Assignment on Anaesthetics and Recovery
Added on 2021-02-21
15 Pages3461 Words41 Views
Disease and DisordersHealthcare and Research
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Anaesthetics and Recovery
Table of ContentsAIM..................................................................................................................................................1TOPIC .............................................................................................................................................1BACKGROUND AND RATIONALE............................................................................................1LITERATURE SEARCH AND CRITIQUE ..................................................................................1LITERATURE REVIEW ...............................................................................................................2Hypovolaemia..............................................................................................................................2Prevalence ...................................................................................................................................2Consequences for patient ............................................................................................................3Causes, signs and symptoms .......................................................................................................3Risk factors .................................................................................................................................3Management interventions ..........................................................................................................5Implications for nurses and patients ...........................................................................................6CONCLUSION ...............................................................................................................................7REFERENCES ...............................................................................................................................8
AIMTo conduct a literature review for an emergency situation in Post anaesthetic care unit(PACU). TOPIC The supportive or emergency situation chosen for this assignment is Hypovolaemia(intraoperative fluid maintenance/ blood loss). BACKGROUND AND RATIONALEPost anesthesia care or recovery is defined as the care intervention for promoting quickand safe recovery of patients after various types of anesthesia (Dasari and et.al., 2019). PACUcare service providers are responsible for managing and handling various emergency situationssuch as postoperative pain, airway and oxygen administration, shivering, nausea, vomiting,infection, bleeding and all other postoperative complications. These complications can be lifethreatening and thus it is required that effective interventions for PAC must be taken intopractices (Sharma and Goel, 2019). Anesthetic drug can abnormal vasodilation which results inhypovolaemia arterial blood pressure or intravascular volume is reduced. The key reason forchoosing this topic for the literature review is that excessive fluid or blood loss in hypovolaemiacan result in hypovolaemic shock which is life threatening. Thus literature review on the topicwill help to manage this emergency situations with appropriate interventions. LITERATURE SEARCH AND CRITIQUE For the analysis of literature various database such as Medline, Pubmed were searched.To enhance the search effective search terms such as anaesthetic care, Hypovolaemia,anaesthetic care for patients were used. A good number of search results were obtained for themanagement and treatment of anesthesia associated Hypovolaemia. However for enhancing thequality of research and valid approaches such as CRAPP test (Currency, reliability, authority andpurpose) of each secondary source was performed. It made the analysis of secondary sourcesaccurate and effective. The incorporation of vast range of literature sources also helped tointegrate the perspectives of various authors which gives broad insight of the issue. 1
LITERATURE REVIEW HypovolaemiaMestek and Lisogurski, Covidien LP, (2019) defines anesthesia associated hypovolaemiaas the contributing factor in the reduction of arterial vasodilation or ventricular contractileperformance or both. Most of the literature searches emphasis upon these aspects only and lessfocus is placed upon impact of anesthetic drug on contribution of venous system or cardiacoutput. With anaesthetic drugs venous capacitance is increased and outcomes related tovasoactive substances is reduced (Gautam and Bhochhibhoya, 2018). It ultimately result inreduction of cardiac output, vasodilatory shock and exposure to hypotension. Hypovolaemia canbe of absolute or relative type. In absolute hypovolaemia fluid (blood, plasma and water) fromvascular compartment are reduced or lost in controlled or uncontrolled manner. On the other hand in relative hypovolaemia an increased or normal blood volume fails tofill vascular compartment because of its increased capacity. Dasari and et.al., (2019) stated thatin all types of hypovolaemia cardiac outcomes and blood pressure are affected and its severitycan cause oxygen deficiency related to mortality and lactic acidemia. Venour functionimpairment due to anesthetic drug is responsible for causing relative hypovolaemia. It is frequentinsidious and also contributes in cardiovascular collapse and decrease in heart rate. Due to thisreason anesthesia induced hypovolaemia is considered as the primary reason for adverse events.All anaesthetic drugs endanger cardiovascular stability and ventricular function impairment. Prevalence According to Rekman and et.al., (2017) there are strong evidences for the association ofadverse events and anaesthetic environment. Hypovolaemia is also one of such events which canalso affect mortality. The potential reason for prevalence of such issues and risk consist ofseveral factors such as lack of training, clinical errors regarding dosage of anaesthetic drugs,limited familiarity with anesthesia process and insufficient monitoring of the physiologicalchanges. Apart from hypovolaemia reemergence from anesthesia, respiratory arrest and airwaycomplexities are common form of adverse events which can take place in post anaestheticenvironment. In the same context Liamis, Filippatos and Elisaf, (2015) stated that nominal value ofarterial blood pressure and cardiac output depends upon factors such as normal volume of blood,vascular tone which contain both arterial as well as venous, venous return or excess, heart rate2
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