ipl-logo

Essay On Rebleeding

2128 Words9 Pages

Rebleeding.
Rebleeding is one of the most feared complications and is usually manifest as deterioration in neurological state. If rupture occurs during anaesthesia, the patient can develop dysrhythmias and brain swelling. If a ruptured aneurysm is not treated, there is a 40% chance of rebleeding in the first 28 days. Approximately 70% of patients who suffer a second bleed will die.

High transmural pressure ( Transmural pressure = Intravascular pressure- Extravascular pressure ) will predispose to rupture of an aneurysm. To prevent rebleeding it’s important to prevent pressure surges especially at the time of laryngoscopy and intubation. Aim was to maintain trans mural pressure gradient.

Cerebral ischemia or Infarction
It can occur immediately …show more content…

Comparatively, Halothane will increase CBF. Theoretically due to the known drawbacks of N2O increases ICP, especially when it is used in conjunction with volatile agents, and it can inactivate Vitamin B-12 in prolonged use. air was use instead of N2O.
Clinically, both Enflurane and Isoflurane have weaker cerebrovasodilatory actions than Halothane, but Isoflurane is preferred because of Enflurane’s potential adverse proconvulsant action and adverse effects on CSF dynamics. Hyperventilation attenuates or prevents the cerebral blood flow, enhancing effects of potent inhalation anaesthetics. When PaCO2 is rapidly reduced, CBF decreases faster with Isoflurane than with Halothane.

Potent inhaled agents reduce CMRO2 by 20-30% at clinically encountered doses. Transmural aneurysm pressure is thought to determine the likelihood of rebleeding. So elevation of systemic arterial blood pressure or reduction of ICP might cause rupture of the aneurysm. We maintained an adequate depth of anaesthesia with Isoflurane. Mannitol was given with the first Burr hole to prevent increase of transmural pressure.

Show More
Related

  • Kelly Malone Case Summary

    242 Words  | 1 Pages

    Justin is the registered nurse that has been given the handover for Kelly Malone’s postoperative care in the surgical unit. Kelly Malone is a 49 female patient who has had a septoplasty and a right ethmoidectomy. Justin is working with Kelly to identify Kelly’s needs in order for Kelly to be discharged from the hospital. Kelly’s postoperative observations were a temperature of 36.2 degrees celsius; heart rate of 68 beats per minute; respiratory rate of 18 breaths per minute, blood pressure of 111 systolic over 73 diastolic millimetres of mercury; oxygen saturation at 93 percent of room air and a self-rated pain score of two out of ten. Kelly has a history of ‘not being able to breathe well through her nose’ and a history of disturbed sleep.

    Read More

  • Patient's Case Study: Syncope

    2129 Words  | 9 Pages

    4.1. Vasovagal Causes. 4.2. Orthostatic hypotension. 4.3.

    Read More

  • HPC Code Of Ethics: What Is Sibert´s Anaesthetic Phase?

    1831 Words  | 8 Pages

    Anaesthetist explained to the author that Isoflurane was suitable for Sibert because of his age and healthy status. Furthermore, Smith et al., (1992) also mentioned that Isoflurane is a good anaesthetic agent for adults and causes less cardiovascular effects. Again, Frink et al.,(1992) emphasised that Isoflurane when used on patients with ASA grade 1,the incidence of post-operative nausea and vomiting is very less even though it causes respiratory

    Read More

  • The Pros And Cons Of Animal Docking

    360 Words  | 2 Pages

    There are also other associated risks such as hemorrhage anesthesia reactions (if

    Read More

  • Lorazepam Case

    820 Words  | 4 Pages

    1. There are several outcomes anticipated for Mr. A. Foremost, stabilizing a number of conditions reported to be fluctuating is the first prioritized outcome. Such conditions include: respiratory rate (12-20 breaths/min), blood pressure (below 120/80 mm Hg), complete ceasing of crackles in the bases, normalized heart rate (60-100 beats/min), reduced and stable body temperature (97.8-99o F), hemodynamic stability, and general normalized parameters determined via ABG analysis (that is, arterial pH in the ECF of about 7.35–7.45, PaO2 of 80–100 mm Hg, PaCO2 of about 35 – 45 mm Hg, HCO3 21–28 mEq/L, and SaO2 or 95%-100%. Also, all possible infections have to be prevented and/or treated. Finally, fluid balance maintenance is also an outcome.

