Additional Information
Book Details
Abstract
Gain a thorough understanding of nursing anesthesia with the most comprehensive text on the market. Written by leading expert, John Nagelhout, CRNA, PhD, FAAN, and new contributing author Sass Elisha, EdD, CRNA, Nurse Anesthesia, 6th Edition features both scientific principles and evidence-based material. Inside you’ll find a solid introduction to the history, education, and legal issues of nurse anesthetist, its scientific foundations, equipment and monitoring, and preoperative evaluation and preparation of the patient. This new edition includes chapters on patient centered care and cultural competence, additional drugs of interest, blood and blood component therapy, anesthesia management for patients with cardiac devices, anesthesia for robotic surgery, anesthesia for transplant surgery and organ procurement, and physiology and management of acute and chronic pain. Not only a key reference for practicing nurse anesthetists, this bestseller prepares you for certification and today's clinical anesthesia practice.
- New coverage includes the latest specifics of pharmacokinetics, drug delivery systems, opiate antagonists, and key induction drugs.
- Updated information on patient safety, monitoring, and pharmacology.
- Unique! Expert CRNA authors provide the current clinical information that you will use in daily practice.
- Over 700 tables and boxes highlight the most essential information in a quick, easy-to-reference format.
- Easy-to-use organization covers basic principles first, and builds on those with individual chapters for each surgical specialty.
- Updated TJC standards for monitoring and administering moderate sedation/analgesia.
- NEW! Expanded content includes; non-OR anesthesia, acute and chronic pain management, anesthesia implications of complementary and alternative medicine, robotic surgery, new and less invasive procedures in interventional radiography, implications of modern implanted cardiac devices, and more!
- NEW! Full-color design and figures clarify difficult concepts and give the text a contemporary look and feel.
- NEW! Co-author Sass Elisha brings a fresh perspective to this edition.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Nurse Anesthesia | i | ||
| Copyright Page | ii | ||
| Contributors | iii | ||
| Reviewers | vi | ||
| Foreword | viii | ||
| Foreword for Nurse Anesthesia, First Edition | viii | ||
| Preface | ix | ||
| Acknowledgments | x | ||
| Table Of Contents | xi | ||
| Unit I Professional Issues | 1 | ||
| 1 Nurse Anesthesia | 1 | ||
| The Problem of the Occasional Anesthetists | 1 | ||
| Historical Antecedents of the Nurse as Anesthetist | 2 | ||
| The First Civilian Nurses to Practice Anesthesia | 2 | ||
| The St. Mary’s Experience | 2 | ||
| The Lakeside Experience | 3 | ||
| The Proliferation of Nurse Anesthetists | 3 | ||
| The Great War, a Small Battlefield | 3 | ||
| Anesthesia: Medicine, Nursing, Dentistry, or What? | 4 | ||
| Organization: “We Who Are Most Interested” | 4 | ||
| World War II and Nurse Anesthetists | 5 | ||
| A Short-Lived Peace for Nurse Anesthetists and the Nation | 6 | ||
| The New Age of Nurse Anesthesia: the 1960s | 7 | ||
| The 1970s: A Turbulent Decade | 7 | ||
| Federal Legislative Initiatives in the 1980s | 8 | ||
| TEFRA | 8 | ||
| An Existential Threat Leads to Direct Reimbursement | 8 | ||
| Non-Legislative Legal Problems Arise | 9 | ||
| Hyde v. Jefferson Parish Hospital District No. 2 | 9 | ||
