Intraoperative Complications & Emergency Management Flashcards

What is the definitive airway management strategy when 'cannot intubate, cannot oxygenate' (CICO) is declared?

Answer: Emergency surgical airway (cricothyrotomy)

In a CICO emergency, an emergency cricothyrotomy provides the definitive pathway to oxygenation when all conventional airway methods have failed.

What are the hallmark early signs of anaphylaxis occurring under general anesthesia?

Answer: Bronchospasm, hypotension, and urticaria

Anaphylaxis under anesthesia typically presents with bronchospasm, cardiovascular collapse, and skin manifestations like urticaria or flushing.

What is the first-line drug for treating anaphylaxis under anesthesia?

Answer: Epinephrine IV or IM

Epinephrine is the first-line treatment for anaphylaxis, addressing bronchoconstriction, vasodilation, and mast cell mediator release simultaneously.

Which intraoperative event is characterized by a sudden decrease in end-tidal CO2?

Answer: Venous air embolism

Venous air embolism causes a sudden drop in EtCO2 due to dead space ventilation as air obstructs pulmonary circulation.

What is the primary treatment for a massive pulmonary embolism occurring intraoperatively?

Answer: Systemic anticoagulation and hemodynamic support

Massive PE requires immediate systemic anticoagulation (or thrombolysis if warranted) and hemodynamic support to maintain cardiac output.

Which monitoring parameter is the earliest and most specific sign of malignant hyperthermia?

Answer: Rapidly rising end-tidal CO2 despite adequate ventilation

Rapidly rising EtCO2 from hypermetabolism is the earliest and most specific sign of MH, preceding significant temperature elevation.