FANZCA Perioperative Care and Management Flashcards

What is the primary purpose of a preoperative anesthetic checklist in line with FANZCA and ANZCA standards?

Answer: To systematically verify equipment, medications, and patient safety parameters before induction of anesthesia

The anesthesia machine checklist ensures all equipment, drugs, and monitoring are functional and available before each case, reducing the incidence of preventable critical incidents.

In the perioperative management of a patient on long-term anticoagulation, which agent is used as a bridging therapy in high-thrombotic-risk patients when oral anticoagulation must be interrupted for surgery?

Answer: Low molecular weight heparin (LMWH)

LMWH is used as bridging anticoagulation in high-risk patients (e.g., mechanical heart valves, recent VTE) when warfarin is held perioperatively, minimizing both bleeding and thromboembolic risk.

Which intraoperative monitoring modality provides continuous real-time assessment of cerebral oxygenation during procedures at risk for cerebral hypoperfusion, such as carotid endarterectomy?

Answer: Near-infrared spectroscopy (NIRS) cerebral oximetry

NIRS cerebral oximetry uses near-infrared light to non-invasively measure regional cerebral oxygen saturation, providing continuous feedback during procedures risking cerebral hypoperfusion.

What is the rationale for using a lung-protective ventilation strategy (tidal volumes 6–8 mL/kg IBW, PEEP 5–8 cmH2O) during general anesthesia?

Answer: To prevent ventilator-induced lung injury (VILI) and postoperative pulmonary complications

Low tidal volume ventilation with appropriate PEEP reduces alveolar overdistension and atelectrauma, decreasing the incidence of postoperative pulmonary complications including pneumonia and respiratory failure.

In perioperative temperature management, what adverse effect is most directly associated with intraoperative hypothermia (core temperature < 36°C)?

Answer: Coagulopathy, increased surgical bleeding, and wound infection risk

Intraoperative hypothermia impairs platelet function and clotting factor activity, increases surgical blood loss, promotes wound infection through vasoconstriction, and prolongs drug metabolism.

What does a positive 'cannot intubate, cannot oxygenate' (CICO) scenario mandate according to FANZCA airway management guidelines?

Answer: Immediate front-of-neck airway (FONA) access via cricothyrotomy or tracheotomy

FANZCA and ANZCA guidelines mandate immediate front-of-neck airway access (scalpel cricothyrotomy as the default technique) when both ventilation and intubation fail, to prevent hypoxic brain injury and death.