Anaesthesia
Browse 162 topics in anaesthesia.
Abdominal Anatomy
Define/Describe - Overview of abdominal regions and divisions... CICM First Part Written SAQ, CICM First Part Written MCQ exam preparation.
Acute Epiglottitis
Management is defined by a fundamental safety principle: Secure the Airway First . Any intervention that disturbs the child—including throat examination, venipuncture, or radiological investigation—can precipitate...
Acute Epiglottitis in Adults
Acute epiglottitis is a life-threatening inflammatory condition affecting the epiglottis and surrounding supraglottic structures, capable of progressing rapidly to complete airway obstruction. Following widespread...
Acute Post-Operative Bleeding
Post-operative bleeding (POB) is a potentially life-threatening surgical complication characterized by excessive hemorrh... MRCS exam preparation.
Acute Upper Airway Obstruction
Key Facts Definition : Blockage of airway above the level of the carina (tracheal bifurcation) Incidence : 2-5% of emergency airway presentations; rare but critical Mortality : 5-10% if treated promptly; near 100% if...
Adductor Canal Block
Roof (Superficial Wall): Sartorius muscle : Forms the roof of the canal for most of its length Fascial thickening : Strong fascia covering sartorius contributes to canal formation Attachment : Fascia blends with...
Airway Fire in the Operating Room - Prevention and Management
Immediate Management (Critical First 60 Seconds): Simultaneously: Remove all airway devices (ETT, LMA, nasal tube, etc.) Disconnect oxygen source - flood circuit with air Pour sterile saline into airway (300-500 mL if...
Amniotic Fluid Embolism (AFE)
Amniotic Fluid Embolism (AFE) is a catastrophic, unpredictable obstetric emergency characterised by the sudden onset of ... MRCOG exam preparation.
Anaesthesia for Aortic Arch Surgery
Aortic arch surgery requires deep hypothermic circulatory arrest (DHCA) with or without selective cerebral perfusion (SCP) . Indications : Aortic aneurysm, acute dissection (Type A), atherosclerotic disease. Core...
Anaesthesia for Aortic Surgery
Aortic surgery ranges from open repair (high risk, physiological insult) to endovascular stent grafting (EVAR/TEVAR, less invasive but still significant). Anatomy: Ascending aorta (coronary arteries, aortic valve),...
Anaesthesia for Cardiac Valve Surgery
Valve surgery requires understanding of hemodynamic goals specific to each lesion . Aortic stenosis (AS): Maintain sinus rhythm, normal-high preload, avoid hypotension/tachycardia, treat dynamic obstruction with...
Anaesthesia for Coronary Artery Bypass Grafting
Coronary artery bypass grafting (CABG) requires myocardial protection during ischemic arrest, hemodynamic optimization , and management of bleeding/coagulopathy . Preoperative : Continue antiplatelet agents (aspirin),...
Anaesthesia for Day Surgery
Day surgery (ambulatory surgery) requires rapid, smooth emergence , effective analgesia allowing oral intake and mobility, minimal PONV , and safe discharge . Patient selection : ASA I-III generally acceptable, BMI...
Anaesthesia for Dental Extractions
Dental extraction anaesthesia requires managing the "shared airway" with the dental surgeon while ensuring patient safety and comfort. Key considerations: (1) Airway management : Nasal intubation, reinforced LMA...
Anaesthesia for Endoscopic Sinus Surgery
Functional Endoscopic Sinus Surgery (FESS) is a minimally invasive technique for treating chronic rhinosinusitis, nasal polyps, and skull base pathology. Key anaesthetic challenges include:
Anaesthesia for Heart Transplantation
Heart transplantation is the gold standard treatment for end-stage heart failure refractory to medical/device therapy. Indications : Dilated cardiomyopathy (50-60%), ischemic cardiomyopathy (25-35%), congenital heart...
Anaesthesia for Laser Eye Surgery
Comprehensive guide to anaesthesia for PRK, LASIK, sedation requirements, and patient fixation for ANZCA Fellowship examination
Anaesthesia for Lung Resection
Lung resection includes pneumonectomy (entire lung), lobectomy (single lobe), segmentectomy/wedge (sublobar), and sleeve resection (bronchoplastic). Indications : Primary lung cancer (NSCLC 85%, SCLC 15%),...
Anaesthesia for Lung Transplantation
Lung transplantation is performed for end-stage lung disease refractory to medical therapy. Indications : COPD (30-35%), interstitial lung disease (25-30%), cystic fibrosis (15-20%), pulmonary hypertension (5-10%),...