| CRNA Achievements of the 1980s | 10 | ||
| The Conductor | 10 | ||
| The Call for Health Care Reform in the 1990s | 10 | ||
| Cost Containment in Health Care | 10 | ||
| Attempts to Measure Quality of Care | 10 | ||
| The Federal Supervision Regulation | 11 | ||
| Doctoral Preparation of Nurse Anesthetists Achieved | 12 | ||
| Upgrading Nurse Anesthesia Educational Requirements | 12 | ||
| Doctoral Degrees | 12 | ||
| CRNA Practice Today | 12 | ||
| International Federation of Nurse Anesthetists | 13 | ||
| Progress in Anesthesia | 13 | ||
| Summary | 13 | ||
| References | 14 | ||
| References | 14.e1 | ||
| 2 Nurse Anesthesia Specialty Practice and Education in the United States | 15 | ||
| Nurse Anesthesia Educational Requirements | 15 | ||
| Nurse Anesthesia Education Today | 15 | ||
| General Educational Requirements for Nurse Anesthesia Programs | 15 | ||
| Nurse Anesthesia Education Program Curriculum | 16 | ||
| Councils’ Configurations and Relationships | 16 | ||
| Current and Future Specialization | 17 | ||
| Certified Registered Nurse Anesthetist Practice | 17 | ||
| CRNA Professional Credential | 17 | ||
| CRNA Scope of Practice | 18 | ||
| AANA Organizational Structure and Function | 19 | ||
| AANA Foundation | 19 | ||
| AANA Association Management Services, Inc. | 19 | ||
| Summary | 19 | ||
| References | 19 | ||
| References | 19.e1 | ||
| 3 Patient Centered Care, Cultural Competence, and Nurse Anesthesia Practice | 20 | ||
| Patient-Centered Care: What It Is and Why Is It Important | 20 | ||
| The Concept of Patient-Centered Care | 20 | ||
| Patient Engagement | 21 | ||
| Shared Decision-Making | 22 | ||
| Benefits of Patient-Centered Care | 22 | ||
| Patient-Centered Care and Cultural Competence | 22 | ||
| Patient-Centered Care as a Dimension of Safety and Health Care Quality | 24 | ||
| Measurement of Health Care Quality in Anesthesia | 24 | ||
| Decision Making and Patient Centered Care in Anesthesia | 24 | ||
| Health Care Quality and Safety in Anesthesia | 24 | ||
| Summary | 25 | ||
| References | 25 | ||
| References | 25.e1 | ||
| Unit II Scientific Foundations | 27 | ||
| 4 Nurse Anesthesia Research | 27 | ||
| Methods of Knowing | 27 | ||
| The Nature of Research | 27 | ||
| The Eight Critical Stages in the Research Process | 27 | ||
| Stage 1: Identification of the Problem | 28 | ||
| Common Mistakes | 28 | ||
| Stage 2: Review of the Relevant Knowledge and Literature | 28 | ||
| Unit III Technology Related to Anesthesia Practice | 229 | ||
| 16 Anesthesia Equipment | 229 | ||
| Organization of the Anesthesia Gas Machine | 229 | ||
| Supply, Processing, Delivery, and Disposal Model | 229 | ||
| Supply | 231 | ||
| Pipeline Supply | 232 | ||
| Configuration | 232 | ||
| Problems With Pipeline Supply | 232 | ||
| Loss of Oxygen Pipeline Pressure | 232 | ||
| Cross-Connection of Gases | 233 | ||
| Cylinder Supply | 233 | ||
| Electrical Power Supply | 236 | ||
| Loss of Main Electrical Power | 236 | ||
| Processing | 237 | ||
| Manufacturers and Models | 237 | ||
| Apollo | 237 | ||
| Fabius GS | 237 | ||
| Aisys | 237 | ||
| Aestiva | 238 | ||
| Aespire | 239 | ||
| Avance | 239 | ||
| ADU | 239 | ||
| Path of Gases Through the Machine | 239 | ||
| Five Tasks of Oxygen | 239 | ||
| Flowmeter | 239 | ||
| Display of Fresh Gas Flow. | 240 | ||
| Care of Flowmeters. | 240 | ||
| Other Flowmeters | 241 | ||
| Auxiliary Oxygen Flowmeters. | 241 | ||
| Common Gas Outlet Flowmeters. | 241 | ||
