4th Session (Obstetric, Paediatric, Neuroanaesthesia, Vascular, Anaesthesia for Patients with Comorbidities)

Nov 2024

Station 1

Scenario: A neonate is intubated after birth for respiratory distress, with radiological features of CDH. ABG reveals respiratory acidosis and hyperlactatemia
HFOV
Definition, classification of CDH
Cardiorespiratory complications
Preop assessment
Airway management and ventilation considerations
Timing of surgery
ABG interpretation
Causes of hyperlactatemia in CDH
Identifying “tension” during CDH correction surgery (tension pneumothorax, abdominal compartment syndrome) and subsequent management
Other complications of CDH and correction surgery
Analgesia for CDH

Station 2

Scenario:An elderly lady presented with cerebellar symptoms, and the CT brain shows a large cerebellar tumor.
Preoperative assessment (physical examination, imaging, echocardiography)
Management during induction
Monitoring intraoperatively
Evoked potential monitoring and implications (e.g. anaesthetic maintenance)
Prone positioning and care during positioning
Mayfield pinning and anaesthetic implications
Mannitol pharmacology in neurosorgery including dosage, mechanism of action and adverse effects
DIfferentials of sudden reduction of capnography during neurosurgery. Diagnosis and management of VAE
Considerations for extubation in OT of neurosurgical patients

Station 3

Scenario:An elderly man with hypertension, CKD, history of CVA presents with severe abdominal pain. SBP 90, HR 125, ECG changes - ST depression in anterior lead. Hb 8.5, Creat 254. CT scan shows a concealed leaking abdominal aortic aneurysm.
Transport considerations from ED to OT
Considerations during induction. Does the surgeon need to be scrubbed and ready?
Explanations regarding the hemodynamics changes with open inlay graft surgery and the attendant management
Intraop monitoring choices
Complications of the surgery
The mortality rate

Station 4

Scenario: A multigravida with PIH presents with severe abdominal pain and minimal vaginal bleed. The O&G team posts a case for emergency LSCS for placenta abruptio with fetal distress.
Definition of placental abruption? The classification of placental abruption?
The difference between abruptio placenta and placenta praevia?
The preop assessment? Details: BP 150/96, HR 130, pulse feeble, ongoing safe O transfusion and crystalloid given one pint.
Gastric prophylaxis
What is your mode of anaesthesia
Concerns regarding general anaesthesia
Blood conserving strategies
Types of uterotonics
Blood loss is 3 L. What are the aims of management