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Anaesthesia for common emergency cases
Abstract
Anaesthesia runs smoothly when it is pre-planned, carefully thought out and all potential risks are considered and communicated. However, emergency case presentation is unpredictable and often occurs in addition to an already busy shift. Nonetheless, emergency case management requires quick thinking, dynamic action and rapid intervention. Identification and treatment of homeostatic abnormalities can be lifesaving. Some emergency presentations exhibit a significant physiological impact on the patient, altering their fitness for anaesthesia and potentially increasing their anaesthetic risk. This article discusses some of the many considerations relating to emergency anaesthesia in a selection of cases. Case examples to be discussed include caesarean section, gastric dilatation and volvulus, haemabdomen/acute haemorrhage and more.
Anaesthesia requirements and considerations can drastically change depending on the patient's presenting problem, comorbid conditions and individual characteristics, making the need for patient-specific care essential (Grubb et al, 2020). These changes are best anticipated and mitigated in advance of the anaesthetic event to improve patient outcomes and reduce mortality rates (Redondo et al, 2024). However, preparation and management of these changes can be challenging in the event of an emergency presentation (Shoop-Worrall et al, 2022; Redondo et al, 2024).
Emergency presentations are, by definition, unpredictable in their occurrence and require urgent treatment to preserve life (Fages et al, 2021). Furthermore, these cases often present outside regular working hours, and the impacts of reduced staffing numbers and increased team fatigue may contribute to higher peri-anaesthetic mortality rates (Grubb et al, 2020; Fages et al, 2021; Shoop-Worrall et al, 2022).
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