Databook of Anaesthesia and Critical Care Medicine

This book is intended to bring together data and clinical guidelines for those involved in the practice of anaesthesia, whether they be specialists or not. It is designed to be a true handbook that will accompany its owner into the operating theatre, where it will serve as a practical reference guide, not as a textbook. We welcome comment, criticism, and suggestions for improvement of the contents; correspondence may be addressed to the authors at P. O. Box 63, Tygerberg 7505, Republic of South Africa. We wish to acknowledge help received from our colleagues over the years of publication: Dr. T.J.V.Voss, Prof. G.G.Harrison, Dr. C. M. Lewis, Dr. W. B. Murray, Prof. A. R. Coetzee, and Dr. W. L. van der Merwe. Acknowledgement is also made to "Anaesthesia Guidelines", long since out of print, on which the first edition of this handbook was based in 1978. Tygerberg, South Africa, May 1987 P.A.Foster l.A. Roelofse v Contents Chapter 1 I. Pre-anaesthetic Assessment and Preparation 3 A. Anaesthetic Risk Assessment 3 B. Cardiac Risk Index . . . . . . 6 C. Respiratory Risk Assessment 7 D. Hepatic Reserve and Anaesthetic Risk 8 E. Pre-anaesthetic Check List . . . . . . . 8 F. Detailed Check of Anaesthetic Machine 10 G. Requirements for Paediatric Anaesthesia .

1.- I. Pre-anaesthetic Assessment and Preparation.- A. Anaesthetic Risk Assessment.- B. Cardiac Risk Index.- C. Respiratory Risk Assessment.- D. Hepatic Reserve and Anaesthetic Risk.- E. Pre-anaesthetic Check List.- F. Detailed Check of Anaesthetic Machine.- G. Requirements for Paediatric Anaesthesia.- H. Ventilator Settings in Paediatric Circuits.- I. Ventilator Settings in Adult Circuits.- J. Guidelines for Endotracheal Tube Sizes.- K. Catheter Sizes.- L. Hypodermic Needle Gauges.- M. Particle Sizes.- N. Mortality and Morbidity.- O. Postoperative Recovery Score.- II. Anaesthetic Physical Constants.- A. Physical Properties of Inhalational Agents.- B. Vapour Pressure Graphs.- C. Volatile Anaesthetic Concentrations (Copper Kettle).- D. Vaporizer Splitting Ratios.- E. The Gas Laws.- F. Gas Cylinder Pressures and Constants.- G. Flammability Limits of Volatile Anaesthetics.- H. Saturated Water Vapour Pressures from 0° to 58°C (mm Hg).- I. Composition of Atmospheric Air.- J. Atmospheric Pressure.- K. Species Variations of MAC.- III. Normal Values of Blood Components.- A. Normal Blood Biochemical Values.- B. Moles and Equivalent Weights.- C. Normal Haematological Values.- D. Normal Coagulation Values.- E. Blood Components and Clotting Factors.- F. Oxyhaemoglobin-Dissociation Curves and P Values.- G. Some Causes of Shifts in Oxyhaemoglobin Affinity and Factors That Influence P50.- H. Hypothermia Corrections for pCO2 and pH.- IV. Cardiovascular, Renal, and CSF Values.- A. Normal Cardiovascular Values.- B. The Blood Pressure Cuff.- C. Calibrating Intra-arterial Pressure Monitors.- D. Normal Values for Intracardiac Pressures (mm Hg).- E. Derived Haemodynamic Parameters.- F. Renal Function Tests with Normal Values.- G. Liver Function Tests.- H. Normal Cerebrospinal Fluid Values.- 2.- I. Respiratory Parameters.- A. Gas Flows in Anaesthetic Circuits.- B. Low-Flow Anaesthetic Techniques.- C. Capnography.- D. Simple Pulmonary Function Values.