Case-Based Anesthesia: Clinical Learning Guides PDF
Preview Case-Based Anesthesia: Clinical Learning Guides
15259_FM.qxd 3/19/09 12:35 AM Page i C L I N I C A L L E A R N I N G G U I D E S CASE-BASED ANESTHESIA 15259_FM.qxd 3/18/09 12:07 PM Page ii 15259_FM.qxd 3/19/09 12:37 AM Page iii C L I N I C A L L E A R N I N G G U I D E S CASE-BASED ANESTHESIA GEORGE SHORTEN Professor of Anaesthesia and Intensive Care Medicine Department of Anaesthesia University College of Cork Consultant Anaesthetist Department of Anaesthesia Cork University Hospital Cork, Ireland STEPHEN F. DIERDORF, MD Professor and Vice Chairman Department of Anesthesia Indiana University School of Medicine Indianapolis, Indiana GABRIELLA IOHOM, MD, PhD Consultant Anaesthetist/Senior Lecturer Cork University Hospital University College Cork Cork, Ireland CHRISTOPHER J. O’CONNOR, MD Professor of Anesthesiology Rush University Medical Center Chicago, Illinois CHARLES W. HOGUE, JR., MD Associate Professor Department of Anesthesiology and Critical Care Medicine The Johns Hopkins Medical Institutions and The Johns Hopkins Hospital Baltimore, Maryland 15259_FM.qxd 3/18/09 12:07 PM Page iv Acquisitions Editor: Frances DeStefano Product Manager: Nicole Dernoski Marketing Manager: Angela Panetta Production Editor: Julie Montalbano Design Coordinator: Terry Mallon Compositor: Maryland Composition/ASI Copyright © 2009 Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street Baltimore, MD 21201 530 Walnut Street Philadelphia, PA 19106 Printed in China. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any in- formation storage and retrieval system without written permission from the copyright owner, except for brief quo- tations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia, PA 19106, via email at [email protected], or via website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Library of Congress Cataloging-in-Publication Data Case-based anesthesia : clinical learning guides / [edited by] George Shorten. p. ; cm. Includes bibliographical references and index. ISBN 978-0-7817-8955-4 1. Anesthesia—Case studies. I. Shorten, George. [DNLM: 1. Anesthesia—Case Reports. 2. Anesthesia—Problems and Exercises. 3. Anesthesiology— methods—Case Reports. 4. Anesthesiology—methods—Problems and Exercises. 5. Anesthetics—Case Reports. 6. Anesthetics—Problems and Exercises. 7. Perioperative Care—methods—Case Reports. 8. Perioperative Care—methods—Problems and Exercises. WO 218.2 C337 2009] RD82.45.C37 2009 617.9’6—dc22 2008052575 DISCLAIMER Care has been taken to confirm the accuracy of the information present and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any conse- quences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascer- tain the FDA status of each drug or device planned for use in their clinical practice. To purchase additional copies of this book, call our customer service department at (800) 638-3030or fax orders to (301) 223-2320. International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: http://www.lww.com. Lippincott Williams & Wilkins cus- tomer service representatives are available from 8:30 am to 6:00 pm, EST. 15259_FM.qxd 3/18/09 12:07 PM Page v Dedicated to the memory of Gerard McDonnell. Dr. Shorten wishes to thank Ms. Renee Mooney for her incomparable efficiency and hard work. 15259_FM.qxd 3/18/09 12:07 PM Page vi 15259_FM.qxd 3/18/09 12:07 PM Page vii F O R E W O R D The discovery and application of anesthesia is the most im- So in this setting, where does Case-Based Anesthesia: Clinical portant contribution of American medicine to mankind. Its Learning Guidesedited by Drs. Shorten, Dierdorf, O’Connor, impact exceeds even the elucidation of the human genome. Iohom, and Hogue fit in? In other words, do we need yet an- Without visionary discoveries by pioneers in anesthesiology, other anesthesiology text? The answer, in this case, is a re- the explosive growth in type, complexity, and safety of surgi- sounding yes! Why? First starting with the title, Clinical cal procedures would not have occurred. More importantly, Learning Guides, the editors have chosen to emphasize