| Scavenging Flowmeters. | 241 | ||
| Oxygen Flush | 241 | ||
| Fail-Safe Systems | 241 | ||
| Low-Pressure Alarms | 242 | ||
| Ventilator Driving Gas | 242 | ||
| Proportioning Systems (Hypoxic Guard) | 242 | ||
| Oxygen Analysis | 242 | ||
| Vaporizers | 242 | ||
| Underlying Physical Principles | 242 | ||
| Classification and Design | 243 | ||
| Variable-Bypass. | 243 | ||
| Measured-Flow (Vernitrol). | 243 | ||
| Tec 6 Injector. | 243 | ||
| Using Vaporizers | 245 | ||
| Models | 245 | ||
| Hazards of Contemporary Vaporizers | 247 | ||
| New Agents and Low Flows | 247 | ||
| Delivery | 247 | ||
| Breathing Circuits | 247 | ||
| Fundamental Considerations | 247 | ||
| Classification of Breathing Circuits | 248 | ||
| Nonrebreathing Circuits. | 249 | ||
| Circle System. | 250 | ||
| Carbon Dioxide Absorption | 253 | ||
| Chemistry | 254 | ||
| Soda Lime | 254 | ||
| Absorbents Lacking Strong Bases | 255 | ||
| Using Carbon Dioxide Absorbents | 255 | ||
| Exhaustion and Replacement of Canisters | 255 | ||
| Ventilators | 257 | ||
| Classification and Theory of Operation—Gas-Driven Bellows Ventilators | 257 | ||
| Hanging Bellows. | 257 | ||
| Theory of Operation—Piston-Driven Ventilators | 257 | ||
| Typical Ventilator Alarms | 258 | ||
| Ventilator Modes and Settings | 258 | ||
| Volume-Controlled Ventilation. | 258 | ||
| Pressure-Controlled Ventilation. | 258 | ||
| Synchronized Intermittent Mandatory Ventilation. | 259 | ||
| Pressure-Controlled Ventilation With Volume Guarantee. | 259 | ||
| Pressure-Support Ventilation. | 259 | ||
| Continuous Positive Airway Pressure (CPAP), Bilevel Positive Airway Pressure (BiPAP) and PEEP. | 260 | ||
| Safety Features of Modern Ventilators | 260 | ||
| Flexibility. | 260 | ||
| Accuracy at Lower Tidal Volumes. | 260 | ||
| Compliance and Leak Testing. | 261 | ||
| Fresh Gas Decoupling Versus Tidal Volume Compensation. | 261 | ||
| Suitability for Low Flows. | 261 | ||
| Electronic Selection of Positive End-Expiratory Pressure. | 261 | ||
| Current Ventilator Designs | 261 | ||
| GE Healthcare 7900 “SmartVent”. | 261 | ||
| GE Healthcare 7100. | 262 | ||
| Fabius GS Ventilator. | 262 | ||
| Apollo Ventilator. | 262 | ||
| Traditional Anesthesia Ventilators | 262 | ||
| Critical Incidents Related to Ventilation | 263 | ||
| Disconnects and Other Causes of Low Pressure in the Breathing Circuit. | 263 | ||
| Failure to Initiate or Resume Ventilation. | 263 | ||
| Barotrauma and High Pressure in the Breathing Circuit. | 263 | ||
| The Anesthesia Workstation and Malignant Hyperthermia. | 264 | ||
| Disposal | 264 | ||
| Scavenging Systems and Disposal of Waste Anesthesia Gases | 264 | ||
| Risk Management | 265 | ||
| Department-Level Aspects | 265 | ||
| Individual Risk Management | 266 | ||
| Anesthesia Gas Machine Checklist | 266 | ||
| Summary | 271 | ||
| References | 271 | ||
| References | 271.e1 | ||
| 17 Clinical Monitoring I | 272 | ||
| Electrocardiogram Monitoring | 272 | ||
| Setting the ST Segment Parameters | 273 | ||
| Electrocardiograph Electrode Placement | 274 | ||
| Electrocardiographic Lead Selection | 274 | ||
| Gain Setting and Frequency Bandwidth | 278 | ||
| Central Venous and Arterial Hemodynamic Measurements | 278 | ||
| Physiology and Morphology of Hemodynamic Waveforms | 279 | ||
| Right Atrial Pressure Waveform | 279 | ||
| Right Ventricular Pressure Waveform | 280 | ||
| Pulmonary Artery Pressure Waveform | 280 | ||
| Pulmonary Artery Occlusive Pressure Waveform | 280 | ||
