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    © All Rights Reserved
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    67 views109 pages

    Revision 600 707

    Uploaded by

    Ankush Malhotra

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 109
    FIBEROPTIC BRONCHOSCOPY INTRODUCTION AND HISTORY ‘The use of a fiberoptic bronchoscope (FOB) to assist in endotracheal intubation dates back to 1967, when a choledocoscope was first used to intubate a patient Initially clinicians used FOB for diagnostic purposes, ordinary intubation procedures {and eventually for airway management in patients with very challenging airways and very soon became an instrument of the frst choice in difficult intubation (DI) cases Inthe 1980s, the Asahi Pentax Company integrated FOB with the charge-coupled device (CCD) which allowed video monitor viewing of the airway and revolutionized its clinical benef, Later on features like fll color imaging, working suction or channel ight emiting diodes (LED) and microvideo complementary metal-oxide semiconductor chips (CMOS) were integrated. Fiberoptic bronchoscope are available from @ number of manufacturers including (Olympus, Pentax, Karl Storz, Ambu [Most ofthe FOBs are quite expensive and delicate, hence knowledge of their functionality and care is paramount to prevent damage and loss of clinical availabilty ‘The Components of Fiberoptic Bronchoscope Eyepiece Itcontains lenses and an adjustable focusing ring which can be fine tuned to sharpen the image according to the visual acuity of the operator. rest eiztzor The complete question bank ‘+ Te conte sco comps tn angutin lee ssn an wenn hana ‘Araston ies ued rung ae deen dtl ft FOS. {These morons bagwin ho sane he OB, lows nay 80" ‘+ Thowoting cham por can wot testa he eat anaste petsn ms we go wc ‘+ Tmopsaion cor cons thong ur paras eneased 26 stat Sah prone tit ea 1. Up gue ures made of roar ge er nar on nab ss ior betararnsen ate gh gong wars 12509-20000 oa, ih a 5-30 2-Thetpte bre canst of 10500-0000 as Sew. ech 7-10 ye arate “rdorangeacatwonty 9 rarontthe mage oe aul con ‘+ Tega ters extort sense to dane ané Bac dts maybacone ‘tle mo anemtedmoge when dap. 2. Ansan we won mara cry npn over the hand. ‘+ Traup ap an aoue movemert lhe angston ne he FOS tp moves ihe cpposte oon by at math 240-30 {4 Thewosing staat 12-28 mm art and nent the FF ‘icon wong pot on beta ew FOR 4+ TmeF08 tere tanngsctonis ngs anna ance ne? a laa al sal on (120) + Rearamtslgitton eg source andi tached te oe conosco ‘+ Thoremer FOS have mire ton coer at souce ah conto scion Pree ‘To ccs tuna bye cls it. tani veh Wo Spa ah + Thrace nt bck cared eh hon an ta abject ow os 4+ When pttonngat e rcs some oaron core depend ot ‘ohne ange th lg andthe se the tae 4+ Theinsdntigtbeam i patsy seated an partly ated hang recon azarae te otal popes tre nse + ‘Aun an acting subs ease he nay etait {ote tee enhance be al ome ef esos Be Ma enh ‘+ Thetoge aut sepras nolo on equ he ject and eee ‘Enon aso cote dont and amber mage oa oars mh rte INDICATIONS FOR FBEROPTC BRONCHOSCOPE INTUBATION Hester 4 = Sueece fom parts hit hyscal exit cengent strata (09 cue mira tenpromansbuor ot anes pena tes baton tage + onc a rt leit (og owe ah epee deta ‘voces naa pps) + procanc aspen nna Bates —rewsetocingign way esses —Yewsosecingrpeneme ~ baer away pate 09 soos, achemalc, oes od priv) —Ponova ot away paar 9 sate) -Tepote ues bj lanad FOB nbaon ~Pastaca win ay slcamenta9. SGA dence. rebopde ltt ee) comes pstening of he doa bes asp he erste oberon whet nar ety + ate atin (0g patent arpa teal aon awh caneraie “raangurd bya wana poate FOB maton cis ote ~erecopeave ster ~Coneremses equpment ncon - Sanfean ope aon ctecton ence dapore pupoees Nasi vauma out, trabogade mutans hoon FOB may ap) -owataciper cosas Hood. fle ants ern 8037 aoe tani os went ang MET en pe [MIVINON INVASIVE VENTILATION} “Nema eaten (NY res te eter font proce vera (raugh arene arta (oul mas ce masa tas) “+ Nivean ba sad evenly spr er arts tn sci rca repley ‘+ Forpins who reson wih act espa fale, gene pine tat ‘soang The resecs canons ht ee espomiveto NV “+ Inger poo nacontaneatan rein ah lof MI jets a ‘net gars win act hyperap repro fae dv w nace naan ‘Slovene tari puma dase ara pee win mae caegere ‘+ Pot nob ols shay tboett 1 Ireont snndonjes rectal eaten sos wha for oon tals cf NV sho be stor two Rowse eng MV ptt shoe ‘rented anosoa eqs esre apd rater. we tated = omer 90 1 Lover acy toss APACHE sr) 2 Aboot bear rm