Anaes SAQs · General surgery anaesthesia
Anaesthesia for emergency laparotomy
Final-examination SAQ for emergency-laparotomy-anaesthesia.
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Target exams
Model answer
Risk (3). Use NELA-style validated risk tool; high predicted mortality in elderly septic shock; consultant-level shared decision and ceilings of care; do not invent percentages.[1][2]
Pre-induction (4). Antibiotics, ongoing resuscitation, arterial line, large-bore access, blood available, vasopressors running, ICU bed requested, airway plan.[3]
RSI (4). Full stomach; preoxygenate; taught reduced-dose haemodynamic induction (local protocol governs dosing); push-dose/infusion pressor ready; VL; capnography; avoid full-dose propofol dump — the shock context is sepsis-guideline owned.[3]
Disposition (4). Planned ICU; continue source-control support, ventilatory and cardiovascular care; watch for ACS after closure; bundle pathway elements.[2]
References3ShowHide
- [1]Eugene N, Oliver CM, Bassett MG, et al. Development and internal validation of a novel risk adjustment model for adult patients undergoing emergency laparotomy surgery: the National Emergency Laparotomy Audit risk model. British Journal of Anaesthesia, 2018.PMID 30236236
- [2]Huddart S, Peden CJ, Swart M, et al. Use of a pathway quality improvement care bundle to reduce mortality after emergency laparotomy. British Journal of Surgery, 2015.PMID 25384994
- [3]Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Medicine, 2021.PMID 34599691