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By Garrioch, Magnus

ISBN-10: 184076077X

ISBN-13: 9781840760774

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He is conscious (implying a systolic BP >50 mmHg). He is in class 3 haemorrhagic shock as defined by the American College of Surgeons ATLS guidelines, which categorise shock into 4 classes depending on the percentage of blood volume lost by an adult patient. ii. • Class 1 (0–15%, 0–750 ml blood loss). Vital signs remain stable. Observe for potential further bleeding, especially if the source of bleeding is unclear. Make a surgeon aware of the patient’s presence and rule out other injuries. • Class 2 (15–30%, 750–1,500 ml blood loss).

How would you categorise this patient’s shock? ii. Describe each category of shock and outline how you would treat each one. iii. What six life-threatening thoracic injuries could this man have, which must be picked up in the primary survey prior to anaesthesia? indd 31 15/10/14 11:37 AM Answer 23 23i. He is stabbed in the chest and is correctly receiving high-flow oxygen through a trauma mask. He is conscious (implying a systolic BP >50 mmHg). He is in class 3 haemorrhagic shock as defined by the American College of Surgeons ATLS guidelines, which categorise shock into 4 classes depending on the percentage of blood volume lost by an adult patient.

Do the pressure gauges indicate how much of the contents remain? Explain why or why not. The fact that N2O is not an ideal gas at room temperature explains this. What is an ideal gas, and why is N2O not ideal at room temperature? iv. Will the cylinder pressures change with altitude and temperature? v. What percentage of N2O content remains when the delivered pressure starts to decrease? vi. 5°C (98°F)? Why/why not? vii. 5°C (98°F) in relation to N2O? indd 23 15/10/14 11:37 AM Answer 19 19i. Oxygen is a true gas at room temperature, N2O is a vapour, so an oxygen cylinder is ‘full’ when filled to a pressure of 2,000 psi (13,700 kPa).

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Anaesthesia by Garrioch, Magnus


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