learn- anesthesiology is considered to be the lead specialty in patient ing in the broader sense, not just Board exam preparation and safety. re-certification, but acquisition of knowledge as part of the The core principle that drives these advances is training process of responsibility and accountability for one’s education and continuing education. It is interesting to note that, in the and lifelong learning. By viewing education through this lens, 19th century, anesthesiology was considered a “technique” the practioner can apply information gained from this text with little scientific merit. It was not until 100 years later into a variety of clinical and examination settings. The Editors that the specialty developed a rigorous scientific foundation accomplish their goal through the innovative approach of with postgraduate training programs. Even more astound- using two formats for case-based learning: “Step-by Step” or ing is the fact that, into the late 20th century, there was a “Reflection.” This is a unique approach for a textbook. paucity of books authored by North Americans. Textbooks Importantly, it recognizes different learning styles to help re- supporting resident education, preparation for board exam- inforce important clinical concepts. This is the first time such inations, and reference for clinical care were predominantly diverse information has been organized on these educationally British in origin. sound principles in a clinical textbook. The editors have cou- In the 1980s the educational scene changed dramatically. pled this with the use of “hot topics” where new evidence can Residents and fellows were recruited from the upper tier of be applied to clinical conundrums as well as to responses to ex- medical school graduates. In addition to publication of core amination questions. This is accomplished by a list of all-star and specialty textbooks and journals, application of electronic contributors, each an authority in his/her own area of expert- media, such as the Internet, has revolutionized the specialty ise. It is as if the reader is being taken through a clinically chal- of anesthesiology. The American Board of Anesthesiology lenge case with an expert at their side. has stated, “The ability to independently acquire and process As Thomas L. Friedman implies in his best-selling book information in a timely manner is central to assure individual The World is Flat(Picador 2007), anesthesiologists worldwide responsibility for all aspects of patient care.” Although use of are truly interconnected, as globalization brings us into wide- the Internet and other electronic media assist in rapidly an- reaching contact with our peers and new opportunities arise. swering questions related to patient care, most residents, fel- Thus, Case-Based Anesthesia: Clinical Learning Guides is tar- lows, and experienced clinicians still use the printed word to geted at an international array of inquisitive trainees and clini- comprehensively learn about a new topic, prepare for board cians whose basic goal is safe and unsurpassed clinical care of examination and recertification, and even organize a clinical our patients. management plan for the patient with a complex array of co- existing diseases. Paul G. Barash, MD Professor, Department of Anesthesiology Yale University School of Medicine Attending Anesthesiologist Yale-New Haven Hospital New Haven, Connecticut vii 15259_FM.qxd 3/18/09 12:07 PM Page viii 15259_FM.qxd 3/20/09 8:30 PM Page ix C O N T R I B U T O R S Hassan M. Ahmad, MD John Dowling, BDS, MB, BCh, BAO(Hons), The Johns Hopkins School of Medicine BMedSc(NUI) The Johns Hopkins Hospital Specialist Registrar in Anaesthesia Baltimore, Maryland Cork University Hospital Cork, Ireland Ioanna Apostolidou, MD Associate Professor of Anesthesiology Craig Dunlop, MBBS, FCARCSI School of Medicine Specialist Registrar in Anaesthesia University of Minnesota Cork University Hospital Minneapolis, Minnesota Cork, Ireland Ashit Bardhan, MBBS, FCARCSI Amanda A. Fox Specialist Registrar Staff Anesthesiologist Cork University Hospital Brigham & Women’s Hospital Cork, Ireland Harvard