| Negative Waveforms | 280 | ||
| Correlation of Pressure Waveforms and the Electrocardiogram | 280 | ||
| Distortion of Pressure Waveforms | 281 | ||
| Implications of Abnormal Hemodynamic Values | 282 | ||
| Variables That Influence Hemodynamic Measurements | 282 | ||
| Other Hemodynamic Indexes | 284 | ||
| Mixed Venous and Central Venous Oxygen Saturation | 285 | ||
| Arterial Pressure Monitoring | 286 | ||
| Transesophageal Echocardiography Monitoring | 287 | ||
| Summary | 289 | ||
| References | 289 | ||
| References | 289.e1 | ||
| 18 Clinical Monitoring II | 290 | ||
| Monitoring Standards | 290 | ||
| Alarm Fatigue | 290 | ||
| Systematic Approach to Monitoring | 291 | ||
| Airway Monitoring | 291 | ||
| Respiratory Monitoring: Ventilation | 292 | ||
| Carbon Dioxide Monitoring | 292 | ||
| End-Tidal Carbon Dioxide Capnography. | 293 | ||
| Transcutaneous Carbon Dioxide Monitoring. | 294 | ||
| Flow, Volume, and Pressure Monitoring of Ventilation | 295 | ||
| Respiratory Monitoring: Oxygenation | 295 | ||
| Pulse Oximetry | 296 | ||
| Oxygen Saturation Physiology. | 296 | ||
| Clinical Use of Pulse Oximetry. | 296 | ||
| Cerebral Oximetry. | 297 | ||
| Temperature Monitoring | 297 | ||
| Thermoregulation | 297 | ||
| Temperature Monitoring Modalities. | 297 | ||
| Additional Monitoring Issues | 298 | ||
| Monitoring for Procedures Outside of the Operating Room | 298 | ||
| Anesthesia Education and Patient Monitoring | 299 | ||
| Summary | 299 | ||
| References | 299 | ||
| References | 299.e1 | ||
| 19 Clinical Monitoring III | 300 | ||
| Electroencephalogram | 300 | ||
| EEG Fundamentals | 300 | ||
| Anesthetic Effects on EEG | 302 | ||
| Considerations for Inhalation Anesthetics and EEG Interpretation | 302 | ||
| Induction Agents | 303 | ||
| Processed EEG Waveforms | 304 | ||
| Monitors for Assessing Central Nervous System Blood Flow and Oxygenation | 304 | ||
| Cerebral Oximetry via Near-Infrared Spectroscopy | 304 | ||
| Transcranial Doppler Ultrasonography | 304 | ||
| Jugular Bulb Oxygen Venous Saturation | 305 | ||
| Evoked Potentials | 305 | ||
| Somatosensory-Evoked Potentials | 305 | ||
| Motor-Evoked Potentials and Electromyography | 306 | ||
| Brainstem Auditory–Evoked Potentials | 307 | ||
| Visual-Evoked Potentials | 308 | ||
| Bispectral Index | 309 | ||
| Summary | 310 | ||
| References | 310 | ||
| References | 310.e1 | ||
| Unit IV Preoperative Preparation | 311 | ||
| 20 Preoperative Evaluation and Preparation of the Patient | 311 | ||
| Preanesthesia Assessment Clinic | 311 | ||
| Timing of Patient Assessment | 311 | ||
| Chart Review | 312 | ||
| Past Medical Records | 312 | ||
| Patient Chart or Electronic Medical Record | 312 | ||
| Patient Interview | 312 | ||
| Medical History | 313 | ||
| Surgical History | 313 | ||
| Anesthetic History | 313 | ||
| Familial Anesthetic History | 313 | ||
| Drug History | 314 | ||
| Adverse Drug Effects and Interactions | 314 | ||
| Drug Allergies | 314 | ||
| Latex Sensitivity | 314 | ||
| Social History | 314 | ||
| Tobacco Use | 314 | ||
| Alcohol Intake | 315 | ||
| Illicit Drug Use | 316 | ||
| Synthetic Androgens | 316 | ||
| Herbal Dietary Supplements | 317 | ||
| Patient Evaluation: Overview of Systems | 317 | ||
| Upper Airway | 317 | ||
| Tests for Prediction of Difficult Intubation | 318 | ||
| Mallampati Classification. | 318 | ||
| Thyromental Distance. | 318 | ||
| Interincisor Distance. | 318 | ||