save oo ating Pet drton 1 Medes parca (PCO? >45 HG, <2 eC) 1 Mesos oem pt <35.710) 1 Inpovmatin gs xennge ae spel win eto ors 1+ Tere or emergent itn, aac wspraty are Sete ‘expr dren sae carte eon) {+ Neespratry eaanhrethat sete bvetring 1 ‘Sees enepnacpany op 0c5 10) Scat amar bang {Sinton vay costo (6. iyegel nase race tor) {sty ocouea pra way ear soon op panera Hoh ak pre) + psa ranges craton of mechan vertatn 9 7) 2 Rec eopnag rane near Mtge nesses 1 ticn str sit ernment intr ty a ‘tes hporemeerhypacae rea tie deo condor er an see Srsogene pm etema (ACFE) Poet, opurave oe! aa.edied stn epee {ena wt Mines ae repairs, shout be te as 4+ Gaayr mkv mpleraten eeu etre aa eae etn “+ Regrsen lest. supe wh apoprate sa rlesoeeleane ‘iprancedin iV eee suse ‘+ orate us oN fen deans apn do gars who ene bo ‘ons oe conforate sping rato win ina eas, soepte ‘rita eings on net estrone mi low et conrses Mie ‘heck ae aires Seng, cde Yori yp — (0s tenn pre veniam + Perpucenn i om onpention sora re ece HO cab ae 2 Ai ert se many paioretavitednto ae + Insaatonihypecapn na concer, ana tng prt petra ey undo sacar vas an ste! pata ee mina ‘te retramingocaton Gone (COZ cnpared wih srg ig son inesteorale secs ‘+ [CU vertats aso have beter moteing an lm eres, voluns ‘rr a an. ar pte dsc eres Cece) ert ras) — 1 canbe eres mou sever yest eres. 1 Sap he eee as ond rode sede avo eae rosie + Cincy he snc notte aoe entah low oe oro roe boast ‘een acest sap. + Sonn ear rp wn et apy he a be ‘+ Tie maat his rat common asain alent wah ate rspetoy ee for the delvay (NV te oye aerate red ae cre C02 ‘het roa ne maa got ‘ras mas covers just neo an may ean ast nots who {erator ronan mas eh part ee an ncaa sense ot esse eos) ‘+ ewer Maeve ys nasa mayest alge a eak ough ho 1 oa mass super noms of umang NI deere and ‘inns sea sen pay res tiv prontuean oxygen reared a ing atcha te face. en hgh ows oon FOZ 0 canbe ‘+ However nny porate veri can oy eon! ow (9 uP 100115 ‘ne donnemnan au nerf oye hae dynes. when ea carmen compton en be arsine WV cae + Forsandand yrs eal dane camry ned wah erat ed ‘ipraay tig) whe rorace vrs peal Pave 3 sein crt “+ Hower. an othe ay fares gure acess ausnet oil tig ‘romowsfaceaay} ence aed ort ant eae 4+ The tne aenovod the besne wen ciperence! sa nee te ose ‘+ Theives orach otleros meee thahon hat tet ‘lunge a eq of NY bary neung oer cece ae ‘Comrent ust nee — ‘esha now ir got away rete PAP ee most cont {bed mace IN tet wh Se esc the “+ lov oes pay posto aray sess (PAP ad exe PAP {>A aw arto ‘+ Thoctrence buen PAP and EPAP ta PAP detains an rey ‘Ancol ween sence yee bls, tea PRP), 1+ They esprenecitybeting ng level NV an each aah ‘potadto nese el ‘Cornus poste ary posse (CPAP) — 1 COnP er tote ley of acontrou elf sete ay ees Iovate + Nein ear ele CNP a pte ne mat + Nowe sce CPAP inka sro ont tarpon posie (Pea tir ypety mo eecive aimpeeng aeraton nan ene ‘Voted verison nthe seit onl mote CVC) — ‘+ AOVC cote hen pte ae ure volume er mimi mes rod wpe Presse supartertaton — 5s sen when pater coo an syn redo be mae, ‘+ Aart bod be pater shou be cbsered day he stew mites {ovewsesnoe any ett peers ‘heoned trunnion tobe heats eee) etre ating “+ Atal gont we ply retake pater inca ad ota arr od {ss Viton he patent donates mgronmentn cal gh and SYOPIONS [rages echange ve pay por we A + omer fy 6 vo ngoreor snow agnor a any ne eg he ‘ral iV sou aaron ans pate promt mae “Trl hosing ysyehany — Many sar nti trate N ae pa scone vray ‘peyton etal enh Get mah att ated) ‘eraser nay be ton rae ns sng age “sentry psn avo PEEP woe ow ie an mar oko donot ‘rsansey Morar ries beng he rte mason) Fr ean so PEEP snob wae tect = + seringon vtec is may na refcon pay Srortas mating he reer ln rae singe nserng arow haruon werrean nah aplaaon exe PEEP {ane pracnnyhspatan ad cusng acon + Thonn estas or ctanpr he mals ypcaly est mance bt | me aes ranpre he mae verison may bene tnorong per comet secur at = ‘+ Forman soins, xt xanton and eases hep abv er and + Fein oa act ced it te, og 9 ‘rl dustonandre-seeecemert— Mot ii ve of Nh rt on to ns pt cay 1 Atti coir scat en totes aoa encanta ae seve + Nn pti in NV etna er ‘Pare sto a0 be moto completions ih a asaton ans presse ‘+ Canimieinrosemen shal rat wang whe tran ays ‘Soul em nanan and acarvin 1+ Mepotan das rot nove, ears tong ceo wo Nou ot ‘te pater holst conse tohve fale NV ae eng tubes + ined cara supzsing lus ncde nonin gos xchange, tess ‘espa na, worsening enpatpty eaten aby ew eos, ‘oly Gera oy races ehemseramirstaity