Poor general condition, old age, frailty, cachexia, shock and hypothyroidism

Respiratory insufficiency, increased intracranial pressure, or women in labor

Young, strong, emotionally stressed or hyperthyroid patients

Tachycardia or hyperthyroidism or excessive ambient temperature

inhalation anesthesia

Children have low tolerance to morphine, so the dose should be reduced

When taking compound medication

calm

analgesia

Inhibit respiratory gland secretion and prevent toxic reactions of local anesthetics

Adjust autonomic nervous system function to eliminate or weaken some adverse neural reflex activities

Level I

Level II

Level III

Level IV

Class V

Level VI

risk factors

assessment method

narrow sense

broad sense

Classification by chemical structure

Classification by action time

Anatomy of the injection site

Injection dose of drug

Drug absorption rate, tissue distribution rate, and biotransformation clearance rate at the injection site

Patient-related factors include age, cardiovascular system status, liver and kidney function

allergic reaction

central nervous system toxicity

respiratory system

Cardiovascular system toxicity

prevention

treat

Puncture the dura mater

The puncture needle or catheter accidentally enters the blood vessel

Broken catheter

Total spinal anesthesia

spinal nerve root or spinal cord injury

Cervical and thoracic epidural anesthesia should not be used in patients with dyspnea.

Patients with inflammation or infection at the puncture site are contraindicated.

People with severe anemia, hypertension and poor cardiac compensation should be used with caution

Patients with severe shock should not use

Spinal cord and spinal nerve injuries

Mainly suitable for abdominal surgery

Neck, upper limb and chest surgeries are also available

All surgeries on the lower abdomen and lower limbs that are suitable for spinal anesthesia

labor analgesia

Headache after spinal anesthesia

urinary retention

neurological complications

Those with a history of spinal trauma or obvious low back pain, and those with severe spinal deformity

Severe systemic infection and inflammation or infection at the puncture site

Those with significantly increased intra-abdominal pressure

Central nervous system disease Spinal cord or spinal nerve radiculopathy

shock patient

Mental illness, severe autonomic nervous system dysfunction, and uncooperative patients such as children

Lower abdominal and pelvic surgery

Anal and perineal surgery

Lower limb surgery

labor analgesia

reflex inhibition

some degree of muscle relaxation

All body pain disappears

forget

Consciousness disappears

inhalation anesthetic

intravenous anesthetic

muscle relaxants

inhalation general anesthesia

intravenous general anesthesia

Combined intravenous and inhaled general anesthesia

Reflux and aspiration

airway obstruction

Insufficient ventilation

hypoxemia

intraoperative knowledge

malignant hyperthermia

Wake-up delay

hypothermia

Depolarizing muscle relaxants

non-depolarizing muscle relaxants

concentration effect

ventilation effect

cardiac output

blood/gas distribution index

The concentration difference of anesthetics in alveolar and venous blood

Ventilation disorders caused by residual effects of drugs

Discharge, bleeding, blood clots, and foreign body obstruction

Tongue falling back

laryngospasm

Bronchospasm

Left hand holding laryngoscope handle

Insert the laryngoscope from the right corner of the patient's mouth

While gradually moving the laryngoscope to the middle of the mouth

After revealing the uvula

until the epiglottis cartilage is seen

When inserting the tube, hold the endotracheal tube behind the glottis with your right hand like a pen.

Until the endotracheal tube cuff enters 3-4cm below the vocal cords

Place the mouthguard between the patient's front teeth

Hold your jaw to open the airway

Use of airway

mask ventilation

laryngeal mask airway

Tracheotomy

endotracheal intubation

combined esophageal-tracheal catheter

No risk of gastric reflux and aspiration, short general anesthesia surgery

Pre-oxygenation and denitrification before tracheal intubation

Assist or control breathing in emergency situations

Patients with small mouth opening

Patients with throat infections, edema and other diseases

Patients with airway stenosis and chronic obstructive pulmonary disease

Patients with full stomach, high intra-abdominal pressure, and high risk of reflux and aspiration

Trauma caused by endotracheal intubation

Excessive phlegm or phlegm scab

Poor endotracheal tube

The endotracheal tube is inserted too deep and blocks one side of the bronchus

Anesthesia machine or ventilator malfunction

Factors causing body hypothermia: below 36 degrees

Factors causing excessive body temperature

Oxygen supply is the amount of oxygen provided by the body to the tissues per unit time through the circulatory system, which is the rate at which arterial blood transports oxygen per unit time.

Oxygen consumption refers to the total amount of oxygen consumed by body tissues per unit time, which depends on the functional metabolic state of the body.

oxygen uptake

oxygen concentration in breathing air

Alveolar air-arterial blood oxygen partial pressure difference

arterial blood oxygen content

arterial partial pressure of oxygen

oxygenation index

pulse oximetry

mixed venous oxygen saturation

When the temperature increases by 1℃, oxygen consumption increases by 10%-15%

Hypermetabolic state or high-sugar diet

Sympathetic excitement, pain, chills, or seizures

Burns, trauma or surgery

Infect

β2 agonists, amphetamines, tricyclic antidepressants

Central venous pressure refers to the pressure in the superior and inferior vena cava located in the chest cavity near the entrance of the right atrium. It is mainly used to reflect right ventricular preload.