| Head and Neck Movement (Atlantooccipital Function). | 318 | ||
| Mandibular Mobility. | 318 | ||
| Dentition | 318 | ||
| Musculoskeletal System | 319 | ||
| Obesity | 319 | ||
| Ankylosing Spondylitis and Rheumatoid Arthritis | 321 | ||
| Neurologic System | 321 | ||
| Cardiovascular System | 322 | ||
| Hypertension | 323 | ||
| Ischemic Heart Disease | 325 | ||
| Coronary Stents. | 326 | ||
| Left Ventricular Dysfunction | 326 | ||
| Valvular Heart Disease | 327 | ||
| Arrhythmias | 328 | ||
| Cardiovascular Implantable Electronic Devices (Pacemaker, Implantable Defibrillators) | 328 | ||
| Diagnostic Testing to Assess Cardiovascular Disease | 329 | ||
| Cardioprotective Pharmacotherapy | 329 | ||
| Statins. | 329 | ||
| β-Blockers. | 329 | ||
| ACE Inhibitors. | 330 | ||
| Antiplatelet Agents. | 330 | ||
| Novel Oral Anticoagulants. | 330 | ||
| Respiratory System | 330 | ||
| Emphysema and Chronic Bronchitis | 331 | ||
| Asthma | 332 | ||
| Upper Respiratory Tract Infection | 333 | ||
| Gastrointestinal System | 333 | ||
| Hepatobiliary System | 333 | ||
| Renal System | 335 | ||
| Endocrine System | 336 | ||
| Diabetes | 336 | ||
| Insulin Pumps | 338 | ||
| Thyroid Gland Disorders | 338 | ||
| Hyperthyroidism. | 339 | ||
| Hypothyroidism. | 339 | ||
| Adrenocortical Disorders. | 340 | ||
| Diagnostic Testing | 340 | ||
| Routine Diagnostic Testing | 340 | ||
| Limitations to Routine Preoperative Diagnostic Testing | 341 | ||
| Timing of Diagnostic Testing | 341 | ||
| Indications for Diagnostic Testing | 341 | ||
| Pregnancy Testing | 341 | ||
| Chest Radiography | 341 | ||
| Electrocardiography | 342 | ||
| Fasting Considerations | 342 | ||
| Pulmonary Aspiration Risk | 343 | ||
| Fasting Interval | 343 | ||
| American Society of Anesthesiologists Physical Status Classification System | 343 | ||
| Advent and Purpose | 343 | ||
| Definition | 344 | ||
| Limitations of the Current System | 344 | ||
| Preventing Operative Errors | 344 | ||
| Summary | 344 | ||
| References | 345 | ||
| References | 345.e1 | ||
| Unit V Intraoperative Management | 347 | ||
| 21 Fluid Administration, Perioperative Goal-Directed Fluid Therapy, and Electrolyte Disorders | 347 | ||
| Fluid Volume, Types of Fluids, and Overview of Fluid Management | 347 | ||
| Normal Physiologic Distribution and Regulation of Fluids | 347 | ||
| Composition and Relative Advantages of Various Intravenous Fluids | 349 | ||
| Crystalloids | 349 | ||
| Colloids | 350 | ||
| Impact of Surgery and Anesthesia on Vascular Flow and Organ Perfusion | 351 | ||
| Historical Approach to Fluid Management | 352 | ||
| Perioperative Goal-Directed Fluid Therapy | 354 | ||
| Hemodynamic Monitoring and Patient Goal-Directed Therapy | 355 | ||
| The Frank–Starling Mechanism | 355 | ||
| Dilution Techniques | 356 | ||
| Pulse Contour Analysis | 356 | ||
| Esophageal Doppler and Echocardiography | 356 | ||
| Measures of Tissue Oxygenation | 357 | ||
| Perioperative Goal Directed Therapy Protocols | 357 | ||
| Perioperative Goal Directed Therapy and Enhanced Recovery | 358 | ||
| Enhanced Recovery After Surgery | 358 | ||
| Preoperative Fluid Management in ERAS Protocol | 358 | ||
| Intraoperative Fluid Management in ERAS Protocol | 358 | ||
| Perioperative Goal-Directed Therapy and ERAS | 359 | ||
| Postoperative Phase and ERAS | 359 | ||
| New Paradigm in Perioperative Fluid Management | 359 | ||
| Electrolyte Balance | 359 | ||
| Disorders of Sodium Balance | 359 | ||
| Hyponatremia | 359 | ||