Arar emodrany fo wean hen op exchange nd ncaa fete ‘expr aire have mrovd casa are Cans of spre a as apowe sPesgard eygensatsaton (S02) 290 pacer an prensa ‘Sar emet etn acoen dtvered va igh fo nsacamuoe (rN) ow tow one stamedinare sab ree now dose escressrsanshea ate ad ‘Frzo bea perme) he ptr, ay oa par stout ely be ae anaaad aar, o tra stings (bv ost aay pressure 10 em HOI on H20 or Somme geste sea ostutest0 en ZO} vi gear sf. Net compensate ante hy fing mas 1 esl sn damage may zr uo pros fet fo mask a sas {Conny ronea ans bags tense pri ananng era eat ‘deren ond oe pelo “+ Eyetmaton sins pan coneton pds eto ened dens ay cat “dros ee ale rope fesure oa tors masta! Pana + ele naneieaion my helper Ns covgeton 1 ost cteonozrs eaury uarey neay pin atype (enous pinay pose {ower rong a apt anor cso. {Te cmpieaen mayb mre oy meas wae er oes MBBS, Protocol for initiation of noninvasive ventilation 1 oroprtely mentored oor, exit, respratary impedance, va cine aro 98 ee ange 1 Aeoty headgear: aod encessive strap tension (one or wo Fags under op) Tnitial settings Beet IV ‘CPAP Psy Sur wihion we cPaPleval at 5108 Hse. Somanesusy —w Gnaalyincease emo ‘eth bocup tolerates (upt20* enexpratory Tite: inepmtoryEmioo} amie | promt 30 Bem 80, ‘sone ene Gross meease pressure ot3t0 span te pressure to = Guay Foplomertation at faotoaenave Insratony Saturation 590% rapes ond pressure (10% weacton Soem a0) oe ‘ebro ate ‘elume beng rrontored) on Brecon Follow-up 1a amar einen 1 Concer sedan e nraveroutyadminere zen 05 tra) neat pens” 1+ Courage restora, a eget check nd aghstrants at esses 1+ Mentor ocasonal lod gst (uti to 2 hours) an then as need o2Toxery, + Peale we danced noun, wa iat anager + Thefatimptant carro nib fill ef np ty aby Pal Sat we 1a Senora cons late exposes S20 ATA amon {Indo oran Sh tt praumona a ater yo mor 2 7 yen a1 ATH ‘+The mad acon f moray tt fon ge. te Sth Ect “+ Tpria rome of xpi. mapa ats elie abst 60m Ha ‘+ Tesalvacan beineasdty oer wosg 100% ongen, Pus heey sreanin te POZ trp Term iby ees Be ose tHe ‘reatng mise yume ners here ery owes 1+ Thereomerra per ongen rap 60) ease a moe _agossve cngen taapy puna rece, has caused age ruber of fates o egos ahah ongen esaee. + ‘tena mo se inet senge os oe ware patent emporio very ign enna of angen tet pros oe MBO) a er \toriom concrete ued bt fe ange vo, ‘+ These wed owas en nen aed ae red one’ engen ey + ext teed ergy Bat coset onaenpnnret 3 «+ Coy symptone nd st gute vrai it ng ot eran ena ‘mucronata. «+ Fatpamr sn copeea resiing ae ac fn note. ego beth rest ‘Tnime piper vaccoraon aia ype med ape maar spacey + exsre creed verge ant nase. tone ated avout ‘+ Thecomsins beg wth sos corscouses and dep nove pass {eric phos wit a gerraeeshyperona ain rset en Phase \stvcaneaien or abou2-Sane anda ponte pane a Worn. (NS oy fated acs sath 8 raed PCOD. ses gu ca Putman Tot, “+ Puma oe et of ongen can asa ate pond expos oxygen 0 [xin Spt appr areata pad wen Grn Soveses raat . ‘athe ets tna tho ant ‘ln oan can be aie note pases (oy Trecoatenctis anos (e)Pumoray neta ore, 1+ Aeagon selec eo want ot can ado colape of parole ng ‘nine ovr artaepes 4+ Tok ongoncor be tour t aa slo sau 2-48 hou wth any sou Lengo enosie roti defn seine 1 On o2 ATA odes choc ulnar Sons ad mons tenis ‘svn cal van deep apeaten 3b hasnt expos renoe ‘Shir rate, necnvtes caugh ar sou TO hors ne nay ces Sgn Spon ace shar oe atin conse ne may “owe Eos On Oe Tas ‘+ Absomal ABC rorpoy wit er wmouta recon ncresaing mest RECS “+ Ec nye nese rai centictn hepa fll ef on 2 preyesve mop, anh aso eves andcaara whch sa Seajed ronan 1 Onsuretet maybe are en te ere ee is ta epuednhighantet + yata ciara hatonaus may asa b ply ane by her ‘ten moral iv of nen day sa os 4+ Mees ne pre intsseteed 2 hah cnc fan ee ‘ow ev ecaty evonc ung Gosee sed rerrar eemorhege. + Pent tes a 0 el geting we ane 4+ Theenzal oom encentan beyond win hse conor deve i anoeheoiay 1 Onyen svs tooradalas bang te prota pe arin ovopmer ot Das oe ec. + Pros are dena aio alo or mueses hang an upaied saconin 4+ These raat ar igre cnr he encontrar at 1 Bahhesepocnses resin grwaten orate reac ibe agai 1 Freaccl gran crocs pes nebo e rena «+ Trenetec rata mown cum prions, mpi a membrane, hi rc ss dln Syrboes ad acva cao + Thetey nas st of lr agp sa tera nom of acue mss orznesinegastone prove, alas ad serene oars + Innyose canis ne exbsieprossen lee acl same rayne nto nd ea Pe rates escape maciaon + Roan abo ore tonal rts jy yang nar metabo by + ttm acs aaeatonacels