Anaesthesia for Middle Ear Surgery
Middle ear surgery encompasses tympanoplasty, mastoidectomy, stapedectomy, and cholesteatoma surgery. Key anaesthetic considerations include:
Anaesthesia for Obesity
Obesity (BMI 30 kg/m²) affects 30% of Australian adults and presents significant anaesthetic challenges due to physiological changes including reduced functional residual capacity (FRC), increased airway resistance,...
Anaesthesia for Ophthalmic Trauma
Comprehensive guide to anaesthesia for open globe injuries, orbital fractures, and intraocular pressure management for ANZCA Fellowship examination
Anaesthesia for Parotid Surgery
Comprehensive guide to anaesthesia for parotidectomy including facial nerve monitoring, Frey syndrome, and sialogogue use for ANZCA Fellowship examination
Anaesthesia for Patients with Pacemakers and ICDs
Patients with cardiac implantable electronic devices (CIEDs) including pacemakers and implantable cardioverter-defibrillators (ICDs) require systematic perioperative management to prevent device malfunction from...
Anaesthesia for Pyloric Stenosis
Infantile hypertrophic pyloric stenosis (IHPS) is a medical emergency requiring correction of hypochloraemic hypokalaemic metabolic alkalosis BEFORE surgery - it is NOT a surgical emergency. Presentation is typically...
Anaesthesia for Radical Neck Dissection
Comprehensive guide to anaesthesia for radical neck dissection including airway compromise, carotid protection, and shoulder dysfunction for ANZCA Fellowship examination
Anaesthesia for Renal Transplantation
for ANZCA Finals : - ESRD Physiology : Cardiovascular disease (leading cause of death), anaemia, platelet dysfunction, hyperkalaemia, metabolic acidosis, altered drug pharmacokinetics - Preoperative : Dialysis within...
Anaesthesia for Salivary Gland Surgery
Salivary gland surgery requires meticulous attention to the facial nerve (parotid surgery) and airway management. Key considerations: (1) Facial nerve preservation : Electromyography (EMG) monitoring mandatory for...
Anaesthesia for Tonsillectomy
Tonsillectomy presents unique anaesthetic challenges due to the shared airway with the surgeon, risk of post-tonsillectomy haemorrhage (PTH) , and frequent paediatric population. Key considerations include:
Anaesthesia for Trauma
Trauma is the leading cause of death in Australians aged 1-44 years, with major trauma requiring coordinated multidisciplinary care including damage control resuscitation (DCR) principles. Primary survey follows ABCDE...
Anaesthesia for Vitreoretinal Surgery
Comprehensive guide to anaesthesia for scleral buckle, pneumatic retinopexy, gas tamponade, and complex vitrectomy for ANZCA Fellowship examination
Anaesthesia in the Elderly
Ageing physiology significantly impacts anaesthetic management due to reduced functional reserve in cardiovascular, respiratory, renal, hepatic, and neurological systems. Pharmacokinetic changes include reduced lean...
Autonomic Nervous System Anatomy
Define/Overview - Division of autonomic nervous system, general organization... CICM First Part Written SAQ, CICM First Part Written MCQ exam preparation.
Awareness Under Anaesthesia and Depth of Anaesthesia Monitoring
Accidental awareness during general anaesthesia (AAGA) is a rare but devastating complication with an incidence of approximately 1:19,000 anaesthetics in the UK (NAP5 data). It is defined as explicit recall of sensory...
Axillary Block
Axillary brachial plexus block targets the terminal branches of the brachial plexus as they surround the axillary artery in the axilla. Coverage : Forearm, wrist, hand (entire upper limb below mid-humerus)....
Bariatric Surgery Anaesthesia
Mechanical Alterations: Increased intra-abdominal pressure : Elevated by 5-15 mmHg above normal due to central adiposity, reducing diaphragmatic excursion Decreased FRC : Reduced by 30-50% in morbid obesity (BMI 40...
Beach Chair Position Anaesthesia
Beach chair position (BCP) involves elevating the head and torso 30-70 degrees from supine with legs lowered, primarily used for shoulder surgery. Physiological effects : Gravitational effects on cerebral perfusion...
Brachial Plexus Blocks
The brachial plexus (C5-T1 roots) provides motor and sensory innervation to the upper limb. Four principal approaches exist for brachial plexus blockade: interscalene (shoulder surgery, 100% phrenic nerve palsy),...
Bupivacaine
Bupivacaine is a potent, long-acting amide local anaesthetic widely used for neuraxial blocks (epidural, spinal), peripheral nerve blocks, and labour analgesia. Structure: Amide local anaesthetic (pipecoloxylidide),...