| Hypernatremia | 360 | ||
| Disorders of Potassium Balance | 361 | ||
| Hypokalemia | 361 | ||
| Hyperkalemia | 363 | ||
| Disorders of Calcium Balance | 364 | ||
| Hypocalcemia | 365 | ||
| Hypercalcemia | 365 | ||
| Disorders of Magnesium Balance | 366 | ||
| Hypomagnesemia | 366 | ||
| Hypermagnesemia | 366 | ||
| Disorders of Phosphate Balance | 367 | ||
| Hypophosphatemia | 367 | ||
| Hyperphosphatemia | 367 | ||
| Summary | 368 | ||
| References | 368 | ||
| References | 368.e1 | ||
| 22 Blood and Blood Component Therapy | 369 | ||
| Estimation of Blood Volume and Loss | 369 | ||
| Transfusion Thresholds and Indications | 369 | ||
| Patient Blood Management | 370 | ||
| Conservation Strategies | 371 | ||
| RBC Alternatives | 371 | ||
| Preoperative Preparation | 371 | ||
| Directed Donor | 372 | ||
| Autologous Transfusion | 372 | ||
| Preoperative Autologous Donation | 372 | ||
| Intraoperative Red-Blood-Cell Salvage | 372 | ||
| Acute Normovolemic Hemodilution | 372 | ||
| Transfusion Compatibility | 372 | ||
| Type and Screen | 373 | ||
| Type and Crossmatch | 373 | ||
| Emergency Transfusion | 373 | ||
| Massive Transfusion Protocols | 373 | ||
| Fractionation | 374 | ||
| Best Practice Transfusion Guidelines | 374 | ||
| Packed Red Blood Cells | 374 | ||
| Fresh-Frozen Plasma | 374 | ||
| Platelets | 375 | ||
| Cryoprecipitate | 376 | ||
| Blood Storage | 377 | ||
| Complications of Blood Transfusion | 377 | ||
| Viral and Bacterial Risks | 378 | ||
| Summary | 379 | ||
| References | 379 | ||
| References | 379.e1 | ||
| 23 Positioning for Anesthesia and Surgery | 380 | ||
| Physiologic Effects of Surgical Positions | 380 | ||
| Cardiovascular System | 380 | ||
| Respiratory System | 381 | ||
| Pathophysiology of Nerve Injury | 382 | ||
| Factors Contributing to Nerve Injuries | 382 | ||
| Positioning Devices | 383 | ||
| Length of Procedure | 383 | ||
| Anesthetic Techniques | 383 | ||
| Patient-Related Factors Contributing to Nerve Injuries | 383 | ||
| Body Habitus | 383 | ||
| Preexisting Conditions | 383 | ||
| Perioperative Neuropathies | 383 | ||
| Ulnar Neuropathy | 384 | ||
| Brachial Plexus Injuries | 386 | ||
| Spinal Cord Injury | 387 | ||
| Postoperative Visual Loss | 387 | ||
| Other Position-Related Injuries | 390 | ||
| Compartment Syndrome | 390 | ||
| Venous Air Embolism | 390 | ||
| Airway Complications of Surgical Positions | 391 | ||
| Surgical Positioning | 391 | ||
| The Supine Position (Dorsal Decubitus) | 391 | ||
| Trendelenburg/Reverse Trendelenburg Positions | 391 | ||
| The Lithotomy Position | 391 | ||
| The Lateral Decubitus Position | 392 | ||
| The Sitting Position | 394 | ||
| The Prone Position | 394 | ||
| Closed-Claims Studies | 395 | ||
| Summary | 396 | ||
| References | 396 | ||
| References | 396.e1 | ||
| 24 Airway Management | 397 | ||
| Anatomy and Physiology of the Airway | 397 | ||
| Developmental Anatomy | 397 | ||
| Upper Respiratory Tract | 397 | ||
| Nose. | 397 | ||
| Mouth. | 398 | ||
| Pharynx. | 398 | ||
| Larynx. | 398 | ||
| Lower Respiratory Tract | 399 | ||
| Trachea. | 400 | ||
| Diaphragm | 400 | ||
| Airway Evaluation | 400 | ||
| Bag Mask Ventilation Assessment | 401 | ||
| Direct and Video Laryngoscopy With Tracheal Intubation Assessment | 405 | ||
| Mallampati Classification | 405 | ||
| Cormack and Lehane Grading System | 406 | ||
| Thyromental Distance | 406 | ||
| Interincisor Gap | 407 | ||
| Atlanto-Occipital Joint Mobility | 407 | ||
