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Anesthesiology

Tracheostomy / Standard and Bedside

What the Anesthesiologist Should Know before the Operative Procedure Tracheostomy, or direct surgical opening of the trachea, is a common procedure performed in critically ill patients. The most common indication for tracheostomy is respiratory failure with ventilator dependency and the need for prolonged mechanical ventilation. Other common indications are upper airway obstruction, protection of tracheobronchial…
Critical Care Medicine

Hypotension

1. Description of the problem What every clinician needs to know Hypotension is blood pressure (BP) that is below that expected for a person in a particular demographic category. Neonates have systolic blood pressure (SBP) in the 50’s and that is entirely adequate for them, whereas a middle-aged person would be expected to have an…
Dermatology

Calcinosis Cutis (Benign Cutaneous Calcification, Benign Nodular Calcification)

Are You Confident of the Diagnosis? Calcinosis cutis may be triggered by multiple diverse etiologies, ranging from chronic illnesses to acute traumatic and iatrogenic insults to the skin. Calcinosis cutis is classified as dystrophic, metastatic, iatrogenic, or idiopathic based on these causative agents. Dystrophic calcification results from localized trauma or inflammation in patients with normal…
Anesthesiology

Congenital Diaphragmatic Hernia

What the Anesthesiologist Should Know before the Operative Procedure Congenital diaphragmatic hernia (CDH) is a condition that develops early in gestation whereby abdominal organs, which may include midgut along with the stomach, colon, left kidney, and left lobe of the liver are extruded into the thoracic cavity through a defect in the diaphragm. The left…
Anesthesiology

Abdominal Trauma – Procedures

What the Anesthesiologist Should Know before the Operative Procedure Abdominal surgery following traumatic injury is performed primarily for two reasons: (1) bleeding, in which there is injury to one or more blood vessels or a solid organ (i.e. spleen, liver, kidney), or (2) contamination, in which there is a hollow viscus injury with intra-abdominal spillage…
Anesthesiology

The Thrombophilic Parturient (e.g., LMWH)

What the Anesthesiologist Should Know before the Operative Procedure Pregnancy induces a hypercoagulable state. While the incidence of thromboembolic complications in the peripartum period is low, they remain a major cause of maternal morbidity and mortality. In most cases, the risks associated with administering anticoagulation therapy are greater than those of the hypercoagulable state associated…
Pulmonary Medicine

Thoracic Surgical Procedures (include mediastinoscopy, VATS, tube thoracostomy, pleuroscopy and thoracoscopy)

General description of procedure, equipment, technique Thoracic surgery encompasses a broad spectrum of procedures. Frequently performed, less invasive procedures include mediastinoscopy, tube thoracostomy, pleuroscopy or thoracoscopy, and video-assisted thoracoscopic surgery (VATS). Mediastinoscopy Mediastinoscopy is a procedure in which a mediastinoscope is inserted into the mediastinum through a small incision. The procedure is typically used for…
Hospital Medicine

Acute pancreatitis

Acute pancreatitis is a disease characterized by acute inflammation of the pancreas, commonly as a result of excessive alcohol use or secondary to gallstones. Every year in the United States, it is responsible for over 200,000 hospital admissions leading to more than $2 billion in healthcare expenses. Patients usually present with rapidly escalating right upper…
Hospital Medicine

Adult respiratory distress syndrome

Acute Respiratory Distress Syndrome I. What every physician needs to know. Acute Respiratory Distress Syndrome (ARDS) also known as, adult respiratory distress syndrome (previously non-cardiogenic pulmonary edema) is a syndrome of acute respiratory failure characterized by bilateral diffuse alveolar infiltrates on chest radiography and resulting hypoxemia. ARDS begins with an injury that results in an…
Anesthesiology

Female urinary incontinence surgery – procedures

What the Anesthesiologist Should Know before the Operative Procedure While urinary incontinence is prevalent in a large number of women (roughly half of all women aged 20 to 80 by survey studies), fewer than half will seek consultation and treatment for this condition. Many older women may have comorbidities (such as cardiovascular disease, diabetes mellitus,…
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