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Emergency anaesthesia in the elderly 

Emergency anaesthesia in the elderly
Chapter:
Emergency anaesthesia in the elderly
Author(s):

Chris Dodds

, Chandra M. Kumar

, and Frédérique Servin

DOI:
10.1093/med/9780198735571.003.0006
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date: 30 May 2020

Emergency surgery in the elderly is needed even if elective surgery would not be considered. Often, it is due to trauma or to intra-abdominal, vascular, or neurosurgical emergencies. The time from onset of the cause of the emergency to operative treatment is directly related to complications and death. Delay to accurate diagnosis is common and may be masked by delirium. Sepsis, pain hypotension, and metabolic disorders may all trigger delirium. Resuscitation and optimization should be concurrent with operative management. Important factors considered include the possible cause of a fall (cardiac/neurologic), likelihood of severe hypovolaemia, electrolyte disorders, and ischaemic vascular disease (occlusive and embolic). Emergency laparotomy is reviewed with the possible reasons behind the appalling outcome data, such as delayed diagnosis and poor nutritional state.

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