Dive in the algorithms from the clinical practice!
Lightning strike
Simona Němcová, MD, Michal Parma, MD, Kristýna Wyrwová, Vojtěch Václavek, Illustration: Simona Němcová
A lightning strike is a type of electrical injury of a short duration, when a current above 80 mA already causes a permanent cardiac arrest. In addition to current magnitude, voltage and duration, the consequences of a lightning strike also depend on the resistance and direction of the current. The consequences of a direct lightning strike are often fatal (30 – 40%), when the patient dies for cardiac arrest due to malignant arrhythmia and respiratory arrest due to weakening of the respiratory center. Most often a person is hit indirectly, through the ground or objects. However, we must not forget about secondary organ damage either.
Pharmacotherapy of acute postoperative pain in children
Petr Štourač, prof.,M.D. Ph.D., MBA, Tamara Skříšovská M.D., Kateřina Kawuloková, Anna Kasanová
Pharmacotherapy of acute postoperative pain in children is an important aspect of perioperative care. In the context of analgotherapy, we try to prevent pain and not to react to its manifestations after a delay. It is important to remember that the paediatric patient is not a small adult and approaches to pharmacotherapy therefore differ. In our algorithm, we will focus on the use of multimodal analgesia, the appropriate choice of analgesic, but also, for example, the assessment of postoperative pain in pediatric patients.
Perioperative anaphylaxis
Sylvia Šefčík, MD, Martin Šefčík, MD, Lucie Marethová, Barbora Zubíková. Illustration: Dan Popek
Perioperative anaphylaxis is a rare complication of anesthesia but can be associated with major morbidity and mortality. Prompt recognition of the reaction and rapid initiation of treatment is critical. The algorithm represents an authentic experience of simulated anaphylaxis occurring during gallbladder surgery. This content helps the solver learn how to recognize and treat perioperative anaphylaxis and learn the most common causes of this condition.
Anaesthesia for scoliosis surgery
Jan Hudec, MD, Deana Slovjaková, MD, Jiří Holek, Daniel Diabelko
Scoliosis is a three-dimensional deformity of the spine that can significantly limit patients' quality of life. Therefore, surgery is indicated for severe scoliosis cases in children. In our algorithm, we focus on the differences in preparation, management, and emergence from anaesthesia during this type of surgery. Our patient will have neuromuscular scoliosis caused by Duchenne muscular dystrophy, which brings significant differences and risks that we aim to highlight.
Traumatic cardiac arrest
Hana Straková, MD, Simona Němcová, MD, Kristýna Wyrwová, Anna Klvačová, Tereza Otipková, Nikoleta Ferencová
Hypoxic cardiac arrest is the reason of traumatic cardiac arrest in up to 7% of cases. On the hypoxic cardiac arrest is necessary to think in case of airway injury.The most important step to eliminate the risk of hypoxic arrest is: adequate airways management, adequate ventilation, high inspiratory concentration of oxygen. At the secured patient we can be alerted by: gradual bradycardia that doesn't respond to atropine and progressing to asystole, electromechanical dissociation and later isoelectric lines, low FiO2 fraction and an increased EtCO2.
Elective abdominal aortic aneurysm repair
Karolína Lečbychová, MD, Nikol Petlachová, Jan Strakoš, Valeria Skopelidou, Barbora Malaníková
Abdominal aortic aneurysm (AAA) is a localized widening of the lumen of the vessel wall, the greatest risk of which is rupture. For this reason, regular check-ups of patients diagnosed with AAA are appropriate to prevent this acute, life-threatening condition. AAA surgery is considered to be one of the most demanding procedures in vascular surgery, so proper preparation and caution during the procedure as well as in postoperative care is in place.
