07 / Anaesthesia · Teaching

The anaesthetic, start to finish

8 modules following one anaesthetic from the pre-operative visit to the recovery bay.

Assessment

The pre-operative visit
Fifteen minutes at a bedside that decides how the next four hours go: the airway, the heart, the lungs, the drugs, and the plan the patient agrees to.
5 beats · 4 pearls

Induction

Induction, in order
Induction is a checklist executed calmly, not a set of drugs pushed quickly. The order rarely changes, and the reason for each step is the point.
5 beats · 4 pearls
Rapid sequence induction
The technique for the patient who may aspirate: the shortest possible interval between losing airway reflexes and having a cuffed tube below the cords.
5 beats · 4 pearls
The airway ladder
Every airway plan is a stated sequence, declared before induction: plan A, plan B, plan C, plan D. The purpose is to move on early rather than repeat a failing attempt.
4 beats · 4 pearls

Maintenance

Maintenance and depth
Keeping a patient asleep, still, pain-free and physiologically stable for as long as the surgeon needs, and knowing which of those four is failing when something changes.
4 beats · 4 pearls

Emergence

Emergence and extubation
The most dangerous ten minutes of many anaesthetics. More critical incidents happen at extubation than at induction, and almost all of them are predictable.
4 beats · 4 pearls

Regional

Regional anaesthesia
Blocking the nerve instead of the brain: better analgesia, less opioid, fewer awake-patient problems, and a specific set of hazards that belong to it alone.
4 beats · 4 pearls

Recovery

Recovery and the first hour
Handover, pain, nausea and the complications that declare themselves in the first sixty minutes after a patient leaves theatre.
4 beats · 4 pearls

Every dose and range in this section is a teaching value for a healthy adult, printed as a textbook would print it so the arithmetic can be practised. It is not a prescribing reference. Real anaesthesia follows your local formulary, your department’s guidelines, and the patient in front of you.

The anaesthetic, start to finish

The pre-operative visit

Induction, in order

Rapid sequence induction

The airway ladder

Maintenance and depth

Emergence and extubation

Regional anaesthesia

Recovery and the first hour