Respiratory and cardiac arrest. No. 9.

Intertitle explaining that sudden heart failure during anaesthesia may be due to (i) Anoxia or (ii) action of the agent on the heart. This is about emergency situations. Standby apparatus is laid out and should include a cylinder of oxygen with tubing as well as sterile needles and syringes, vials of stimulant drugs. Wooden wedge and mouth gags are also required. Training staff in resuscitation methods is also encouraged. Sylvester s method is recommended although chest massage and mouth-to-mouth are also shown. The next emergency is Respiratory Obstruction or Arrest . A female patient who has stopped breathing is shown; her recovery is dependent on her general health, her medical records are briefly referred to and the situation in the operating theatre - what kind of anaesthetic has been used and whether a tube can be applied nasally and her airway cleared. She is intubated orally and artificial respiration is performed. The next situation is Cardiac Arrest ; a pale patient is shown. Signs of arrest are that the skin goes grey, pupils are part dilated. Circulation has to be reinstated within 4 minutes to stop damage to the brain. Artificial respiration is initiated with oxygen. Needles are used to stimulate the intercostal space, if this is unsuccessful then the surgeon has to perform heart massage by opening the chest wall and massaging within the cavity. Next the diaphram is opened so that the heart can be massage directly. If this is unsuccessful then more procedures are suggested until the heart starts beating again. All along artificial respiration is required with oxygen. A saline drip is applied. The anaesthetist should accompany the patient back to the ward. Preferably with oxygen still in place. ICI The End.