Part 2 Final Exam Viva Demonstration - Parkinson's Disease and Fractured NOF with Faith

Great work with this viva and especially after doing a hectic night shift! seriously well done!

Here are some of the resources mentioned:

GUIDELINES ON PERIOPERATIVE MANAGEMENT OF ANTICOAGULANT AND ANTIPLATELET AGENTS December 2018
https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0006/458988/Guidelines-on-perioperative-management-of-anticoagulant-and-antiplatelet-agents.pdf

Management of Proximal Femoral Fractures 2011
https://anaesthetists.org/Portals/0/PDFs/Guidelines%20PDFs/Guideline_management_proximal_femoral_fractures_2011_final.pdf?ver=2018-07-11-163755-037&ver=2018-07-11-163755-037

Do Not Attempt Resuscitation (DNAR) Decisions in the Perioperative Period
https://anaesthetists.org/Portals/0/PDFs/Guidelines%20PDFs/New%20archived/Guidelines_DNAR_decisions_perioperative_period_2009_final_.pdf?ver=2020-12-01-093913-800&timestamp=1606819367259

Camptocormia (Bent Spine Syndrome)
https://en.wikipedia.org/wiki/Camptocormia

The optimal effect site concentration of remifentanil in combination with intravenous midazolam and topical lidocaine for awake fibreoptic nasotracheal intubation in patients undergoing cervical spine surgery

https://pubmed.ncbi.nlm.nih.gov/22240620/
Conclusion: The estimated EC(95) of remifentanil Ce for smooth nasotracheal fibreoptic intubation with conscious sedation was 3.38 (95% CI 2.90-3.46) ng·mL-1 when used in combination with midazolam and topical lidocaine. Remifentanil TCI may provide a tolerable experience of awake fibreoptic intubation despite the high incidence of recall.

Crisis Resource Management in Anaesthesia
https://youtu.be/i-rRipHMZ5Q
https://youtu.be/3DC8onloQ38
https://vimeo.com/461283262

Fat embolism syndrome:
Distinct pattern of clinical symptoms and signs following fat emboli,
-        more frequent in closed fractures
-        mostly associated with fractures of long bones. (1-3% single long bone or 33% bilateral femoral)
-        overall mortality 5 – 15%
-        typically presents 24 – 72 hours post injury (rarely 12 hrs to 2 weeks)
-        classic triad: respiratory changes, neurological abnormalities, petechial rash (not always present)
-        other clinical features include pyrexia, tachycardia, right heart strain, myocardial depression coagulopathy & renal changes

 Bone cement implantation syndrome:
·       No agreed definition. 
·       Characterised by hypoxia, hypotension, arrhythmias, increased PVR & cardiac arrest. 
·       Usually occurs at one of 5 stages: 
Femoral reaming
Acetabular and femoral cement implantation, insertion of prosthesis,  or joint reduction
·       Fat embolism seems to be the most likely aetiology

Disclaimer:
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