Caesarean Section
Caesarean section (CS) is the surgical delivery of a baby through incisions in the abdominal wall and uterus. It is one ... MRCOG exam preparation.
Caesarean Section Anaesthesia
Caesarean section is the most common major surgical procedure in Australia, with approximately 30-35% of births delivered by caesarean section. Neuraxial anaesthesia (spinal, epidural, or combined spinal-epidural) is...
Can't Intubate Can't Oxygenate (CICO)
What is it? Can't Intubate Can't Oxygenate (CICO) is a life-threatening airway emergency where tracheal intubation has failed AND oxygenation cannot be achieved via facemask or supraglottic airway (SGA). This...
Cancer Surgery and Anaesthesia
What is it? Anaesthesia for cancer surgery requires specialized knowledge of cancer biology, immunosuppression effects, optimal surgical timing, and perioperative considerations that differ significantly from...
Carbon Dioxide Transport
Carbon dioxide (CO2) is transported from tissues to lungs via three mechanisms: dissolved CO2 (5-10%), bicarbonate (60-70%), and carbamino compounds (20-25%). The bicarbonate pathway involves carbonic anhydrase...
Cardiac Anatomy & Coronary Circulation
Define/Describe - Overview of cardiac chambers, orientation in thorax... CICM First Part Written SAQ, CICM First Part Written MCQ exam preparation.
Cardiac Tamponade
Cardiac tamponade is life-threatening compression of the heart by fluid (blood, effusion) in the pericardial space impairing diastolic filling and reducing cardiac output. Pathophysiology: Pericardial pressure...
Cardiomyoplasty and Skeletal Muscle Ventricle
Cardiomyoplasty is an experimental surgical technique using skeletal muscle to assist or replace cardiac function. Two approaches exist: (1) Dynamic cardiomyoplasty—wrapping the latissimus dorsi muscle around the...
Cardiopulmonary Bypass Cannulation
Cardiopulmonary bypass (CPB) cannulation establishes extracorporeal circulation for cardiac surgery. Arterial cannulation (ascending aorta 95%, femoral 3%, axillary 2%) delivers oxygenated blood (cannula size: 20-24...
Cardiopulmonary Resuscitation (CPR) - Adult
Cardiopulmonary resuscitation (CPR) is a lifesaving technique combining chest compressions and rescue ventilations to maintain circulatory flow and oxygenation during cardiac arrest. High-quality CPR is the...
Cardiovascular Physiology
Cardiovascular physiology forms the foundation of critical care practice, informing haemodynamic monitoring, vasoactive ... CICM Fellowship Written, CICM Fellow
Cerebral Blood Flow & Autoregulation
Normal CBF values: 50 mL/100g/min total; grey matter 80-100, white matter 20-25 mL/100g/min... CICM First Part Written, CICM First Part Viva exam preparation
Clinical Governance in Anaesthesia
Comprehensive guide to quality improvement, audit, morbidity meetings, and clinical governance frameworks for ANZCA Fellowship examination
Coagulation Cascade & Fibrinolysis
Primary haemostasis involves platelet adhesion (via vWF-GPIb), activation (shape change, granule release), and aggreg... CICM First Part Written, CICM First
Communication Skills in Anaesthesia
Comprehensive guide to difficult conversations, breaking bad news, escalation protocols, and patient-centered communication for ANZCA Fellowship examination Professional Skills component
Congenital Diaphragmatic Hernia (CDH)
CDH is a developmental defect where abdominal contents herniate into the thorax through a defect in the diaphragm, causing pulmonary hypoplasia and pulmonary hypertension. Key anaesthetic principles:
Dental Anaesthesia
Challenges: Airway obstruction : Surgeon's hands and instruments in airway Monitoring difficulty : Face and airway obscured by surgical drapes Limited access : Cannot easily perform laryngoscopy or adjust airway...
Depth of Anaesthesia Monitoring
Depth of anaesthesia (DoA) monitors process electroencephalogram (EEG) signals to assess the hypnotic component of general anaesthesia. The three main technologies are: (1) Bispectral Index (BIS)—algorithm combining...
Difficult Airway Management
The difficult airway occurs in 1-6% of emergency department intubations and carries mortality of 25-30% if mismanaged, p... ACEM Primary Written, ACEM Primary V
Difficult Ventilation - Can't Intubate Can't Ventilate (CICV) Management
Immediate Recognition of Can't Intubate Can't Ventilate (CICV/CICO): Failed intubation: Multiple attempts unsuccessful Failed face mask ventilation: Cannot achieve chest movement, EtCO2, or SpO2 Failed SGA rescue:...
