The practice of transfusing blood has been around for centuries. The science of transfusion medicine started in the early twentieth century with the discoveries of human blood types and sodium citrate. Human blood typing is the pillar and foundation for…
INTRODUCTION Perioperative fluid administration has two goals: to ensure adequate intravascular volume to maintain cardiac output and tissue perfusion and to prevent electrolyte and acid–base disturbances. Intravenous fluid therapy represents a core element of anesthesia practice, a companion to the…
INTRODUCTION Hemostasis is an ordered process involving cellular and biochemical components that functions to limit blood loss secondary to vascular injury, maintain intravascular blood flow, and promote revascularization after thrombosis. Normal physiologic hemostasis is a constant balance between procoagulant pathways…
~~ The concentrations of hydrogen and bicarbonate ions in plasma must be precisely regulated to optimize enzyme activity, oxygen transport, and rates of chemical reactions within cells. Each day approximately 15,000 mmol of carbon dioxide (which can generate carbonic acid…
Point-of-care ultrasound (POCUS) refers to the use of ultrasound at the patient’s bedside for procedural guidance and/or aid in diagnosis. The use and application of POCUS has rapidly expanded over the past 20 years. POCUS is now routinely used by…
INTRODUCTION Anesthesiologists have long been at the forefront of patient monitoring. This has been of necessity because we are responsible for continuously assessing the patient's physiologic status and the effects of surgery and anesthetic agents. This chapter provides an introduction…
Patient positioning in the operating room facilitates surgical procedures; however, positioning can be a source of patient injury and can alter intraoperative physiology. Positioning injuries during surgery remain a significant source of perioperative morbidity. Anesthesia providers share a critical responsibility…
INTRODUCTION The Role of Regional Anesthesia Peripheral nerve blocks can provide surgical anesthesia and postoperative pain relief ( Table 18.1 ). The main emphasis of this chapter will be on ultrasound guidance for peripheral nerve blocks. However, paresthetic-based techniques and…
PRINCIPLES Spinal, epidural, and caudal blocks are collectively referred to as central neuraxial blocks . Significant procedural, physiological, and pharmacological differences exist between the techniques, but all blocks result in some combination of sympathetic, sensory, and motor blockade. Spinal anesthesia…
Expertise in airway management is the cornerstone of safe anesthesia practice. The past decades have seen an evolution of airway management, notably with the adoption of supraglottic airway (SGA) devices in the early 1990s and, more recently, the rapid uptake…