ne scn erayme eben CNS aes ‘Sut Gar nin Buty (GABA) we see onary wih cree Stoosroe Preven and ooreg + Troranapamertt ho conn tgp sympa ateon shove be “+ nse todo ron he meray set he eticton # ea ‘ipa ee pert wc srw ce 1 UntorPumonary Tony Dosen UPTO) hart concept sed pret ‘Re onantatpunonay taney win colesed and pened ey + Oramruie 00% anger tt smoeper tke to pods 1 UPTD,AUPTO (125 ul pose oh resem nel pty 1+ Thocezotanras of pogession hs conan cane nea ya vate anton procs ne DIFFICULT AIRWAY: ASSESSMENT AND ALGORITHM + Fate nt in sian, cancers escheat toro ‘etn re abe anand aways aang eo ‘+ Tecaneptnayenets emergency aren maragone cde pean ‘+ tsa saan ngee emit htt i ety wn epmase vette AN layomssey areal ean me ‘ttn away msren “Te LEMON sssesomon vse saris of scl vustons Wo dtemine who et Losey — ‘Ts rfrstoecirician's gral inpression at haw wie et {rine patent ave stoma fae orto Rat, rus anton, trome nyo whch ear be eco ete iay” ‘+ Rpewal meson ey cy rencraby sect bt pay «+ Woperstarcsers a tn a ance tet, ranean re! Comers. sbomc abv enema rar ren icy Soest eevavao (682106) — ‘+ Thos fn manible th tance batoen the enum andthe histone, nd ‘he exenot noun epenng sat nga geome eterna the ssa ‘ores hd “+ Aromat ate canopan Merah scanty pet est om fogeo Sepaced etesn te sore + ‘eure mu prog aca bo sarin te annoncap an ting 1 Atomal patents epee be he tne aon el be mane {eormen herein an he echmentoe octane hye ‘The sessmertiderses th ooton henna be ete ot he tore ‘+ Rromal pants te pace wo tga ine uprrxyrget ah (i be “cebeteon ne rpanr nan che mod carne and nectar nto, sarin yb) + be myc og ne neck rect nraoscny eto ngosile ‘ecu lw arg al have lobe neato por ueabon se ratamoat ze — 1 Tettatanpat canon a spe cotng stem ep pret act 1+ hor mes pact alin eral is. tought a #0, Sir prescott reten + Thetalaroat cass ania toro, tse ant ou opening 2 ‘hes fe longu rd roves an est peor mba et 1+ Inger longa cer ri resets on lnnaotcony ce pre (iy a lace Moree eee iy (0 Oberetoncbsety— 4+ spol mane ce iecon vaura wth maton ry ih arpn of be {per ary avr tae asses op. ur aman cee ena. an ho he ven eget Hse cea won nano oun ie ‘Thorens ses inte vperauay of be cha pater mato vation ot regio dot erynoscony mae ae a an oersze lace ose Ne ok obty— + ean patet ale ine sig onto rbaen 1 Thening poeton «eee yh tanec rr on be bn ore shel ance no. «Thun decennd cerca sone motiycanpomaes he retype view 1 Meet erdbon soy an ont or heat’ ai anon eon ‘Sey cognate teens a compare pg can ry ee wexneoty, + Imunomprve, ontauma pats, uk maby cn assed y psy et se nase — “+ Renan acta ha es heuer ba ea ULBT atone per ot ‘+ ThoULBT por by raveg te pte’ exon ou ae ov pero ssh orower cr Wts pate can} cra ugar wth er ower Inca out ygetop thay: the pan comet ech up l, ‘icy tenny nore tay ct bonnes veto — “he preirfted UY r umaiey he mearn ROMAN “ead and neck ation nay eects win est ec mak verlten ‘ay de bruce oaiy a pr arey so eu ‘+ Reon ned comet ato oer’ ps efor te bg and ‘tek parts e pans ung) anes overs at Ose ‘nso that esse he egures pet pene ova ge a ‘Peder rina coche pray dasa (COPO) pena ea, ‘Seared metas and any ar enon ocean puma compare +0: onsmctronestyeborcine sep seo 1+ Otsrcson oe upet away. ecu nt wily sd, eke BEY more “ite seed presnses wi be egestas wa Pst Bo + Ott (oa) mans nsx EP20 an inependent mart cut OV Resor rer say aoe ath contiton ches wal wi ‘reso am dom oon ead ion sn serena “+ Mak sostracuresreaenaiy sormal anton sane fac a nck ‘loeingststarca schon exes ort oH) ante I 8 ‘plese ne wth th mask 1+ Marat coset ae ee esate wih eer mak whhae 1 mene uty 090255 yous ns a mane fot BV. 1 Esornousnss coe ty wth BN 1 Tarproe franc gant when he masks and spa he chook, tnt ae aries, snub at ug BA, were ey eo {eet hn moves ntl awe ey a dino et etyomy — 1 mest cay cased by ect cots oe arte ec. ty © ‘ey ranar, detotor of taatony aberrations ond an Surgery (recent or emote) ‘Mon hematoma, ebices or ther mas) ‘Acces ce Anatomy (bey, poor nam or mers poor access) Raion (ecner anv deta 6 sens) ‘Tomer (claig trie sway ter) ‘Evan tr cut rcnyretony eu plping src ving te arte ceyrad marae on eng poll een wih ‘rican a choy montane moe deutin oan ann ict engineer — RODS mnemonic for difficult extraglottic airway placement Rested ng (00 omnes) or meuth opening Derpted oats amy NEUROMUSCULAR MONITORING Smeaton eg ong of MSs ad eer met snd sees he 1+ We sues use of quate, chet mesure nauemUscUar ‘ure fe, ceo, cone) (EMG) Heroes AG) ‘renter ernst ond rcoer fom eorex