![]() ![]() While we work hard to provide accurate and up to date information that we think you will find relevant, Forbes Advisor does not and cannot guarantee that any information provided is complete and makes no representations or warranties in connection thereto, nor to the accuracy or applicability thereof. Here is a list of our partners who offer products that we have affiliate links for.The reported incidence of postoperative respiratory compromise varies from 0%–14%. This is likely caused by trauma to the anterior soft-tissue and prolonged prone position both can result in upper airway oedema and impaired respiration. During induction of general anaesthesia in patients with cervical instabilities, no protective mechanism exists for the compromised spinal cord due to the paralysed neck musculature. Forceful manipulation during laryngoscopy and tracheal intubation may jeopardise the spinal cord. #Pull the pin challenge 20 manualManual inline axial stabilisation with fibre-optic nasal or oral endoscopy can reduce risk of spinal cord injury during tracheal intubation.Ĭontrolled hypotension reduces blood loss and facilitates surgical exposure. ![]() Unwanted effects include spinal cord ischaemia and neurological damage. At least 65% of the usual spinal blood flow is required for physiological integrity and a 12% decrease in blood flow may produce paralysis. Maintaining adequate blood pressure is important for neural perfusion.Ī mean arterial pressure of 65 mm Hg or 20 mm Hg below baseline in normotensive patients is usually safe. This is more apparent in cases of traumatic spinal cord injury where the patient may already have a contused and swollen spinal cord. The first step in handling any intraoperative drop in spinal cord signal/function is increasing the blood pressure. Positioning the patient is important to permit access to the surgical field and is necessary to avoid pressure areas or iatrogenic injuries. Adequate head and neck control is mandatory to prevent damage to the spinal cord, such as skeletal traction via Halo ring or Mayfield tongs. PULL THE PIN CHALLENGE LEVEL 21 FOR FREEīeing in a prone position may increase intraocular pressure leading to ischaemia, decreased perfusion pressure and blood supply to the retina. ![]()
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