Dr. Michael Greco – Post-Op Emergencies

There are critical elements in perianesthesia care.

• Co-existing disease process and anesthesia
• Levels of sedation and advantages/ disadvantages (conscious sedation, MAC, general)
• Intubation techniques and equipment (standard versus emergency)
• Differentiating spinal and epidural blocks
  • Safe management of catheters
  • Emergency identification and management of complications
  • Regional nerve blocks (Neck, upper and lower extremity, eyes)
• Identifying potential emergencies and complications resulting from regional blocks
  • Horners syndrome
  • Pneumothorax, vertebral artery injection
  • Hematoma and intravascular injection

Anesthetic medication can cause problems.

• Pharmacokinetics and pharmacodynamics
• Benzodiazepines
• Opioids
• Induction agents
• Inhalation agents and physiology
• Depolarizing and non-depolarizing muscle relaxants
• Acetylcholine receptor competitive antagonists
• Antiemetics
• Common emergency medications in the perianestheisa setting

There are post-operative Complications with Clinical Application.

• Modulation of pain
  • Pharmacologic and non-pharmacologic methods to employ
  • Physiologic complications from pain
• Local Anesthetic Systemic Toxicity (LAST)
  • Signs and symptoms (early and late)
  • Treatment algorithm
  • Post-op Nausea and Vomiting (PONV):
  • Risk factors, medication management, prophylaxis, rescue therapy
  • Hypothermia: Heat loss physics, delayed awakening, warming interventions
  • Perform a focused yet thorough physical assessment (systems review)

Respiratory Emergent Complications are real life case studies.

• Airway obstruction: Upper and lower
• Pharyngeal muscular weakness
• Laryngospasm vocal cord paralysis
• Airway edema
• Other airway emergencies:
  • Postoperative cervical hematoma
  • Foreign bodies
  • Residual effects of anesthesia
  • Pharmacologic reversal
  • Compromised oxygen exchange
  • Bronchospasms
  • Non-cardiogenic pulmonary edema
  • Hypoventilation and hypoxia
  • Pulmonary embolism
  • Pseudeocholinesterase deficiency
  • Atelectasis
  • Aspiration
  • Pneumothorax
  • Emergency tracheotomy

Obstructive Sleep Apnea Airway Emergent Complications is a real life case study.

• Physiology of OSA
• Comorbidities of concern
• Diagnosis
• Planning for treatment
• Emergency interventions
• Effects on airway management and ventilation
• Implications for care across the perianesthesia setting

Cardiovascular Emergent Complications are real life case studies.

• Pulmonary edema
  • Fluid overload
  • LV failure
  • MV dysfunction
• Hypertension and hypotension
• Postoperative dysrhythmias
• Myocardial infarction
• Hypervolemia and hypervolemia

Real Life Case Studies on Neurological Emergent Complications.

• Emergence delirium/excitement
• Somnolence
• Visual disturbances
• Intraoperative awareness
• Malignant hyperthermia

There are concerns about post-operative urinary retention.

• Risk factors to heighten awareness
• Evaluation and the latest in treatment

There are tips to reduce high risk populations.

• Obese patients
• Pediatric patients
• Obstetric patients
• Geriatric patients

Do you want to receive Dr. Michael Greco?

This is a description.

• Confidently respond to the respiratory and cardiovascular emergencies that occur after surgery
• Take away essential post-op assessment strategies to identify early concerns
• How can the medications used during surgical cases present challenges afterwards when the patients admit to the floor?
• Emergent interventions for patients with known or unknown sleep apnea
• Documentation strategies for the crisis post-op patient situations
• Anticipate the unique needs for your Obese, Pediatrics, Geriatrics & Obstetrics patients

If not treated quickly, post-operative problems can be fatal. Complications can lead to extended hospital stays, increased cost, and diminished quality of life. If you care for patients who have received anesthesia or analgesia, this seminar is for you. Michael Greco, DNP, CRNA, CPAN, CAPA will help you understand the factors associated with post-operative risk.

The immediate post-operative period can be dangerous. Other potential problems may be present later in the follow-up care. If you attend this seminar, you will learn how to adequately evaluate patients following surgery, as well as how to prevent crisis situations from even happening.