oes BIOA) + qurmatne manors nt arate ite manor win peor nee ‘sosinor may be tae tuto todeamne te dp bested coe {tore + katie otrancar (OF fe mace mje (nth aprgrranare ‘Senior cot cau aso eco + lnc ea tne tay een ed ate covey tom rewomscla "boa gp stengh aera. det sent Specter 1 Mertens tino sa msn oa partes rsa ‘oat espra. conracon cbt n bene re + Theyre nev snare aay pare ay D8 senabeo haarad or mote oe aacshene wonton + Sinuitrwras re comeceda stra tectotes adn Pe ke ang he oreo perenne Stay str ar Se shmsaon 2 he + Thoreata decote pce italy nthe poate ease pos “+ Teln nan ether er pepranane isan se is every aay acs atresia [Souinor a engeua reve tanh cosa verte ale eae rd emaiis he abr poles AP) meas. “ru teponels neato athe AP minan by ono asin othe eb Moirat ura smusten aa mss rrpnce a acho aerg he ‘eave ood co oer oxma oth wt ova wih gost ‘ered toe cramer pxmaly one Ure sac oe wa ‘+ Fadtnanestmdaton ss ac han Una ane stndon, bet may ‘acess # sagen poston ins serosa hands ft (os, ne errs ame cea oes une surge! apes sump seep ee Soe. 1+ Bohectao can ae cea th a ang cour fh a 1+ Cotracsn of eens ca tte ee eth eigt supe mc {athe een sje asesnd ypabatn(vialy)mesporee > + Realremogap quanta) montorng peel and eammende) toh ‘amt Soper sn eo ceat mie ‘+ Ineoranty ng recoy fom reromsclrBod corey he simdson ‘exponee te muss and be eye may eee «dee covey met ‘muses ht woud at ste estan Poser neve — ‘+ Teper ia ai can be struts yong decode upto bbe ‘ne male anamentang ne ssn ec oh ra oe Paced — omic msn tn te permed on rad ib 1 Useosatonetanyenine meets afer ener nats enstane nonplaring MAGA, arate ngpeton TOF ae TOFR) arate Pater stration Sig wach — ‘+ Sees (7 stron mehr ne nga nectar 10 ‘cons 5 simuatn usec pte ef MEAS od ne cd ‘Sealy ‘Theta eto (TOFR) clad a naa betaan he fut ate 14) ahotfow (TO) seueoe ane (Avia rw nto mace he TORR (2)ng ra ptr kek any in cht TOR {Dig ogra no eptarang Hck. 4 derass perry. towed Ton ‘a.anay 1. The aezese in TOFR to noma aoe 8 cae ae (O)Asot 0 TOF stu reece lowed yarns oreo Orethe ‘rare sof TOF simu he TOFR rarest nein fe TOFR howe’ oy royense rear ne aereane in TF) Fo O61 90 sung newsman Bk (6) ing roy eke TORR noma ern twee (Poenarerey am mol scan he rosie ne ‘oles ha 1 seo pa “+ Merssmnsratentaraeolatay NUBA rsnses as heen) show {acs of oresovay ereag elas he repose. + Win popesoneneraepsr oc te th aaappar towed ye ‘et enh ona ye ot + Rrneuonarodr back apie he TOF chs reappear ene by oe win he “Tm TOF cout TOF id a mar aaa rod aga, dt {TOFC = 1:98 pace ofrectine acejchln recaps (ACHR) hocks “in ceprang ak ade oe ecu al ur ches dein lrelluge os orleans ras eck co + Fatehnrepawot TOF senses erin, exposition, re ‘opect snebpmen! a ops tase Bc re sinuatn, clad tans, vas eet strut a foweney fs30Hr or econ wich canes sueaned ms oon ‘+ Tne corwacten oes ane el tne MMBAcrced chads neato ance ono aes aarti TOF sermon + Ton tank bs pevomad aa tnqurey ow apes 60 ehh he Iremenay at wch lrtan msc conarton cars. 7 eae, — i | Oe + Postar cit PTC coc re acond tn (5) sa loan + Tons tonsenty maize pesos csticotr Ach ase ko Pe ‘neroruae jan atte he eszorse ts stsege aston = pialse ‘+ Toe snuato sun aoparntaeleate otecovey ng te St tite pteriten + TorCie store te ans dhe corey aly acer 8 TOFR of + Thopatem vet dng den eh erdepaning mime eck wth + HPT nn oy emits Aes TORE rated ra val prose eae tars + Thun TOF monoang ate soe te aera strat maya caer reese opr nitro st agatonal NMBA er veri Ite darn teeny ere. syn ‘+ Assuc we suggest te eee mus ee ane san teloe ‘xg TOF nonung. “+ Doin siraiton a devped cane the ascent own, ead of {au sm rg alow nor seca scissor a. 1 Thetwo rian hase doee! 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Hepat tm — Changesin apt neon a noma agg ice Onsen pti mass an con, ww at dseaed hp Hos on reign Dimi! soin lve, rein nares concent ot ty rseinocind erage such scoot “+ Aonp cues vrai decrein goer talon re catnnsckanoes and ‘rl ncn nev tray be unrest bye seen Boo ea ‘tegen an resin Sone + Comores tw ammonia. og, bts hyped. nd ‘Sear desc can cure ur Soe nna con Imeloatos er ese changes ce terest pera encrypts 0xreasu ony mae te vine hse pale arate ty © slnescod suceptity repro Ventnor mada ich ‘ston sammy ae (NSAIDs) aerate nan — + soni on ery cn inn mn fe 1+ Decreases ttt wry 10101 een amc mas reat @ ower rnvalconpetnert eae out hahr aa ana ry encraon = ‘Stectv onan ormany ans pete, 2 nn deseo sso. + zee bay ay 2914 per do essa alge Yuin auton {rts pens a owes tert are mie eee ‘tutpsionethe incl rye ‘+ Fat trnaon Patife may bo one ae eararca may be Secresss dito ‘eee tn etrtogear 09oecaenns “+ The preoperative anes corauaon nce easement presen an ‘try okmesca condone ana tenet, nonce of nara ‘oun, and parts ale noun cgi yon aac + Mh be prereset wih ge et homing athe ot martes ha cover cess in sere ove fay and meen Itepepones npc roca + eneer ne ret voto on perceratne avant 8 ade nd Sdsrtteune ano eno ge espero mots + Inte Anercan Seto Aneel ASA) Pye Sat tam an ‘Shame teen, con tp age 3k aoe esc ley an yocatonainatan — Assesment tei — yn ir prs anew a srl reer Seo ‘ect ad tedcnd anos mata ta gel arene ‘+ Fralaersoer lon rset nan eased ben lyre nade reas a ubun tedaconpety. ant deaease massage ere Ufetay exceed lenges Yom sorta oe Sone “+p panos moat ana my Meg Sarat cogntve ‘pret aswel srg oops ay charg ts ated narg fact on ‘+ tear fay in he presperatve pr cant ep er patent an {aay coors rogrng supe crows posopraie ern Sates, ‘rat oveomos «+ tore spc itt st rven Bat srg esomes maybe proven ‘ie eal prs paren onsen ans mos ‘rte ere wan posiasn pon et may atte ra {ata an nl ar exetase rang nutter usoneratan oa ‘ita epson pono nse mel cs Frailty criteria (oe er assesses te yal ay sre to (Fed Fray Tso eat renee ‘Siting (wsghe | #10 pound wei ee ing previ year ton) ‘Weakness (rp | Lowest 2th percentile measure by hanged strength ayramemeter shouson | Feng “Tear get gong reverting an fir 30 ‘atety level Klee expend ess han 20 percent for gender ‘Walking seed | Lowest 200 percentile waking 15 Tet normal pce Tntrmecaly a was defied by meeting wo oF ree cera, wie al pater were cane by meeting fur ove ay eke, ‘aa vay see as hav a6 Bee Se ne eres, ‘+ Ore eumpeisne FAL scl ora assessnert at kes ey mrt a ‘puto, erates aque Renan atcay cmb ser Arla {Sthany waningene at nenor tints peranon congess heat {are arg aca, ares sche. an wry ema we Loss ‘+ Pemape bs nes ren aressrrt sb Cia ay Se ase et “atropntng teomse and hemes arhop wh acter o ty ng our = Tha tot serge may haw straps e rptng id owsmen beret crear ey re he ey os {sever talon reset condons an heres 1+ Cote aatbiy ol hse peau peoertve at sceeneg inet ‘any prem mary cnr ue ak ol sree on whos ‘para ana ect wn pleneing sora astsimerts sy nel ‘+ TeASA Bran Hoa nave ues supe at basen copnton sau te adn pte cr an 6 yea Parc ove wn ado teoeig conte meaner + Sterpatee sald erred aor open rovocegve dade {op conker mateon nae enon srson + Ouinnoan cite mesentery renga {Seto cnte har mir een 4+ Thenedons favre pron vet ig le pate thng mae snesentorspdpnary ‘+ Thum te spprntyfecandaion oe mdaton cha oe set eet oale pen vate peepee ne ‘ances of nedeatons common se ye ptents Batre ptetay lar fr 1+ Arteta tol ntcnplerts mil be nage fren ane Soames + Agemancanrting enzyme (ACE) rs rptnen repr Moca cesta ah ctebsapetne npotensn «+ Inmany coms ACE anor ar ANB are et fr apart 2h pro + Bewdaoepner are mamas or asada shy ne mrosta wh eee ‘ohofeetpeabe clear. Rosine porte tig at ecrimendad ire rrr rcadesin ders ‘Noa flowing cavees ap ero: ‘An desocardoam (EC fr aon win coca bean eas, sant “imo perer ers doves erst esse of ae ne ‘Siecru bent anos nr crSovesoae tak ore ego ‘eres er ghee at supe eso 4+ Ronse ot ander E56. shh some iatston had trl {Gotabesecormansns peop ECGin at tet ae tn 8 year sore aso g90 (xR) 1+ Inga. a recounting (XR once fr cdr pant Underons eecbe reno uae ‘+ Inpabs waymemat ctor ponary Ssease «CHR may esas etre ght agent pment sx non soa ts ‘+ Menoyoon an anata typcaty tae major pel proces ‘nts pcb (og process wt "10 pen are ‘esdrg atten 7520 mh ae ana nebo ‘reoefte rere ue 3 Kow unig endear + Benerang ont eae and eres ania, epee ob oc ‘Peon wot ot Hoes ae ae ek cr yey mayb pores {waar came at aret seme ate este + Preopeate crn an altorin mayb reaued aloe mocerate: hes ‘Sgn ntl pasan rose wn aroun toy hw ose oo Ian sos hs pets havea lave gh hance rel yee a neon ‘Teche ofanestnooniquo eo paersou gues by ‘susan tbe agen proseasecossing duss(e Ba neaio pret ocerabe contains ana pe eles 1+ Necro! archer repoal anes eines may ce meray imate ee osnowabre essoncalvetiasn conned nt Geet mero prey me pn en cep oro. eer anestesa may bo pte inte folowing cna santos Pats oir acoso eee mean wt conpipaty oe ‘Sherresone nun et ral oenens and deep perehr en bbe Parte ceroses aac plo, duno ype cr xpecad mae Mocs ‘Gs at woe exacted by spats tlcrde wn ean sovee Myton. sRagurenant for oe seston do tert mbit leconforaby te poston ecestay eraser tony etutarce mb aah, bit copra