Medical School Boston, Massachusetts Dorothy Breen, FCARCSI, FJFICM Specialist Registrar in Anaesthesia Kelly Grogan, MD Cork University Hospital Assistant Professor of Anesthesiology and Critical Care Medicine Cork, Ireland The Johns Hopkins School of Medicine The Johns Hopkins Hospital Siun Burke, FCARCSI Baltimore, Maryland Research Fellow Cork University Hospital Anthony Hennessy, FCARCSI Cork, Ireland Specialist Registrar in Anaesthesia Cork University Hospital Asokumar Buvanendran, MD Cork, Ireland Associate Professor of Anesthesiology Rush University Medical Center Charles W. Hogue, Jr., MD Chicago, Illinois Associate Professor Department of Anesthesiology and Critical Care Medicine Charles D. Collard The Johns Hopkins Medical Institutions and The Johns Hopkins Hospital Professor and Vice-Chairman Baltimore, Maryland Department of Anesthesiology Baylor College of Medicine Michelle Isac, MD Houston, Texas Assistant Clinical Professor of Anesthesia McMaster University W. Christopher Croley, MD, FCCP Hamilton, Ontario, Canada Assistant Professor of Anesthesiology and Critical Care Medicine Rush University Medical Center Jason S. Johnson, MD Chicago, Illinois Associate Professor of Anesthesiology School of Medicine Stephen F. Dierdorf, MD University of Minnesota Professor and Vice Chairman Minneapolis, Minnesota Department of Anesthesia Indiana University School of Medicine Indianapolis, Indiana ix 15259_FM.qxd 3/20/09 8:30 PM Page x x CONTRIBUTORS Roy Kan, MBBS(Singapore), MMed (Anesth) James O’Driscoll, FCARCSI Department of Anesthesiology and Critical Care Medicine Specialist Registrar in Anaesthesia The Johns Hopkins School of Medicine Cork University Hospital The Johns Hopkins Hospital Cork, Ireland Baltimore, Maryland Owen O’Sullivan, MB, BCh, BAO Justin Lane, FCARCSI Specialist Registrar in Anaesthesia Specialist Registrar in Anaesthesia Cork University Hospital Cork University Hospital Cork, Ireland Cork, Ireland Richard J. Pollard, MD Peter John Lee, MB, BCh, BAO, FCARCSI Southeast Anesthesia Consultants Specialist Registrar in Anaesthesia Charlotte, North Carolina Cork University Hospital Cork, Ireland David M. Rothenberg, MD, FCCM The Max S. Sadove, MD Professor of Anesthesiology Audrey R. Leverich, MD Associate Dean, Academic Affiliations Fellow in Cardiothoracic Anesthesiology Rush University Medical Center Department of Anesthesiology Chicago, Illinois Weill Cornell Medical College New York-Presbyterian Hospital Leon Serfontein, MBChB, FANZCA New York, New York Consultant Anaesthetist Cork University Hospital Jay K. Levin, MD Cork, Ireland Department of Anesthesiology and Critical Care Medicine The Johns Hopkins School of Medicine Mansoor A. Siddiqui, MBBS, FCPS, FCARCSI The Johns Hopkins Hospital Specialist Registrar in Anaesthesia Baltimore, Maryland Cork University Hospital Cork, Ireland Bryan V. May, MD Southeast Anesthesiology Consultants Nikolaos J. Skubas, MD Charlotte, North Carolina Associate Professor of Anesthesiology Weill Cornell Medical College Nanhi Mitter, MD Department of Anesthesiology Assistant Professor New York, New York Department of Anesthesiology Rush University Medical Center Joshua D. Stearns, MD Chicago, Illinois Assistant Professor of Anesthesiology and Critical Care Medicine The Johns Hopkins School of Medicine Laurel E. Moore, M.D. The Johns Hopkins Hospital Department of Anesthesiology Baltimore, Maryland The University of Michigan Ann Arbor, Michigan Jason Van der Velde, BAA, MBChB, EMDM-A Trauma Research Registrar Mohan Mugawar, FCARCSI Cork University Hospital Specialist Registrar in Anaesthesia Cork, Ireland Department of Anaesthesia Cork University Hospital John Vullo, MD Cork, Ireland Southeast Anesthesiology Consultants Charlotte, North Carolina Christopher J. O’Connor, MD Professor of Anesthesiology Adrienne Wells, MD Rush University Medical Center Assistant Professor of Anesthesiology Chicago, Illinois Rush University Medical Center Chicago, Illinois Brian D. O’Donnell, MB, FCARCSI, MSc Clinical Lecturer in Anaesthesia Cork University Hospital Cork, Ireland
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