    Read More

  • Essay On Infective Endocarditis

    320 Words  | 2 Pages

    This causes elevated pulmonary capillary pressure which pushes fluid into the interstitial spaces and alveoli (Bickley & Szilagyi, 2013) 2) Dizziness is a concerning symptom as it may mean her pulmonary hypertension is worsening. Insufficient circulation of blood through the pulmonary capillaries can lead to hypoxemia in persons with respiratory or cardiac disease (Porth, 2011). I would have liked to know what this patient’s pulse oximetry was or if she

    Read More

  • MVA Research Papers

    1510 Words  | 7 Pages

    These findings support further work to demonstrate the airway clearance benefits of HFCWO

    Read More

  • Nebulized Epinephrine Essay

    429 Words  | 2 Pages

    The child immediately improved and was stable on continuous delivery for many hours. When the source of the humidified water was switched to a Vapotherm system at the same flow (10 L/min) but not containing epinephrine, the child’s croup worsened, only to improve again when epinephrine was added to the humidifying water. A similar experience was found with a second child with croup which led to the hypothesis that epinephrine may be deliverable in the vapour phase as opposed to droplets as has been the usual method with a nebulizer. It also appeared that the improvement in upper airway obstruction was not due (at least alone) to the high flow delivering continuous positive airway pressure, as originally theorized by Klein and

    Read More

  • Symptoms And Definition Of Aneurysm

    868 Words  | 4 Pages

    As an aneurysm increases in size, the risk of rupture increases leading to uncontrolled bleeding. Although they may occur in any blood vessel particularly lethal examples include aneurysms of the Circle of Willis in the brain, aortic aneurysms affecting the thoracic aorta and abdominal aortic aneurysms. Classification: Aneurysms

    Read More

  • Dyssynchrony Case Summary

    1209 Words  | 5 Pages

    The problems that Mr. A is at risk for would include ventilator- associated Pneumonia, coagulation issues, speech compromise and muscle impairments. Although Mr. A. is young, he could still be at risk for pressure ulcers because of lack of movement, decrease nutrition and immunity compromise related to the splenectomy. The nurse will have to monitor vital signs, laboratory values, intake and output, wound healing and the patient as a

    Read More

  • M1 Unit 4 Seminar

    685 Words  | 3 Pages

    As a result, these patients can’t bring the carbon dioxide out, they become retain the carbon dioxide which makes it so hard for them to breathe

    Read More

  • Nursing Simulation Paper

    945 Words  | 4 Pages

    Professor Griffiths explained the background of the patient, Sally Jacob. Sally Jacob was a 65-year-old female who was going to have a right side femoral popliteal bypass. Her background includes having hypertension for the 15 years, DNC heavy menstrual bleeding, peripheral arterial occlusive diseases in the right leg, and complains of having nausea and vomiting following a procedure due to the anesthetic

    Read More

  • Awake Extubation Case Study

    717 Words  | 3 Pages

    The anaesthetist removed the ETT and proceeded to place a tight fitted mask on patients face. (REF)She then alerted the team that there was a problem with the patient airway (REF). The mask did not mist up – indicating of no air movement return, there was no carbon dioxide trace on the capnography and the patient oxygen saturation dropped steadily from 100% to 90%. He instigated vigorous jaw thrust to improve oxygenation, and using continuous positive airway pressure(CPAP) to deliver 100% oxygen flow through the breathing bag attached to the anaesthetic machine but all this effort was not having any effect on the ventilation. He then asked my mentor the Operating Department Practitioner (ODP) to administer 50mg/5ml of intravenous Propofol.

    Read More

  • Essay On Gynecomastia

    1529 Words  | 7 Pages

    This may be treated with an implantation or injection of fat. Another possible complication involving the nipple is nipple loss, but complete or partial nipple death is a very rare complication because the operation is designed to maintain adequate blood supply to the nipple. Yet, if the nipple and surrounding areola die because of an insufficient blood supply, they would require removal; this problem is then treated with dressing changes to aid healing. The nipple could be reconstructed at a later date, but nipple reconstructions have limited

    Read More

  • Laparoscopic Cholecystectomy

    1042 Words  | 5 Pages

    Anesthesia was induced by 2.5 mg/ kg i.v propofol. Tracheal intubation was facilitated by 0.6 mg/kg i.v rocuronium. Neuromuscular block was maintained at 80-90% level by 10 mg i.v rocuronium increments as evaluated using train of four stimulation of the ulnar nerve. Anesthesia maintenance was achieved by sevoflurane and 100% oxygen. The lungs were ventilated using a Datex Ohmeda (ASPIRE 5 U.S.A.) ventilator with a circuit incorporating C02 absorber.

    Read More

More about Essay On Rebleeding

Open Document