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Non-theatre environments (imaging, cardiac catheterization laboratory, and emergency department) 

Non-theatre environments (imaging, cardiac catheterization laboratory, and emergency department)
Non-theatre environments (imaging, cardiac catheterization laboratory, and emergency department)

Naville Chia

and Edwin Seet

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date: 05 July 2020

This chapter reviews the provision of anaesthesia away from designated operating theatres. It begins with a description of the range of sedation used, from no sedation to general anaesthesia. It classifies what a remote environment may be and the challenges likely to be faced. The concerns for the anaesthetist are reviewed; this includes monitoring haemodynamic, respiratory, temperature, and brain function. There follows a discussion on the equipment, staffing, and environmental needs for safe practice. Patient assessment is reviewed, as is their response to standard sedative and analgesic medications. Specific risks in imaging procedures are explored, such as radiation exposure and problems due to contrast media. Magnetic resonance suites are reviewed along with their hazards before discussing cardiac catheterization suites. Transcatheter aortic valve implantation and anaesthetic techniques are explored before coronary angiography. Prehospital and emergency department care are then reviewed with emphasis on the vulnerability of elderly patients in such circumstances.

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