commana (9 > deca soscate lenge arapn of a nepel poem sSancesimonteg— 1+ Stand Ameria Sosetyf ess (ASA) mans are ore cla nary pon omen scr, ncaa «+ Wneomuruor Hock pet (MBA)is admit eight nove ‘+ Rane procesadecroncphogrpy EEG) such se biped (8) + Grane van resents cop whe ar en scsi wn ‘evtpmert of pstapanve rourecopve eae (NOD ar oar ahrse + Oder pate a olen more suscepti nerve ander esse fltinary ‘Sebcton an xing of rast ges ‘Ast op Caner consratons— 1+ Theis an enanced responce toa gen rg dan a arshate dering shoul eageseusta 4+ Thelen aperomtes can hep aod ecssne seco ph and ae ce ects of neste peso, yperson screserg he renal betwen ape eser tiger cing apt Ineaenesaneshete and tnt ges — 1+ Ts ceosof menos aneunate nin apn 6. opt eo) “reentrant does, ‘crs sal evenness ‘+ Dssesof rast pes so rau deg he marance pase of lrechona platy seer aes: oer a coarse Swi cneiratons rv anshet agers hte foo Pept + sr att pater have an tres shams espa a ree 1 Thelnat nto cos of pepo osseqont be oss shoud ered 140% 50 paca tnghg 178 mphg an shoad be sol sarNies, ‘+ Sint ramoranes ees dig an emg eioen tropa must te evened by 301050 peck mee toed a ole eco ie, im crise tron seman nly eet hsm ‘emosinarc ase fees 1+ Neaty on pa concen aia aye doe iighrin Cer ate teense fa dented lane dateton sane + Thm stout sear ucin oe of ties 03 mg, ose chon hed0.2 mph ‘anatymedd syne sponse) es waa he erode so esto onerarabe sou + eoper ttre my be zit or tose it emo emeromse ‘hued hypovtri rcxramyopaty nthe bene coor ey on 1 Aloo are arsine ce pte er ates 1 ‘Akane eps ave eplrtal cus spor Gores, he neeas ‘ian tenoony ond deconsed ewer eos n eaten can esun ‘Sroremypoveten ores Sonacing ais ‘+ orton petn doesn rat ghamecodraic ft 016 ‘perenne ron srs ons. serpoctng pod ‘reine porvorte + Then amore op i oe tro! etn ain ar + Clenarcels tra acca patents wh ealineaicey 1 Hreomeay lovin say ne 1 de of mist aly oy 0.2510 1g atonal between oral oss maybe nr Pann ong + Bomgnameconame cunges ,rerases an sersay an stoner thonges devo omanne aye renee EC atuatn endear vou teen dv tinowareabor sat (er sau recerenieg reson of men ere ‘+ Casto oang prety rceesy wen a op or oer anes pes ‘ncurey steele epi eoeson ss ove se elt ese ang. anc ors can te srergae. ldatn anette — {+ Tominimum vor concn (AC) at amsohaeprovering movement _dporen of pans eporste a uel elon a hon aes 2 parce tov Wan cine ‘ator a 0 percents uy ee sols ‘gp = 04 TN) {tenn opin oun neo ka spe ps urnrown 2 resonate bine oss on AMEN erat hh ose us a maaan tay ‘tert we TM to uty on + Theratomlelorcarg A to oa te unrdeing Pat ay cone wn wet {Bi andi ovrdseng ht may ona win se TBH. “+ us totne ich elena seen ger th chet and aanited ‘eal ens seats an ops, ue organ seraary epost abou be memaedn ese ere “+ Thepuarg pnsle stidbet re shor ng and mma tok ae ‘shone ane ahi rpc rcovary ol anacuaren peace ete min ‘The ity sty estes pate wih severe beay ay ree ston turer’ ais tl peal immed vee. Thee nde sSeecaaed er een opment fr potonng ‘arg aorhign wiht cpaoy bots and opr ables + Congrats wit inter perang te may notremainvad tne pate Sits en ate Pe ables pontone er han Tenrb ‘vere Tenby noo lee wc. + ‘bon am aba wen he aor he use fr open es, may ‘+ arousmears ceca tsing he arr pater i see best ‘eareet sehen aba tev bee evap ita ar are ven, ‘Tose may mo potas proves py cr paso hasten gerne PATIENT PREPARATION FOR ANESTHESIA Prpaankranxnes elses measures io evn asatn. a appcaten ‘Sander mea Sot ef aeons ASA) Motors. Aspen rhs — 1+ Strid propane ny soul owns aot wh test {orzo ast cna ors oon cp. pstosrengel en Gistonrents bol abt) + Inmwatstde sore engin obo hs ard oc nt aed nga sneha and may Sema rab nan patel nara wos 1+ Meagee nine pacie pushes te ASA hal orotrecarrand ute se ‘iphone meses cnc nn th poe ian ‘+ spat ofc rsoung res wan opsaingoam evar of “Seine remascaton “+ Meamedkaton regan patent wih bee acne shoud be ‘anni rarer awe ces on peal ees, ates eect ant + Prensa th patent thoes od ay alow ane wit ‘tthng orm tees o revenge reat ronda ‘er orestene nd ene manors — ‘+ Insane wo cbsty. ug general anesesa we measure remot ‘anima baed prssur rae an eve res rnte née Pn 38 + ‘earl, reer census toes esse mesures porate “+ Nenmasve oo pie massrenertin saber tn testy i fon Comaiaits by hee and cone sap oer pst ms * Miopemtanaton nqgulacaca tr! brasaraebond posse ‘mentrng an orroesed renee ed sang + Blog preser le mut hen ape pater wi bat ata 3 ‘tec atone wih ona oe et cat wich ay res «+ ort estan (oe orlowerig