Ethical and Legal Considerations in Pediatric Anesthesia
1. Informed consent is the process by which adult patients’ autonomy and agency are honored in medicine decision making. 2. In pediatrics, parents are the surrogate decision makers for the children, and…
Obstetric Anesthesia for Parturients with Respiratory Diseases
II.Asthma A. Introduction 1. Asthma presentation and symptoms. Asthma causes episodic partially reversible airway obstruction resulting from bronchoconstriction, inflammation, hyperresponsiveness, and mucous plugging. Symptoms include wheezing, chest tightness, difficulty breathing, and…
Ultrasound and Echocardiographic Techniques in Obstetric Anesthesia
I. Introduction II. Focused cardiac ultrasound A. Introduction B. Techniques C. Clinical applications D. FoCUS training, certification, and program maintenance III. Pulmonary ultrasound A. Introduction B. Technique C. Applications IV….
Cardiac Disease in the Obstetric Patient
3. Left heart obstruction (mitral valve area <2 cm2, aortic valve area <1.5 cm2, or peak left ventricular outflow tract gradient >30 mm Hg by echocardiography) 4. Reduced left ventricular function (ejection…
Neurologic Deficits Following Labor and Delivery
2. Despite the very low incidence of neurologic injury, it represents a significant contributor to malpractice litigation. Davies et al.11 performed an obstetric anesthesia closed claims analysis of 426 claims from…
Thrombophilias/Coagulopathies
Vascular spasm, mediated by vasoconstrictor substances released from platelets, reduces blood flow and occurs in the first stages of hemostasis. Damaged endothelium attracts platelets, which adhere to it, forming a…
Newborn Resuscitation
2. Fetal lung development takes place throughout pregnancy, and lung maturation continues well into the neonatal period. The pulmonary transition that occurs in the fetus is initiated before labor begins. Cortisol…
Renal and Hepatic Disease in the Pregnant Patient
C. Assessment of renal function during pregnancy 1. Renal function is commonly assessed by two techniques. The first measures serum levels of creatinine and BUN. However, these serum values will not…
Difficult Airway Management in the Pregnant Patient
B. Factors contributing to the difficult airway. Difficult mask ventilation, difficult laryngoscopy, and difficult intubation are factors that contribute to a difficult airway. 1. Difficult mask ventilation and difficult laryngoscopy occurs…