| Mandibular Protrusion Test | 408 | ||
| Supraglottic Airway Assessment | 408 | ||
| Cricothyrotomy Airway Assessment | 409 | ||
| Radiologic and Ultrasonographic Imaging | 409 | ||
| Tracheal Intubation | 410 | ||
| Management of the Difficult and Failed Airway | 410 | ||
| Definition of a Difficult and Failed Airway | 412 | ||
| Incidence of a Difficult and Failed Airway | 412 | ||
| Difficult Airway Algorithms | 412 | ||
| ASA Difficult Airway Algorithm | 413 | ||
| DAS Difficult Intubation Guidelines | 413 | ||
| Difficult Airway Cart | 415 | ||
| Awake Intubation | 415 | ||
| Awake Intubation Techniques | 416 | ||
| Patient Preparation | 416 | ||
| Airway Blocks | 417 | ||
| Topical Anesthesia | 418 | ||
| Glossopharyngeal Block | 418 | ||
| Superior Laryngeal Nerve Block | 419 | ||
| Transtracheal Block | 420 | ||
| Cricoid Pressure | 420 | ||
| Adjunct Airway Equipment and Techniques | 421 | ||
| Supraglottic Airway Devices | 421 | ||
| Laryngeal Mask Airway | 421 | ||
| Second Generation Supraglottic Devices | 422 | ||
| Intubating Supraglottic Airway Devices | 424 | ||
| Supraglottic Tubes | 425 | ||
| Supraglottic Device Considerations | 425 | ||
| Intubation Stylets | 425 | ||
| Trachlite Lighted Stylet | 425 | ||
| Eschmann Stylet (Gum Elastic Bougie) | 426 | ||
| Airway Exchange Catheters | 426 | ||
| Flexible Scopes and Fiberoptic Stylets | 426 | ||
| Flexible Bronchoscope | 426 | ||
| Rigid and Semirigid Fiberoptic Stylets and Laryngoscopes | 428 | ||
| Shikani Optical Stylet and Levitan FPS. | 428 | ||
| Bonfils Retromolar Intubation Fiberscope and RIFL. | 428 | ||
| Video Laryngoscopy | 429 | ||
| GlideScope Video Laryngoscope | 429 | ||
| Karl Storz C-MAC Video Laryngoscope | 429 | ||
| McGrath Video Laryngoscope | 429 | ||
| Channel Scope Devices | 430 | ||
| Subglottic Interventions and Emergency Front of Neck Access | 430 | ||
| Needle Cricothyrotomy With Transtracheal Jet Ventilation | 431 | ||
| Surgical Cricothyrotomy | 431 | ||
| Retrograde Intubation | 433 | ||
| Tracheotomy | 434 | ||
| Tracheal Extubation | 434 | ||
| Tracheal Extubation Techniques | 435 | ||
| Tracheal Extubation of the Difficult Airway | 435 | ||
| Complications After Tracheal Extubation | 436 | ||
| Residual Neuromuscular Blockade | 436 | ||
| Laryngospasm | 436 | ||
| Laryngotracheobronchitis | 438 | ||
| Complications of Airway Management | 438 | ||
| Airway Trauma | 438 | ||
| Aspiration | 439 | ||
| Esophageal Intubation | 440 | ||
| Endobronchial Intubation | 440 | ||
| Endotracheal Tube Complications | 440 | ||
| Summary | 440 | ||
| References | 440 | ||
| References | 440.e1 | ||
| 25 Cardiovascular Anatomy, Physiology, Pathophysiology, and Anesthesia Management | 441 | ||
| Cardiovascular System | 441 | ||
| Heart | 441 | ||
| Gross Anatomy | 441 | ||
| Cardiac Silhouette | 441 | ||
| Pericardium | 441 | ||
| Surface Anatomy | 441 | ||
| Cardiac Skeleton | 441 | ||
| Chambers of the Heart | 442 | ||
| Right Atrium. | 442 | ||
| Right Ventricle. | 442 | ||
| Left Atrium. | 443 | ||
| Left Ventricle. | 443 | ||
| Myocardium | 443 | ||
| Heart Valves | 443 | ||
| Atrioventricular Valves | 443 | ||
| Tricuspid Valve. | 443 | ||
| Mitral Valve. | 443 | ||
| Semilunar Valves. | 443 | ||
| Coronary Circulation | 443 | ||
| Coronary Arteries. | 444 | ||
| Left Main Coronary Artery. | 444 | ||
| Left Anterior Descending Coronary Artery. | 444 | ||
| Left Circumflex Coronary Artery. | 444 | ||
| Right Coronary Artery. | 444 | ||