Distributive Shock (Adult)
Distributive shock is characterized by profound systemic vasodilation leading to maldistribution of blood flow and inadequate tissue perfusion despite normal or elevated cardiac output. Unlike hypovolemic or...
ECMO Cannulation and Vascular Access
Extracorporeal membrane oxygenation (ECMO) cannulation establishes vascular access for temporary mechanical circulatory and/or respiratory support. Two configurations exist: (1) Veno-arterial (VA) - femoral vein...
Electrical Injury and Lightning Strike
Electrical injuries cause devastating deep tissue damage, cardiac arrhythmias, and systemic complications disproportionate to visible burns. Key principles:
Electroconvulsive Therapy (ECT) Anaesthesia
Electroconvulsive therapy (ECT) involves inducing a generalized tonic-clonic seizure under general anaesthesia for treatment of severe psychiatric disorders. Anaesthetic goals : Provide brief unconsciousness (2-5...
End-of-Life Care in Anaesthesia
Comprehensive guide to palliative care, organ donation in Australia/NZ, and withholding/withdrawing treatment for ANZCA Fellowship examination Professional Skills component
Endocrine Physiology (Adrenal, Thyroid, Pituitary)
Endocrine physiology is fundamental to understanding the stress response in critical illness, metabolic regulation, and ... CICM First Part Written, CICM First
Epidural Anaesthesia
Epidural anaesthesia involves injection of local anaesthetic into the epidural space (potential space between ligamentum flavum and dura) producing segmental sensory block with less motor block than spinal. Anatomy:...
Erector Spinae Plane Block
Composition: The erector spinae is a large, complex muscle group located posterior to the vertebral column, consisting of three columns:
Ethics, Consent, and Capacity in Anaesthesia
Comprehensive guide to informed consent, capacity assessment, advance directives, and refusal of treatment for ANZCA Fellowship examination Professional Skills component
Extubation Criteria
Extubation is the planned removal of an endotracheal tube after determining a patient can maintain adequate spontaneous ... ACEM Primary Written, ACEM Fellowshi
Failed Intubation Drill
Failed intubation occurs in 1-3% of emergency department intubations and can rapidly deteriorate to a CICO (Can't Intuba... ACEM Primary Written, ACEM Primary V
Failed Spinal Anaesthesia: Management Options and Intubation Strategy
Failed spinal anaesthesia occurs in 1-5% of caesarean sections , with complete failure reported in 0.5-1% of cases. When spinal anaesthesia fails to provide adequate surgical anaesthesia, the anaesthetist must rapidly...
Femoral Nerve Block
Origin and Course: Formed from : L2-L4 lumbar plexus (posterior divisions) Exits : Lateral border psoas muscle Passes : Beneath inguinal ligament Position : Lateral to femoral artery, deep to fascia iliaca,...
Fetal and Neonatal Physiology
The CICM First Part examination frequently tests fetal and neonatal physiology as it underpins understanding of duct-dep... CICM First Part Written, CICM First
Foreign Body Aspiration - Acute Upper Airway Obstruction and Bronchoscopy
Foreign body aspiration is the inhalation of objects into the airway, most commonly affecting children aged 1-3 years (peak incidence). It is a life-threatening emergency requiring prompt diagnosis and intervention....
General Anaesthesia Induction
General anaesthesia induction is the transition from consciousness to unconsciousness with loss of protective airway reflexes, requiring controlled manipulation of physiology and airway management. Rapid sequence...
High Spinal and Total Spinal Block - Recognition and Management
Immediate Recognition: Sensory level above T4 (high spinal) with respiratory symptoms Progressive ascending weakness (numbness in hands T1-T4, respiratory C3-C5) Severe hypotension with bradycardia (sympathetic...
Hypertrophic Cardiomyopathy - Anaesthetic Considerations
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disorder (1:500 population), characterised by asymmetric left ventricular hypertrophy with myocardial disarray, presenting significant anaesthetic...
Interscalene Brachial Plexus Block
Formation: Roots : C5, C6, C7, C8, T1 (ventral rami) Interscalene location : C5-C7 roots between anterior and middle scalene muscles Trunks : Form superior (C5-C6), middle (C7), inferior (C8-T1) trunks Interscalene...
Intraoperative Bronchospasm - Recognition and Management
Immediate Recognition: Rising peak airway pressure ( 30 cmH₂O with plateau pressure unchanged suggests bronchospasm) Expiratory wheeze (may be absent in severe bronchospasm = "silent chest") Decreased tidal volume...
