Abstract
A multiple-injured trauma patient undergoes an emergency operation. After an initial uneventful period, the patient develops a series of ventilatory problems. Each time the problems lead to a rapid deterioration of the patient’s oxygenation status, which puts the patient at risk and the anesthetist under time pressure. She has to find the cause of the clinical deterioration and has to rapidly take therapeutic measures before the patient is seriously harmed. The circumstances of this series of ventilation problems, however, are challenging for the anesthetist because every time the pathophysiological disturbances present with an almost identical set of symptoms and monitor parameters, but the underlying cause is always a different one. Furthermore, the physician has difficulty diagnosing the problem because the apparent changes of one organ system are caused by concealed alterations of another system: The significant decrease in the blood pressure is caused by a pulmonary problem (i.e., tension pneumothorax) and a decrease in arterial saturation is due to performance limitations of an anesthesia machine when ventilating a patient with ARDS.
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St.Pierre, M., Hofinger, G., Buerschaper, C., Simon, R. (2011). The Challenge of Acute Healthcare. In: Crisis Management in Acute Care Settings. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-19700-0_2
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DOI: https://doi.org/10.1007/978-3-642-19700-0_2
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