| Coronary Artery Dominance. | 444 | ||
| Venous Drainage. | 444 | ||
| Cardiac Innervation | 444 | ||
| Cardiac Conduction System | 445 | ||
| Sinoatrial Node. | 445 | ||
| Internodal Tracts. | 445 | ||
| Atrioventricular Node. | 445 | ||
| Atrioventricular Bundle. | 446 | ||
| Purkinje System. | 446 | ||
| Structural and Regulatory Proteins. | 446 | ||
| Comparison-Skeletal and Cardiac Muscle Cells. | 447 | ||
| Generation of Membrane Potentials | 447 | ||
| Resting Membrane Potentials. | 447 | ||
| Ventricular Muscle Fiber Action Potential | 448 | ||
| Gate Theory. | 448 | ||
| Phases of the Action Potential. | 448 | ||
| Refractory Periods. | 449 | ||
| Sinoatrial Node Action Potential. | 449 | ||
| Physiology of the Heart | 449 | ||
| Cardiac Cycle. | 449 | ||
| Diastole. | 449 | ||
| Systole. | 450 | ||
| Physiology of Coronary Circulation. | 450 | ||
| Coronary Blood Flow. | 450 | ||
| Control of Coronary Circulation and Oxygen Supply and Demand. | 450 | ||
| Autoregulation. | 451 | ||
| Cardiac Output. | 452 | ||
| Cardiovascular Reflexes | 454 | ||
| Cardiac Output Regulation. | 454 | ||
| Valsalva Maneuver. | 454 | ||
| Baroreceptor Reflex. | 454 | ||
| Oculocardiac Reflex. | 454 | ||
| Celiac Reflex. | 455 | ||
| Bainbridge Reflex (Atrial Stretch Reflex). | 455 | ||
| Cushing Reflex. | 455 | ||
| Chemoreceptor Reflex. | 455 | ||
| Vascular System | 455 | ||
| Anatomy | 455 | ||
| Vascular Anatomy | 455 | ||
| Arteries. | 455 | ||
| Arterioles. | 456 | ||
| Capillaries. | 456 | ||
| Venules. | 456 | ||
| Veins. | 456 | ||
| Arterial Circulation | 457 | ||
| Microscopic Anatomy of the Arterial Circulation. | 457 | ||
| Thoracic Aorta. | 457 | ||
| Upper Extremity Arteries. | 457 | ||
| Descending Thoracic Aorta. | 458 | ||
| Abdominal Aorta. | 458 | ||
| Iliac Arteries. | 458 | ||
| Lower Extremities. | 458 | ||
| Venous Circulation | 459 | ||
| Head and Neck. | 459 | ||
| Upper Extremities. | 459 | ||
| Thorax. | 459 | ||
| Abdomen, Pelvis, and Lower Extremities. | 459 | ||
| Microcirculation | 459 | ||
| Anatomy. | 459 | ||
| Local Control of Capillary Blood Flow. | 459 | ||
| Angiogenesis-Growth of Collateral Circulation | 459 | ||
| Blood Pressure | 460 | ||
| Pressure, Flow, and Resistance Interrelationships | 460 | ||
| Ohm’s Law. | 460 | ||
| Blood Flow. | 460 | ||
| Poiseuille’s Law. | 460 | ||
| Resistance. | 460 | ||
| Resistance of Systems. | 460 | ||
| Regulation of Mean Arterial Blood Pressure | 460 | ||
| Short-Term Regulation. | 460 | ||
| Long-Term Regulation. | 461 | ||
| Physiology of the Venous System | 461 | ||
| Hypertension | 462 | ||
| Extent, Definition, and Etiology | 462 | ||
| Pathophysiology | 462 | ||
| Anesthesia Management for the Patient With Hypertension | 462 | ||
| Preoperative Evaluation | 462 | ||
| Anesthesia Management | 463 | ||
| Induction of Anesthesia | 463 | ||
| Maintenance of Anesthesia | 464 | ||
| Postoperative Considerations in the Hypertensive Patient | 464 | ||
| Pericardial Disease | 464 | ||
| Acute Pericarditis | 464 | ||
| Index | 1235 | ||
| A | 1235 | ||
| B | 1243 | ||
| C | 1246 | ||
| D | 1253 | ||
| E | 1256 | ||
| F | 1259 | ||
| G | 1260 | ||
| H | 1262 | ||
| I | 1265 | ||
| J | 1268 | ||
| K | 1268 | ||
| L | 1268 | ||
| M | 1272 | ||
| N | 1275 | ||
| O | 1278 | ||
| P | 1281 | ||
| Q | 1287 | ||
| R | 1287 | ||
| S | 1290 | ||
| T | 1294 | ||
| U | 1297 | ||
| V | 1298 | ||
| W | 1300 | ||
| X | 1300 | ||
| Y | 1300 | ||
| Z | 1300 | ||
| Endsheets 2-3 | IBC2 |