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Scoliosis, Consent and Hypotension | Anaesthesia Worst Case Scenarios
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- เผยแพร่เมื่อ 2 มิ.ย. 2024
- For the full video, check out the Final Exam Course
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Exam Stem
You are seeing a 14yo female accompanied by her mother in preadmission clinic. She’s booked for a planned multilevel thoracic spine fixation in two week’s time for idiopathic scoliosis.
Her regular medications are
- Paracetamol
- PRN diclofenac
- Esomeprazole
- Multivitamin
- Vitamin D
- Symbicort
- Fluoxetine
Past Medical History
- Childhood asthma
- Idiopathic scoliosis
- Anxiety and depression
Vitals
- HR 80,
- BP 110/70,
- RR 16
- Sats 97%
- Height 156cm
- 48kg
She attends the local high school.
What are the components of informed consent?
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Fantastic presentation, thank you very much - and good luck in your final exam!
3 remarks:
a) given that it seems to be a slow bleed, you could do a contrast CT first to determine bleeding location and maybe it´s amenable to a interventional radiological procedure like coiling (before doing a very invasive procedure like laparotomy or thoracotomy) and
b) does the initial X-ray actually show a situs inversus totalis or was that just something to throw off the candidate...?
c) I´d also place a indwelling urinary catheter and have at least hourly a look at adequate urine output
Can you pls explain how to assess this patients cardiac reserve in case of congenital scoliosis