Anaesthesia Coffee Break Viva practice with Luke - Suxamethonium, oxygen delivery to tissues, sodium nitroprusside, functions of the liver
Aug 29, 2021
Luke Fletcher, a trainee anaesthetist in the Northwest Training Scheme, discusses critical concepts in anaesthesia. He dives into succinylcholine's mechanism and adverse effects, including hyperkalaemia implications. The conversation shifts to oxygen delivery strategies, highlighting the importance of cardiac output and hemoglobin. Luke also demystifies sodium nitroprusside's pharmacology and risks of cyanide toxicity. Lastly, he outlines the liver's diverse functions in metabolism and drug clearance, showcasing the intricate balance of the body's systems.
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Using A Viva As Study Motivation
- Luke had just finished his written exam and felt relieved but contemplative about missed points.
- He used the viva as motivation to restart focused study and practice under exam conditions.
Core Oxygen Delivery Equation
- Oxygen delivery (DO2) equals cardiac output times arterial O2 content (CaO2), normally ≈1000 ml/min.
- CaO2 depends on haemoglobin, SaO2 and PaO2 (CaO2 = Hb×1.34×SaO2 + 0.03×PaO2).
Practical Ways To Raise Oxygen Delivery
- To increase DO2, raise cardiac output or arterial oxygen content by boosting haemoglobin or saturation.
- Use fluids, inotropes, chronotropes or transfusion and increase FiO2 as appropriate.