- E. Pulmonary Function Tests.- F. Flow Volume Curves.- G. Some Clinical Tests of Respiratory Function.- H. Normal Neonatal Values.- I. Radford’s Ventilation Nomogram.- J. Blood-Gas Parameters in Various Acid-Base Disturbances (Henderson-Hasselbach).- K. Correction of Metabolic Acidosis Based upon Base Excess and Body Weight.- L. Oxygen Delivery to Tissues.- M. Reading a Chest X-Ray.- II. Respiratory Assessment and Support.- A. Indications and Contraindications for Endotracheal Intubation.- B. Pre- and Postoperative Respiratory Considerations.- C. Indications for Respiratory Support.- D. Criteria for Weaning from Respirator.- E. Outline of Cardiopulmonary Resuscitation.- III. Blood and Fluid Replacement.- A. Normal Blood Volumes.- B. Significant Volume Losses.- C. General Intravenous Fluid Requirements.- D. Intraoperative Fluid Requirements.- E. Neonatal and Paediatric Fluid Requirements.- F. Standard Blood Orders for Elective Surgical Procedures.- G. Blood Products Available.- H. Suggested Treatment of Blood Loss During Surgery.- I. Composition of Representative Intravenous Solutions.- J. Indications for Total Parenteral Nutrition.- K. Guidelines for Total Parenteral Nutrition.- L. Some Indications for Haemodynamic Monitoring and Manipulation.- 3.- I. Drugs and Doses.- A. Standard Drugs and Doses in Anaesthesia.- B. Opioid Receptors and Agonists.- C. Total Intravenous Anaesthesia.- D. Action of Antiarrhythmic Drugs.- E. Antiarrhythmic Drugs.- F. Vasodilators.- G. Some Preferred Drugs for Caesarean Section.- H. Diabetes Mellitus.- I. Cardiac Stimulants.- J. Suggested Concentrations for Use as Continuous Infusions.- K. Bronchodilators.- L. Growth Charts.- M. Common Pharmacokinetic Terminology.- N. Some Pharmacokinetic Values for Anaesthetic Drugs.- O. Drugs Influencing Intracranial Pressure.- P. Assessment of Neuromuscular Block.- 4.- I. Clinical Problems and Solutions.- A. Potential Drug Interaction with Drugs Used in Anaesthesia.- B. Causes of Bleeding During Anaesthesia.- C. Treatment of Postoperative Pain.- D. Transfusion Reactions.- E. Air Embolism ― Diagnosis.- F. The Full Stomach.- G. Prevention and Treatment of Aspiration Pneumonitis.- H. The Acute Asthmatic Attack.- I. Correct Intubation of the Trachea.- J. Pulmonary Embolism.- K. Respiratory Depression During and After Anaesthesia.- L. Malignant Hyperpyrexia.- M. Anaesthesia for the Diabetic Patient.- N. Delayed Recovery After Anaesthesia.- O. Causes of Coma.- P. Complications of Local Anaesthesia.- Q. Hypotension and Anaesthesia.- R. The Adrenal Cortex and Anaesthesia.- S. Osmotic Diuretics.- T. Porphyria and Anaesthesia.- U. Placental Transfer of Drugs.- V. Correction of Hyperkalaemia.- II. Miscellaneous.- A. Apgar Scoring.- B. Neurobehavioural Assessment of the Newborn.- C. Postoperative Reinfarction Rate After Previous Myocardial Infarction.- D. Coma Scales.- E. Nomograms for Estimation of Body Surface Area.- F. Growth Tables for Infants and Children.- G. Sensory Charts.- H. Exponentials.- I. SI Units.- J. Blood Chemistry Units and Conversion Factors.- K. Useful Conversion Factors.- L. The World Federation of Societies of Anesthesiology (WFSA).- M. ISO Standards.- N. Setting an Intravenous Infusion.- O. Syringe Coding.- P. Simple Hand-Held Computer Programs.- Q. Greek Alphabet.- References.