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This book describes the approach to anesthetic and perioperative management in different categories of high-risk patient scheduled to undergo elective noncardiac surgery. Individual sections focus on patients with conditions entailing cardiac and hemodynamic risks, respiratory risks, renal and metabolic risks, neurological risks, and other forms of risk. For each condition, up-to-date guidance is provided on risk evaluation, risk stratification, and intraoperative and postoperative anesthetic management. This is the first time that such different clinical situations have been gathered together in a single textbook of anesthesiology. All of the authors are international experts with extensive clinical experience. The aim is to provide trainee anesthesiologists with clear guidance that will prove invaluable when managing a wide range of patients with serious illnesses or conditions that pose a significant anesthetic risk. The book will also serve as a valuable reference for more experienced anesthesiologists and intensivists.
A concise summary of perioperative management of high-risk surgical patients, bridging the gap between the operating theatre and ICU.
This book is aimed at surgeons faced with the immediate management of acute surgical problems in a variety of resource settings. The topics covered are common in both developed and developing countries as well as in tropical and non-tropical settings. The book offers an introduction to trauma, which includes primary, secondary and tertiary surveys, trauma resuscitation, and multidisciplinary care followed by a short section on acute burns management and a discussion of a range of specific surgical topics including various of acute abdomen, upper and lower gastrointestinal bleeding, perianal conditions, oncological issues that require acute intervention, abdominal wall problems, urological emergencies and neck swellings. It also addresses the rational use of antibiotics and medications and the role of high dependency units. Each chapter includes a flow chart algorithm with multiple endpoints that relate to the resource situations available to the surgeon. The book is of interest to clinicians dealing with changes in acute surgery and the increasing disparity between developed and developing countries
This book focuses exclusively on the surgical patient and on the perioperative environment with its unique socio-technical and cultural issues. It covers preoperative, intraoperative, and postoperative processes and decision making and explores both sharp-end and latent factors contributing to harm and poor quality outcomes. It is intended to be a resource for all healthcare practitioners that interact with the surgical patient. This book provides a framework for understanding and addressing many of the organizational, technical, and cultural aspects of care to one of the most vulnerable patients in the system, the surgical patient. The first section presents foundational principles of safety science and related social science. The second exposes barriers to achieving optimal surgical outcomes and details the various errors and events that occur in the perioperative environment. The third section contains prescriptive and proactive tools and ways to eliminate errors and harm. The final section focuses on developing continuous quality improvement programs with an emphasis on safety and reliability. Surgical Patient Care: Improving Safety, Quality and Value targets an international audience which includes all hospital, ambulatory and clinic-based operating room personnel as well as healthcare administrators and managers, directors of risk management and patient safety, health services researchers, and individuals in higher education in the health professions. It is intended to provide both fundamental knowledge and practical information for those at the front line of patient care. The increasing interest in patient safety worldwide makes this a timely global topic. As such, the content is written for an international audience and contains materials from leading international authors who have implemented many successful programs.
Essential Surgery is part of a nine volume series for Disease Control Priorities which focuses on health interventions intended to reduce morbidity and mortality. The Essential Surgery volume focuses on four key aspects including global financial responsibility, emergency procedures, essential services organization and cost analysis.
This book combines concise descriptions of the various andrological surgical interventions in the adolescent and adult with detailed analysis of the pre- and postoperative psychosexual counseling of the patient and his family that is appropriate to each procedure. It offers a multidisciplinary approach to the candidate for andrological surgery that reflects the everyday experiences of an andro-sexology team. Each chapter focuses on a particular surgical procedure. Succinct description of the disease and its epidemiology, diagnosis, and treatment is followed by extensive discussion of all aspects of psychosexual relevance and the required counseling. Topics addressed include, for example, the impact of diagnosis, body image issues, fears relating to the surgical procedure and its outcome, the risk of excessive expectations and consequent disillusionment, relationship issues and communication problems, and the role of the sexologist. The analysis and guidance offered in this book will be of particular value to the less experienced andrologist and will assist in achieving postoperative patient satisfaction.
Equity and Excellence : Liberating the NHS: Presented to Parliament by the Secretary of State for Health by Command of Her Majesty
The first textbook on the subject, this is a practical, clinically comprehensive guide to ethical issues in surgical practice, research, and education written by some of the most prominent figures in the fields of surgery and bioethics. Discussions of informed consent, confidentiality, and advance directives--core concepts integral to every surgeon-patient relationship--open the volume. Seven chapters tackle the ethical issues in surgical practice, covering the full range of surgical patients--from emergency, acute, high-risk, and elective patients, to poor surgical risk and dying patients. The book even considers the special relationship between the surgeon and patients who are family members or friends. Chapters on surgical research and education address innovation, self-regulation in practice and research, and the prevention of unwarranted bias. Two chapters focus on the multidisciplinary nature of surgery, including the relationships between surgery and other medical specialties and the obligations of the surgeon to other members of the surgical team. The economic dimensions of surgery, especially within managed care, are addressed in chapters on the surgeons financial relationships with patients, conflicts of interest, and relationships with payers and institutions. The authors do not engage in abstract discussions of ethical theory; instead, their discussions are always directly relevant to the everyday concerns of practicing surgeons. This well-integrated volume is intended for practicing surgeons, medical educators, surgical residents, bioethicists, and medical students.
Primum non nocere... The fact that a surgical procedure can leave any kind of pain casts a shadow over this tenet, which is seen as the basis of medical practice and anchor of its principle ethic... It is all the more surprising in that medicine has only paid attention to this paradoxical chronic pain situation for the past few years. Clarifying the knowledge acquired in this field has become all the more urgent for any care-giver today confronted by a legitimate request from patients: Why and how can a surgical procedure, which is supposed to bring relief, leave behind an unacceptable sequela? This is the approach which the contributors to this new subject of major clinical interest invite you to follow as you work your way through this book.
The two previous editions of Applied Physiology in Intensive Care Medicine proved extremely successful, and the book has now been revised and split into two volumes to enhance ease of use. This first volume comprises three elements -- "physiological notes," “technical notes,” and seminal studies. The physiological notes concisely and clearly capture the essence of the physiological perspectives underpinning our understanding of disease and response to therapy. The technical notes then succinctly explain some of the basics of “how to” in this technology-centered field of critical care medicine. Finally, a number of seminal studies are provided on diverse topics in intensive care. Applied Physiology in Intensive Care, written by some of the most renowned experts in the field, is an up-to-date compendium of practical bedside knowledge that will serve the clinician as an invaluable reference source on key issues regularly confronted in everyday practice.