Transport 124
  Atmosphere to Alveolus 125
  Alveolus to Blood 125
  Oxygen carriage by the blood 127
  Effect of Anaesthesia on O2 Transport 130
  Types of Anaesthesia 130
  General anesthesia 131
  Regional anaesthesia 131
  Conscious sedation 133
  Assessment of General Anaesthesia Using Guedel Classification 133
  History of General Anaesthesia 133
  Stage of analgesia 134
  References 136
  CHAPTER EIGHT 137
  GENERAL PRINCIPLES OF ANAESTHETIC PRACTICE 137
  Introduction 137
  Causes of Peri-Op mortality: 137
  Administration of Anaesthesia Using Various Techniques 137
  Premedication 138
  Induction/ Intubation 139
  Maintenance 139
  Monitoring 140
  Patient monitoring 140
  Termination/Extubation. 140
  Recovery 140
  Discharge 141
  Documentation 141
  Desirable qualities of Anaesthetists 141
  The History of Neuraxial Anaesthesia Goes back to 1885. 142
  Anaesthetic 144
  General anaesthetic 146
  Intravenous agents (non-opioid) 147
  Intravenous opioid analgesic agents 149
  Neuromuscular blocking drugs (Muscle relaxants) 149
  Depolarizing muscle relaxants 150
  Non-depolarizing muscle relaxants 150
  Adverse effects 150
  Anaphylaxis 151
  Intravenous reversal agents 151
  Summary 151
  References 152
  CHAPTER NINE 153
  TOTAL INTRAVENOUS ANASTHESIA (TIVA) 153
  Introduction 153
  Indication & Advantages for TIVA 154
  Limitations/ Disadvantages 155
  Properties of Ideal Drug for TIVA 155
  Drugs Use During TIVA 155
  TIVA Regimens and Principle 155
  Principle of TIVA 156
  Equipment and Monitor 156
  Monitoring during TIVA 156
  Summary 157
  CHAPTER TEN 158
  AIRWAY OBSTRUCTION 158
  Introduction: 158
  Airway Obstruction 158
  Types of Airway Obstructions 158
  Causes of Obstruction 159
  Mechanical causes 159
  Functional causes 160
  Type of Obstruction 160
  Total Obstruction: 160
  Partial Upper Airway Obstruction: 161
  Special Investigation 161
  Laryngoscope and Bronchoscopy 161
  Flexible Fibreoptic Bronchoscope: 161
  Advantages: 161
  Disadvantages 162
  Direct laryngoscope: 162
  Radiographic Imaging 162
  Anterior Posterior and lateral: 162
  Computer tomography scan: 162
  Magnetic resonance imaging: 163
  General Management 163
  Principles of Airway Management Technique 163
  The Endotracheal Intubation 163
  Surgical Airway Management 164
  Management 165
  Specific treatment 165
  Prevention 166
  Prognosis 166
  Possible Complication 166
  Lower Airway Obstruction 166
  Management of Lower Airway 167
  Recurrent Airway Obstruction 168
  Signs and Symptoms 168
  Causes 168
  Respiratory Insufficiency 169
  Hypoxaemia 169
  Treatment: 170
  Respiratory Failure 170
  Signs and Symptoms of type Ii Respiratory failure 171
  Diagnosis 171
  Treatment 171
  Oxygen Therapy 172
  Methods Of Administration Of O2 172
  Hazards of O2 Therapy 173
  References 176
  CHAPTER ELEVEN 180
  CARE OF UNCONCIOUS PATIENT 180
  Introduction 180
  Causes of Unconsciousness 180
  Structural lesion (major illness or injuries): 181
  Metabolic disorders 181
  Investigations 182
  Eye opening 182
  Best Motor Response 183
  Best verbal Response 183
  First Aid treatment: 183
  How to perform cardio-pulmonary resuscitation (CPR) in an Unconscious patient with cardiac arrest. 184
  Treatment 185
  Nursing management 185
  Goal of Nursing Care 186
  Nursing Diagnosis 186
  Complications 186
  Fractured ribs 187
  Prognosis 187
  References 187
  CHAPTER TWELVE 191
  POLYTRAUMATIZED PATIENT 191
  Introduction 191
  Definition 191
  Causes of Polytrauma 192
  Pre-operative Investigations 193
  Anaesthetic Consideration in the management of Polytrauma Patients 193
  Special Considerations for Regional Techniques in Trauma Patients 193
  Management 194
  The Primary Survey 194
  Airway Management (including cervical spine protection) 195
  Breathing and Ventilation 196
  Circulation 197
  Hemorrhage Control 198
  Disability 199
  Exposure/ Environment 199
  Enhancing Health Care Team Outcome 200
  Nursing, Allied Health, and Inter-professional Team Monitoring 201
  Technique of Management 202
  Regional Anaesthesia in Trauma Patients 204
  References 206
  CHAPTER THIRTEEN 207
  GERIATRIC ANAESTHESIA 207
  Introduction 207
  Definition 207
  Physiological Changes in Aging 209
  Cardiovascular system: 209
  Respiratory System: 209
  Renal System: 210
  Nervous system: 210
  Gastrointestinal system: 210
  Other Changes In Old Age 210
  Age - Related Pharmacological Changes 210
  Inhalational Drugs 211
  Opioids 211
  Neuromuscular Block 211
  Peripheral Nerve Block 211
  Anaesthetic Management For The Elderly 211
  Premedication 212
  Anaesthesia Technique 212
  Regional Anaesthesia/Analgesia 213
  Spinal Anaesthesia 213
  Epidural Anaesthesia 214
  Dissociative anaesthesia: 214
  Post Operative Care 214
  Case Dicussion 215
  The Elderly Patient with a Fractured Hip 215
  Anaesthesia For Elderly (Geriatric Anaesthesia) 218
  Age Related Anatomical And Physiological Changes 219
  In the Cardiovascular System of Geriatrics 219
  In The Respiratory System of Geriatrics 219
  In The Nervous System of Geriatrics 220
  In the Renal System of Geriatrics 220
  In the Gastro Intestinal System of Geriatric 220
  In the Musculoskeletal System of Geriatrics 220
  In the Skin of Geriatrics 221
  Pharmacological Age Related Changes: 221
  Consideration Principles of The Elderly Anaesthesia 221
  Choice of Technique of Anaesthesia in The Elderly 222
  Disadvantages: 222
  General Anaesthesia in Geriatrics 222
  Post Operative Care Of Geriatrics 223
  Summary 223
  Recommendations 225
  References 226
  CHAPTER FOURTEEN. 231
  ANAESTHESIA FOR DAY-CASE SURGERY 231
  Day-Case Surgery 231
  Advantages Of Day - Case Anaesthesia/Surgery 231
  Modalities 231
  Patient Selection 232
  Contraindications 232
  Pre-Anaesthetic Evaluation 232
  References 237
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