Isoflurane Pharmacology
Isoflurane (1-chloro-2,2,2-trifluoroethyl difluoromethyl ether) is a halogenated methyl ethyl ether volatile anaesthetic agent introduced in 1981 that remains widely used globally for maintenance of general...
Ketamine
Ketamine is a phencyclidine (PCP) derivative dissociative anaesthetic producing analgesia, amnesia, and unconsciousness while preserving airway reflexes and cardiovascular stability. Mechanism: Non-competitive...
Ketamine Pharmacology
Ketamine is a phencyclidine derivative dissociative anaesthetic that exists as two stereoisomers: S(+)-ketamine and R(-)-ketamine. The S(+)-enantiomer demonstrates 3-4 times greater analgesic potency and 1.5-2 times...
Labour Analgesia
Cervical Dilation and Uterine Contractions (0-10 cm): Origin: Uterine contractions, cervical dilation, lower uterine segment distension Pathway: Visceral afferents via hypogastric plexus → sympathetic chain → enter...
Lignocaine (Lidocaine)
Lignocaine (lidocaine) is the prototypical amide local anaesthetic, widely used for infiltration, nerve blocks, spinal and epidural anaesthesia, intravenous regional anaesthesia (Bier's block), and as an...
Local Anaesthetic Systemic Toxicity (LAST)
Local anaesthetic systemic toxicity (LAST) is a life-threatening emergency occurring when local anaesthetics enter systemic circulation, causing CNS and cardiovascular toxicity. Incidence: 0.1-0.3% of peripheral nerve...
Local Anaesthetic Systemic Toxicity (LAST) - Management and Lipid Emulsion
Immediate Recognition (Early Warning Signs): Prodromal symptoms: Circumoral numbness, metallic taste, tinnitus Neurological: Agitation, confusion, drowsiness, seizures Cardiovascular: Hypertension, tachycardia...
Local Anaesthetics
Local anaesthetics (LAs) block nerve conduction by inhibiting voltage-gated sodium channels (VGSC) in neuronal membranes, preventing action potential generation and propagation. Classification: Esters (procaine,...
Lower Limb Nerve Blocks
The lumbar plexus forms within the psoas major muscle from the anterior rami of L1-L4 nerve roots. It gives rise to several important branches that innervate the anterior and medial thigh:
Ludwig's Angina
The infection typically originates from odontogenic sources (80-90% of cases), most commonly from the mandibular second and third molars whose roots extend below the mylohyoid muscle into the submandibular space. The...
Lumbar Spine and CSF Dynamics
Define/Describe - Overview of lumbar spine anatomy... CICM First Part Written SAQ, CICM First Part Written MCQ exam preparation.
Magnesium Toxicity and Management in Obstetrics
One-liner : Magnesium toxicity in obstetrics is a potentially life-threatening iatrogenic complication of therapeutic magnesium sulfate administration, characterized by progressive neuromuscular and cardiovascular...
Massive Haemorrhage and Transfusion
Massive haemorrhage is defined as loss of 50% total blood volume within 3 hours, or blood loss exceeding 150 mL/min. Mortality ranges from 30-40% for trauma-related massive transfusion and 10-20% for surgical...
Massive Transfusion Protocol (Adult)
A massive transfusion protocol (MTP) is a standardized institutional approach to rapidly deliver large volumes of blood products to patients with life-threatening hemorrhage. MTP activation streamlines blood bank...
Massive Transfusion Protocol (MTP) - Hemorrhage Management
Activation Criteria (Activate MTP if ANY present): Blood loss 1500 mL or 30% blood volume Blood loss 150 mL/min sustained Need for 4 units PRBC in <1 hour Systolic BP <90 mmHg with ongoing bleeding Base deficit...
Maternal Physiological Changes in Pregnancy
Pregnancy induces profound physiological adaptations that significantly impact anaesthetic management. By term, cardiac output increases 40-50% (stroke volume +30%, heart rate +15-20%), blood volume expands 40-50%...
Maze Procedure and Atrial Fibrillation Ablation
The Maze procedure is a surgical treatment for atrial fibrillation (AF) that creates lines of conduction block in the atrial myocardium to restore sinus rhythm. Modern techniques include cut-and-sew Cox-Maze III/IV,...
Medicolegal Issues in Anaesthesia
Comprehensive guide to medical negligence, duty of care, documentation requirements, and expert witness responsibilities for ANZCA Fellowship examination Professional Skills component
Multiple Gestation and Anaesthesia
Multiple gestations (twins, triplets, higher-order multiples) complicate 1.6% of pregnancies in Australia but account for 10-15% of perinatal mortality and morbidity. Twin pregnancies are classified as monochorionic...