Normal value 5-12cmH2O

Depends on factors such as cardiac function, blood volume, venous vascular tone, intrapleural pressure, venous blood return volume, and pulmonary circulation resistance

And can reflect the ability of the right ventricle to discharge the blood returned to the heart

The right internal jugular vein or right subclavian vein is commonly punctured and catheterized into the superior vena cava.

The left internal jugular vein and femoral vein can also be used

Bleeding

Infect

hematoma

arterial embolism

aneurysm formation

arteriovenous fistula

acral ischemia

peripheral nerve damage

Insufficient intake

gastrointestinal loss

kidney loss

intracellular transfer of potassium

Treat primary disease

Potassium supplement

Use drugs with caution

Too much intake

Abnormal distribution of potassium in the body

Decreased renal excretion

Massive destruction of tissue cells and release of potassium

Treat the underlying disease

Give calcium

Sources of limit potassium

Promote potassium excretion

Promote the transfer of potassium into cells

Fluid loss in the body before surgery

Anesthesia-induced vasodilation or relative hypovolemia

Physiological requirements during surgery

surgical bleeding

Distribution of body fluids to the third space caused by surgical trauma

Management of intraoperative blood loss

Prioritize replenishing blood volume

Reasonable selection of solution preparations

Determine the order and speed of infusion

crystal solution

Colloidal liquid

mental state

Breathing

circulatory system

Awakening level evaluation meets the standard

For those who have used narcotic analgesics and sedatives, observe for 30 minutes without any abnormal reaction.

Local anesthesia or spinal anesthesia

Postoperative hypotension

postoperative hypertension

Arrhythmia

severe trauma patient

Critically ill patients after various complex major surgeries

Patients requiring respiratory management and respiratory support

Patients with cardiac insufficiency or severe arrhythmia

Patients after cardiopulmonary and cerebral resuscitation

multiple organ dysfunction syndrome patients

organ transplant patients

Acute patients with reduced functions of various systems and organs who may recover after short-term intensive treatment

Vital signs are stable, system and organ functions are stable or restored, and no intensive monitoring or special treatment is required.

The condition becomes chronic

No longer able to benefit from ICU monitoring and treatment

Acute respiratory distress syndrome occurs during non-cardiac diseases such as severe infection, trauma, shock and burns.

Damage to pulmonary capillary endothelial cells and alveolar epithelial cells causes diffuse interstitial and alveolar edema

acute hypoxic respiratory failure

Clinically manifests as progressive hypoxemia and respiratory distress

Treatment to control primary disease and infection

respiratory support therapy

liquid management

medical treatement

Nutritional metabolism support

Maintain vital organ functions and prevent MODS

acute injury stage

relatively stable period

acute respiratory failure stage

terminal stage

correct hypoxemia

Block adverse reactions caused by hypoxia

Clinical indications for oxygen therapy

acute ventilatory dysfunction

absorptive atelectasis

oxygen poisoning

assisted ventilation

controlled ventilation

Assisted-controlled ventilation

minute mandatory ventilation

Synchronized intermittent mandatory ventilation

pressure relief ventilation

pressure support ventilation

adaptive support ventilation

Can recruit alveoli

Reduce the occurrence of shear injuries caused by periodic alveolar recruitment and collapse

Increase functional residual capacity

Improve ventilation-blood flow ratio

Increase lung compliance

Effectively increase oxygen partial pressure

anaphylactic shock

hypovolemic shock

septic shock

cardiogenic shock

neurogenic shock

Replenish blood volume

Correct acid-base balance imbalance

Use of Cardiovascularly Active Drugs

Respiratory management and oxygen therapy

acute respiratory failure

heart failure

The process of waiting for a donor for patients who need a heart or lung transplant

Infect

Bleeding

thrombosis

cerebral ischemia

Ischemia and necrosis of distal limb after intubation

renal insufficiency

Severe immunosuppression

significant bleeding tendency

uncontrolled sepsis

disease with poor prognosis

irreversible organ failure

brain dead patient

ventricular fibrillation

pulseless ventricular tachycardia

Pulseless cardiac activity

heart at rest

Recognize cardiac arrest early

Activate emergency medical services system

Start high-quality CPR early

defibrillation

The purpose of administering medications during resuscitation is to

Route of administration

Commonly used drugs

Skin turns from blue to rosy

The dilated pupils begin to shrink

Spontaneous breathing occurs

Measurable blood pressure

palpable aortic pulse

Modified Fry-MODS diagnostic criteria

Reflects the diagnostic criteria for the pathophysiological process of MODS

Disease-specific MODS scoring and diagnostic system

Anesthesiologists provide analgesia technology and vital sign monitoring during delivery to provide safe and comfortable delivery conditions for mothers and babies.

Methods of labor analgesia

mild analgesia

moderate analgesia

severe analgesia

full receptor agonist