Home > Acute medicine, Critical Care, Endocrinology > Term 4 Week 9 (w/c 29/10/12)

Term 4 Week 9 (w/c 29/10/12)

Welcome to this weeks Gasclass. Thank you for all your contributions last week.

You have been asked to review a 23 year old lady who has insulin dependent diabetes.

What specific questions or features do you ask / look for when performing your assessment?

Thank you for your contributions yesterday surrounding the multi-system involvement in aptients with diabetes.

You go to assess the patirent and find a cachectic female who has been admitted with abdominal pain. She had had several admissions over the last 12 months with alcohol intoxication and admits to drinking 2 bottles of cider a day. She smokes 40 cigarettes a day.

The surgical team wish to undertake an urgent laparoscopy.

What is your anaesthetic plan? What else do you want to know?

Thanks for responses. The patient is not intoxicated, her BM s 14.7  HR 110 BP 95/40 SpO2 99% on 2L RR 24.

Amylase is 58 Blood Gases pH 7.32 pCO2 4.2 pO2 10.2 HCO3 18

An ultrasound scan has suggested RIF pathology.

What is your anaesthetic plan? How are you going to manage her diabetes?

A little quiet yesterday with regards to the anaesthetic plan. You take her to theatre and she initially undergoes a laparoscopy where it is discovered that she has a large perforated caecal mass. She undergoes a laparotomy and bowel resection.

What is your plan for postop management?

  Wait until someone else has tweeted before adding more. Don’t forget to add #gasclass to tweet.

There are no trick questions in #gasclass. It is an educational tool only. Everyone’s opinion is as valid as the next person. Follow the conversation by using (or searching for) the hashtag #gasclass on twitter. We welcome input from all specialties and you can send us a direct message if you would prefer to remain anonymous.

@gasclass

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