GasGasGas - The FRCA Primary Exam Podcast VivaCast 005 - Clinical Station Urgent Onco-Laparotomy
Jan 27, 2025
Join the discussion as Tom navigates a critical anaesthetic plan for an oncology patient facing bowel issues. They delve into immediate concerns like hypovolemia and possible sepsis, emphasizing the A to E assessment. Tom discusses vital investigations and the management of new atrial fibrillation, showcasing fluid resuscitation and risk stratification methods. They also explore the intricacies of anaesthesia considerations and the importance of a multidisciplinary approach in high-stakes situations. Valuable exam presentation tips keep the insights flowing!
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Start With A Structured A-to-E Assessment
- Tom emphasises an A-to-E structured assessment for a sick oncology patient with bowel perforation and shock signs.
- He uses targeted tests (VBG, lactate, FBC, electrolytes) to judge severity and optimise before surgery.
Assess Respiratory And Perfusion Signs Immediately
- Check respiratory effort, oxygen requirement and get a chest X-ray if they're on oxygen or tachypnoeic.
- Inspect peripheral perfusion, mucous membranes and conscious level to judge circulatory compromise.
Order Key Labs And Baseline ECG Early
- Send FBC, U&Es, VBG (with lactate) and cross-match blood early for suspected ischemia and transfusion needs.
- Obtain an ECG and compare with previous tracings before major surgery.