Near-Drowning and Submersion Injury
Near-drowning (submersion with survival 24 hours) causes severe hypoxic brain injury, pulmonary complications, and often hypothermia. Key principles:
Neck and Laryngeal Anatomy
Define/Describe - Overview of neck and laryngeal divisions and boundaries... CICM First Part Written SAQ, CICM First Part Written MCQ exam preparation.
Neonatal Anaesthesia
Fetal circulation physiology - PVR SVR, PDA-dependent lesions, transition challenges Immature organ systems - Low lung compliance, immature cardiac calcium handling, impaired thermoregulation Pharmacokinetic...
Neuraxial Anaesthesia in Obstetrics
What is it? Neuraxial anaesthesia encompasses epidural, spinal, and combined spinal-epidural (CSE) techniques for labour analgesia and caesarean delivery. These techniques provide superior pain relief with minimal...
Neurostimulation & Ultrasound in Regional Anaesthesia
Neurostimulation and ultrasound guidance have transformed regional anaesthesia by improving block success rates and reducing complications. Ultrasound provides real-time visualization of nerves, needle trajectory, and...
Nitrous Oxide Pharmacology
Nitrous oxide (N2O) is a colourless, sweet-smelling inhalational anaesthetic agent with unique physicochemical properties that distinguish it from volatile anaesthetics. Key ANZCA Primary exam points include:...
Nitrous Oxide Pharmacology
Nitrous oxide (N2O) is a colorless, odorless, non-irritating gas and the only inorganic compound used as a general anaesthetic. It is the weakest inhalational anaesthetic with a MAC (minimum alveolar concentration) of...
Obstetric Haemorrhage - PPH and Massive Transfusion
Primary PPH is defined as blood loss ≥500 mL within 24 hours of vaginal delivery or ≥1000 mL following cesarean section. Major PPH is blood loss 1000 mL or blood loss accompanied by signs of hypovolemia. PPH affects...
Obstetric Hemorrhage
Obstetric hemorrhage is a leading cause of maternal morbidity and mortality worldwide, representing one of the most crit... CICM Fellowship Written, CICM Fellow
Paediatric Airway Anatomy & Physiology
Paediatric airway management requires understanding of profound anatomical and physiological differences from adults. Infants have a proportionally larger occiput, larger tongue, higher larynx (C3-C4), and...
Paediatric Airway Management
The paediatric airway differs fundamentally from the adult airway in anatomy, physiology, and pathology. Children are NO... ACEM Primary Written, ACEM Primary V
Paediatric Anaesthesia Principles
Paediatric anaesthesia requires understanding of age-related physiological differences . Airway : Large tongue, cephalad larynx (C3-4 vs C4-5 in adults), narrow cricoid (subglottic region), short trachea, prominent...
Paediatric Cardiac Anaesthesia
Understanding circulation patterns - Systemic vs pulmonary blood flow balance, Qp:Qs ratios Shunt physiology - Direction and magnitude affect oxygenation and cardiac output Single ventricle physiology - Series...
Paediatric Trauma
Blood volume - 80 mL/kg (neonate) to 70 mL/kg (older child); hypovolaemic shock manifests late TBI management - Age-specific GCS, higher tolerance for hypotension but avoid hypoxia at all costs Hypotensive...
Paravertebral Block
Medial: Vertebral body (posterior aspect) Intervertebral disc Intervertebral foramen Lateral border of vertebral canal
Pelvic Anatomy (Obstetric Relevance)
Define/Describe - Overview of pelvic boundaries and contents... CICM First Part Written SAQ, CICM First Part Written MCQ exam preparation.
Pelvic Fracture: Haemorrhage Control and Anaesthetic Management
Pelvic fractures in trauma are associated with life-threatening haemorrhage due to disruption of the extensive pelvic venous plexus and arterial network. Immediate haemorrhage control involves application of a pelvic...
Pericardiectomy for Constrictive Pericarditis
Pericardiectomy is the surgical removal of the pericardium for constrictive pericarditis, a condition where a thickened, fibrotic, or calcified pericardium restricts diastolic filling, creating a "stiff shell" around...
Perioperative Anaemia Management
Comprehensive guide to patient blood management, iron deficiency, EPO, and transfusion triggers for ANZCA Fellowship examination
Perioperative Arrhythmia Management
Comprehensive guide to atrial fibrillation management, beta-blockers, amiodarone, and perioperative cardiac rhythm disturbances for ANZCA Fellowship examination
Perioperative Medicine and Optimisation
Comprehensive guide to perioperative optimisation, comorbidity management, and multidisciplinary care pathways for ANZCA Fellowship examination
Perioperative Myocardial Infarction
Perioperative myocardial infarction (PMI) represents acute myocardial injury occurring within 30 days of surgery, result... FRCA exam preparation.
