This chapter provides an overview of general adult intensive care, the key components of which are resuscitation and stabilisation; physiological optimisation to prevent deterioration and organ failure; support of failing organ systems; and management and communication with patients and family…
Improvements in surgical and perioperative technique, immunosuppression regimens and organ preservation over the last century have meant that organ transplantation is now considered the primary treatment for organ failure. Solid organ transplants (kidney, liver, heart, lung and pancreas) make up…
General anaesthesia outside the operating theatre suite is often challenging for the anaesthetist. Although the principles of remote site anaesthesia are common to many situations, each specialised environment poses its own unique problems. In hospital the anaesthetist must provide a…
Background The variation in resources available to healthcare systems in regional populations of the world is widely acknowledged. The terms developed and developing world mislead, suggesting binary options and inevitable progress to a complete state. The reality is a skewed…
Patients scheduled for elective surgery are usually in optimal physical and mental condition, with a definitive surgical diagnosis; any coexisting medical disease is defined and well controlled. These patients have often discussed plans for surgery and anaesthesia (including postoperative care)…
Obstetric anaesthesia and analgesia involve caring for women during childbirth in three situations: Provision of analgesia for labour, usually by epidural or spinal analgesic techniques Anaesthesia for peripartum operative procedures such as instrumental (e.g. forceps or Ventouse) or caesarean delivery…
In the UK and much of the developed world, more than half of all cardiac surgical procedures are undertaken to revascularise ischaemic myocardium. Of the remainder, surgery for acquired valvular disease, congenital anomalies and disorders of the great vessels comprise…
In thoracic anaesthesia there are a number of key areas that require specific consideration in the preoperative, intraoperative and postoperative phases of care. They include understanding of pulmonary anatomy, assessment of fitness for lung surgery, understanding the indications and methods…
Neurosurgical procedures include elective and emergency surgery of the CNS, its vasculature and the CSF, together with the surrounding bony structures, the skull and spine. Almost all require general anaesthesia; however, some procedures require an awake patient. In addition to…
Major vascular surgery Many aspects of vascular surgery have changed during the last two decades, largely as a result of advances in radiological practice and cardiology. Examples include improvements in the treatment of myocardial infarction, the development of endovascular aortic…