ae fn wea ta ener “+ Acari apd tod ose cf conte avis ad nay bean opton lermproved sara lr tennanve ons pase meneame ih ott 1+ Thevoure camp systems araw newogy Pat une ge ca neath Pore poste — 4 Pancreas when otoning pater win bat for sa98 {To moropaty potions pert can erence psn cerngemon mpaed vert) mane rte damage, ranconjoys cay res > ‘ate 1+ Theracoteeing ransom ater ara surgery nceses we mle Sot ovo BM: an red eer te, Concertos rete sitet goers opts win sb ncte he towe Sip cht do Crendnbugpotns + erase hing slum reed wet of being ented by the wat ot {teinreabdoral cones ne dapragh) and notaned anus ond Mum llmdrgiciiresed cana: out one wan arpa wit eee (rome ensemrbug)er str pation 1+ Ingato wn abet nese change an aus mare pny estan dlengaprlepeode nese pimonay our hypoarsann wih stance ‘reatng and acoma neha anno tar egy pase stad up postion (eee redone orsomstngamsFowtr) - ‘+ Umantr sont poston roe erat tnon pte win cbsty Dyreduing peau once Pal an apg ‘wothucnand te vir eros ‘+ Wen err bedi bea Creu be hen revert he patent sng ow (tebed capa fame te ecards ont em par oat a ay ‘ete ads be egy care ‘+ ater wih cbs who ae pope postions pane fr gee anesthesia may ‘ave rood epeton het, wh eens tinctona esa apsty {RC hing complanen, nd ongeraton compared win sips poston. art sprs oad b ocd uno Ce an pv ae en omen wh ahd congmuinteo we rey sn “+ Teles pnton rene te wl th bconan tom Saphogr and ‘noeares te comet ene range aay + Theta dena postion corned wen head and upper ty ean may be apt cng recy fom gnarl sentra ier oneness oe neuro ote gey + Coston ort eto mol airy congeston ding a poten may ‘+ eanbechatorang supa he heed na nual ston. he nck ten ‘oranda sacl a odes owl can be het ‘+ Ussotgetbass may revere ress pems ssh she Np. “+ Unc onion dean ng vores by afin boil cote nar the conagn wich ray ante eyo med hporrine, ‘+ Core pation and ade ingot ngs eal ep yo ‘amps’ sane ma sul fon porge prs ‘Spt cose eg holes mayb necessary scored ih ae and sromtot wie + Bets andsauprort ute spt ptt wi obey mtb ante to Sion eatena meg a mstpontesutcet pao aac ese ‘+ Cory odtng presse ports wil tp prover ressurelt epher eve nes + Patan stale here aula dung He mantanance pase ot en “recraso ne sts are peo st poten wr operating abe es and may non be epbone 1 Thou clveccie sch be maton ott an ep proet sh, “+ Gmeralanesnesa. agonal artes ase ae al ben anes ‘Sic pats obey and oval no wcrin has ben oust be ‘Sips t anata espeto pra pase cones special pars ‘Stvctety monty craopanrycompestons + Werrenorlerosesa (nna oesbose, arene ree Bods a “recon sci, es technische Comers sats wh tty etry hose wn cnet sap sen (OSA) ef epost ‘eresrary of eva oes resems, ‘+ Neral nests and peer nrve Docs oe te adage of mores ‘oslperabopon eft ode ne of apes fo pstopratve lene. | cnet eeeste pera br Juginone apr exeoeh + Poster perl anonens ay mt peteeeane ep Arte ‘pets wit oes who unas wpe absonnaorbowcr pce, 4+ Utsnun usar ang redo maybe ogres ten otro ness or genera aresesa nous be poste a pancar ‘roms tr sowed sida carn may me oe wna ‘eae sPestoneg~ + Pata win but have erated apatiy ace pi, omy Icon one sry ree ety essere er ry en ‘+ Pte wt obstymay ote ucentaie he an posten eo ‘+ Spotancus rating hn patents wih premrent sbi cbs may mere strom na fran rie soz ota sages ese att ey ‘eure conte venibon unser err anestena we thar an ancorach {Sho ETT ernest nwa Senter cole veriaion sonopte tet mask vartiatn orton + in eat opto. toy be tet ole in cna are te ania case rer nar raters deve + tet wo ae ares ncous. ho wou eure doped eten {otamste loge grnaes great rca soar) ey {eed canoae leon eosesa, ue ptt sestes oO Shier srt or yarn + ypocapa maybe ope prema npter wh noah ‘date Gah orcbnty ypoematn syne 1+ Meer the agpcch ogra anes n patents wth bes crar ‘ape on spray aoe + Ptans wobety haw apr nonce hypo nd egrets ‘acon ya fan pare wth nara! ‘+ Beomse ew ptes essay mov eigen ee he “rieaben ond ragemestl esate sees ses ‘+ Otesty sk ctr cet onreess ar genral anesmesa betel dng he dane ase conway ‘tetova regentseon fe rg Ay manogeent ‘ona of ana oveo — “tar wn cbt are stom mana win mack vernon ane: mse ‘otson is erry reso rat areas (an eration er [roorars inept o sectors bray) ‘+ Fon mas eran cnt ctricaycatngrg new pars tease ot ‘amcary wen mace ea handing, soersonatso mand copannea um ora ge ure, ‘+ Pato ah Sbety armen vequeintan ier tar a uraiie ‘way SOA: o9 UA ‘+ Thy reo eure cont verano prevent hpoeritonand

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