Perioperative Temperature Management
Comprehensive guide to thermoregulation physiology, hypothermia prevention, temperature monitoring, and therapeutic temperature management for ANZCA Fellowship examination
Phaeochromocytoma Crisis
The cornerstone of acute management is alpha-adrenergic blockade FIRST using phentolamine (IV) or phenoxybenzamine (oral), followed only then by beta-blockade to control tachycardia. Beta-blockers administered alone...
Popliteal Sciatic Nerve Block
The popliteal fossa is a diamond-shaped space posterior to the knee joint containing the neurovascular structures supplying the lower leg and foot.
Post-Intubation Management
Immediate post-intubation management requires systematic verification of correct ETT placement, secure fixation, and ini... ACEM Primary Written, ACEM Primary V
Postpartum Haemorrhage
PPH is defined as blood loss ≥500ml following vaginal delivery or ≥1000ml following Caesarean section. However, these definitions are based on estimated blood loss, which is notoriously inaccurate—visual estimation...
Pre-eclampsia and Anaesthesia
Pre-eclampsia affects 3-5% of pregnancies in Australia and is a leading cause of maternal morbidity and mortality, with higher incidence in Aboriginal and Torres Strait Islander women (5-8%). It is defined as...
Pre-operative Assessment for Cardiac Surgery
Cardiac surgery represents one of the most extensively studied surgical specialties, with robust outcome data:
Pre-operative Cardiovascular Assessment
Perioperative cardiac stress results from sympathetic activation, fluid shifts, pain, and inflammation. Surgical stress increases myocardial oxygen demand while simultaneously compromising supply through tachycardia...
Preoperative Cardiac Risk Assessment
Comprehensive guide to cardiac risk stratification including RCRI, functional capacity assessment, and preoperative testing for ANZCA Fellowship examination
Primary Postpartum Haemorrhage (PPH)
Primary postpartum haemorrhage (PPH) is defined as blood loss of ≥500ml following vaginal delivery or ≥1000ml following ... MRCOG exam preparation.
Prone Positioning for Surgery
Prone positioning is essential for posterior spinal, neurosurgical, and some plastic/ENT procedures. Physiological effects : Reduced cardiac output (10-20% decrease), increased central venous pressure, decreased...
Propofol
Propofol (2,6-diisopropylphenol) is the most commonly used intravenous anaesthetic agent for induction and maintenance of general anaesthesia and sedation in ICU. Structure: Simple phenol derivative with two isopropyl...
Propofol Pharmacology
Propofol (2,6-diisopropylphenol) is a phenol derivative intravenous anaesthetic that acts primarily as a positive allosteric modulator of GABA A receptors, particularly at the beta-subunit, increasing chloride...
Pyloric Stenosis
Hypertrophic pyloric stenosis is a condition of acquired gastric outlet obstruction caused by hypertrophy of the pyloric muscle, typically presenting at 3-8 weeks of life with projectile vomiting. Key anaesthetic...
Quadratus Lumborum Block
Structure: The quadratus lumborum (QL) is a thick, quadrilateral muscle located in the posterior abdominal wall, extending between the 12th rib and the iliac crest.
Rectus Sheath Block
Formation: The rectus sheath is a fibrous compartment formed by the aponeuroses of the three lateral abdominal wall muscles (external oblique, internal oblique, transversus abdominis) as they envelop the rectus...
Renal and Retroperitoneal Anatomy
Define/Describe - Overview of kidney position, relations, and structure... CICM First Part Written SAQ, CICM First Part Written MCQ exam preparation.
Research Methodology, Statistics and Critical Appraisal
Hierarchy of Evidence: Systematic reviews/Meta-analyses (highest) Randomised Controlled Trials (RCTs) Cohort studies Case-control studies Case series/Case reports Expert opinion (lowest)
Retinoblastoma - Ocular Oncology and Intra-Arterial Chemotherapy
Retinoblastoma is the most common primary intraocular malignancy in children , with an incidence of 1 in 15,000-20,000 live births (approximately 300 new cases per year in the USA, 8-10 per year in Australia). It is...
Robotic Surgery Anaesthesia
Robotic-assisted surgery (RAS) presents unique anaesthetic challenges due to the combination of pneumoperitoneum, steep Trendelenburg position (25-45°), and reduced patient access once robot docked. Da Vinci system :...
