Intraoperative Complications & Emergency Management Flashcards

What is the management of a patient who develops complete heart block with hemodynamic compromise intraoperatively?

Answer: Transcutaneous pacing and atropine IV

Complete heart block with hemodynamic compromise requires immediate transcutaneous pacing and atropine to restore adequate heart rate.

What does 'cannot intubate, can oxygenate' indicate for airway management strategy?

Answer: Continue oxygenation via supraglottic airway and plan awake fiberoptic intubation

If oxygenation is maintained but intubation fails, a supraglottic airway can temporize while planning definitive management such as awake fiberoptic intubation.

Which patient position reduces passive regurgitation risk during induction in a full-stomach patient?

Answer: Head-up (reverse Trendelenburg 20-30°)

Head-up positioning (reverse Trendelenburg) reduces passive regurgitation risk by using gravity to retain gastric contents below the esophagus.

What is 'total spinal' anesthesia and its immediate management?

Answer: Unintentional intrathecal overdose causing respiratory arrest; treated with intubation and ventilation

Total spinal from unintentional intrathecal overdose causes phrenic nerve block and respiratory arrest requiring immediate intubation and ventilatory support.

A patient develops severe bronchospasm during anesthesia. What is the first pharmacologic intervention?

Answer: Deepen anesthesia and administer inhaled albuterol

Deepening anesthesia reduces airway reactivity, and inhaled albuterol is the first-line bronchodilator for intraoperative bronchospasm.

Which electrolyte abnormality most commonly causes intraoperative cardiac arrhythmias?

Answer: Hypokalemia

Hypokalemia increases myocardial excitability and arrhythmia risk, particularly in patients on digoxin or with pre-existing cardiac disease.