| Abstract: |
Fat embolism occurs most commonly after long bone fractures and is manifested by hypoxia, tachycardia, mental status changes and petechiae in conjunctiva, axilla, and upper thorax. It is managed by oxygen administration judicious fluid management and corticosteroids in large doses. Air embolism may be caused by sitting position in posterior fossa surgery or from air entry in the central venous cannulation or arterial cannulation It is presented by hypoxia, hypercarpia, bronchoconstriction, hypotension and cardiovascular collapse. Once it is detected inform the surgeon to close the dural opening, nitrous oxide is discontinued, air is aspirated from CVP if hypotension developed use trendlenburg position, fluid administration, inotropic agents.Venous thromboembolism has neither specific nor sensitive signs to be of diagnostic value. Tachycardia is the most frequent non specific non specific finding on ECG. Arterial blood gases may also show (S1Q3T3), D-dimer of less than 500 µg/dl is considered the cut off excluding venous thromboembolism. Once it is diagnosed antithrombotic therapy must be started immediately using heparin infusion to achieve active partial thromboplastin (PTT) between 1.5-2.5 times. Also acute myocardial infarction is presented by sever chest pain, sweating, pallor and tachycardia. It is diagnosed by clinical symptoms, ECG changes and CK, CKMB and troponin and it is managed by thrombolytic therapy or emergency Percutaneous Coronary Intervention (PCI).These are the most common causes tachycardia during anesthesia, which can be detected by good monitoring including electrocardiogram blood pressure, respiratory rate, pulse oximeter, end-tidal CO2.
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