Sciatic Nerve Block
Origin: Formed from : L4-S3 nerve roots (sacral plexus) L4 contribution : From lumbar plexus via lumbosacral trunk Sacral contributions : L5, S1, S2, S3 ventral rami unite in greater sciatic foramen Formation : Within...
Sedation and Analgesia Protocols in ICU
Analgesia-First Approach: Treat pain before sedation; 50-70% of ICU patients have significant pain, and untreated pai... CICM Second Part Written, CICM Secon
Severe Preeclampsia, HELLP Syndrome, and Eclampsia
Severe preeclampsia is defined as preeclampsia with severe features that indicate end-organ dysfunction and increased risk of maternal and fetal complications. It affects 2-8% of pregnancies globally and remains a...
Sevoflurane
Sevoflurane is a fluorinated ether inhalational anaesthetic with blood:gas partition coefficient 0.65 (low solubility), enabling rapid induction and emergence compared to isoflurane (1.4) and halothane (2.4). MAC...
Skeletal Muscle Physiology
Define - Skeletal muscle structure at macroscopic and microscopic levels... CICM First Part Written, CICM First Part Viva exam preparation.
Spinal Anaesthesia
Spinal anaesthesia involves injection of local anaesthetic into the subarachnoid space producing rapid, dense sensory and motor block with predictable dermatomal distribution. Mechanism: Local anaesthetic acts on...
Spinal Cord and Peripheral Nerve Anatomy
Define/Describe - Overview of spinal cord structure and boundaries... CICM First Part Written SAQ, CICM First Part Written MCQ exam preparation.
Spinal Injury Anaesthesia in Trauma
Acute spinal cord injury requires immediate spinal protection, cardiovascular stabilisation, and prevention of secondary injury. Key principles:
Strabismus Surgery - Oculocardiac Reflex, PONV, and Suxamethonium Alternatives
Strabismus surgery (squint surgery) is one of the most common paediatric surgical procedures , correcting misalignment of the eyes by tightening, loosening, or repositioning extraocular muscles. It is typically...
Stress Response and Critical Illness
The stress response to critical illness is a coordinated neuroendocrine-metabolic-inflammatory cascade designed for short-term survival. The HPA axis releases cortisol (essential for vascular tone and...
Supraclavicular Brachial Plexus Block
Location: Level : Divisions of brachial plexus (after trunks, before cords) Position : Posterior and lateral to subclavian artery, superior to first rib, inferior to clavicle Space : Interscalene groove continues,...
Supraglottic Airway Devices
description: "ACEM comprehensive guide to SGA use in emergency medicine",... ACEM Primary Written, ACEM Primary Viva exam preparation.
Thoracic Anaesthesia
Thoracic anaesthesia requires one-lung ventilation (OLV) for most intrathoracic procedures to provide surgical exposure and protect the dependent lung from contamination. Indications for OLV: Thoracotomy (lobectomy,...
Thoracic Anatomy
Define/Describe - Overview of thoracic boundaries and contents... CICM First Part Written SAQ, CICM First Part Written MCQ exam preparation.
Tracheo-Oesophageal Fistula (TOF)
TOF is a congenital anomaly where the trachea and oesophagus fail to separate during embryological development, creating abnormal connections. Oesophageal atresia (OA) is usually present. Key anaesthetic principles:
Tracheostomy Care
Tracheostomy patients presenting to the ED require systematic assessment and immediate action for airway emergencies. The most critical emergencies are:
Transfusion Reactions
Recognition requires high clinical suspicion—any new symptom during transfusion warrants immediate cessation and systematic investigation. The two most challenging differential diagnoses are TRALI (transfusion-related...
Transversus Abdominis Plane (TAP) Block
The TAP block provides analgesia to the anterior abdominal wall (T7-L1 dermatomes) by depositing local anaesthetic in the transversus abdominis plane between internal oblique and transversus abdominis muscles where...
Upper Airway Anatomy
Define/Describe - Overview of upper airway divisions and boundaries... CICM First Part Written SAQ, CICM First Part Written MCQ exam preparation.
Vascular Access Anatomy
Define/Describe - Anatomy of the specific access site... CICM First Part Written SAQ, CICM First Part Written MCQ exam preparation.
Venous Air Embolism - Detection and Management
Immediate Recognition: Sudden drop in EtCO2 (earliest sign) 2 mmHg drop from baseline Mill wheel murmur on precordial Doppler (characteristic churning sound) Sudden cardiovascular collapse during sitting position...
Ventricular Assist Device Implantation
Ventricular assist device (VAD) implantation is a major cardiac surgical procedure for patients with end-stage heart failure. The three configurations are: (1) Left VAD (LVAD) - most common (80%), blood inflow from...