Stabilising the acute abdomen

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: During this lecture we discuss the why’s, when’s, what’s and how’s of fluid therapy administration for the acute abdomen patient. We will briefly discuss what an acute abdomen means and what the clinical signs are. We will discuss why patients with an acute abdomen often present with shock, what the clinical signs of shock are and the importance of treating shock. This lecture discusses the use of crystalloid fluid therapy administration vs colloid administration and the advantages and disadvantages of both.

: Unlike elective procedures, critically ill patients present a number of anaesthetic challenges such as an unstable cardiorespiratory system, altered circulating fluid volume and metabolic derangements. Despite these problems a thorough pre-operative clinical examination and subsequent anaesthetic plan is vital as the key to success lies in correct preparation and anticipation of problems and this session explores how preparation may maximise subsequent anaesthetic success. Premedication may be unnecessary if the patient is obtunded and drugs such as the alpha-2 agonists which have major cardiovascular effects should generally be avoided. Induction of, and recovery from, anaesthesia are critical periods. This presentation describes a best practice approach to induction, maintenance and recovery of these patients. Finally, commonly encountered problems such as regurgitation, dysrhythmias and delayed recovery are discussed to aid correct planning. Throughout the session the emphasis is on practical first principles rather than offering an anaesthetic ‘recipe’ to allow adaption of the ideas into the participant’s own practice situation. A recording of a live Q&A session follows covering questions regarding fluid therapy and anaesthesia for the acute abdomen patient.

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