ANZCA Final Exam Resources

Crises

Crisis Generator

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Generate Crisis!

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Stem

You are doing your usual general surgical list at a private hospital. On the table you have a 55-year old woman having an elective laparoscopic cholecystectomy. Her medical background is significant for sarcoidosis. After capnoperitoneum has been established, you hear the monitors alarm and see the following on the screen:

Heart rate 28 bpm

Systolic blood pressure 77 mmHg

Question 1

What do you do?

Question 2

What are the potential causes of this patient’s bradycardia?

Question 3

Crisis

Proposed Structure

Primary (ischaemic event, structural conduction problem)

Secondary

Metabolic (severe electrolyte derangement, severe acidosis)

Autonomic (vagal response, elevated ICP)

Anaesthetic (drug response or error, paradoxical response in anaphylaxis)

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