Term 7 Week 1 (w/c 07/10/13)
Good morning everyone.
Welcome to a new term of Gasclass. We have been away over the summer but the team is reassembled and stronger than ever so that hopefully over the next few weeks we can tap into our (and your) collective knowledge to have some really useful discussions.
For those who are new to Gasclass, we hold our actual case discussion using twitter. There are lots of advantages to this including the fact that it is optimised for mobile devices. You can follow the conversation by searching for #gasclass (don’t forget to include this hashtag in your answers so that others can see it)
We will usually begin with some fairly open ended questions about a core topic. This is to allow a wide range of people to join and also to begin building the cognitive framework on which we can expand with more advanced topics as the week goes on. We will endeavour to produce a summary at the end of each week so that people can revisit the conversation whenever they please.
We have some ideas in the pipeline for future developments but we also like to receive feedback and suggestions for improvement. Feel free to send us a direct message if you have anything to say (or if you would like us to post a comment on your behalf.)
As with a real classroom the more people that contribute the more productive the weeks discussion is likely to be so get involved!
Case information for this week
You are the anaesthetist responsible for the trauma list. The next patient on your list is a young adult male who was involved in a road traffic collision 36 hours ago. He is currently in the intensive care.
In general terms, describe the key components to preparing and moving a patient from the intensive care to the operating theatre including any key bits of information you will seek and resources you will require?
You now have some more information about the intended surgery. The patient has a flexion distraction injury of the upper thoracic spine identified on his trauma CT (illustrated below). He is currently intubated and ventilated but assessment prior to RSI suggested there was lower limb paralysis. The surgical team feel early surgery is indicted to allow decompression, stabilisation and earlier mobilisation?
What are the headline issues and anaesthetic goals in the management of these kinds of patient? Assume the injury is at the T4 level…
You discuss the surgery with the team. They are planning on a posterior approach to decompression and stabilisation. The team have reason to believe it is an incomplete lesion and they would like to be able to monitor spinal cord function intraoperatively…
What methods of spinal cord monitoring are you aware of? Will this alter your planned technique?
There are no trick questions in #Gasclass. Everyone’s contribution is welcome. Please do not forget to add the ‘hashtag’ #gasclass to every Tweet so that it is included in the conversation. To help give new contributors an opportunity to join in we would advise that you should only add one idea per tweet and not contribute until another Tweeter has joined in.