Anterior Mediastinal Mass: Worst Case Scenarios
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- Опубліковано 8 сер 2024
- In these Worst Case Scenario videos, I'll run through examples of viva style exam scenarios where I ask all the tricky questions and outline many of the challenging situations you may be asked about in a particular case.
This is for anaesthesia trainees sitting the ANZCA part 2 exam but I feel it could be really valuable for anyone doing their anaesthesia training to gain an insight into some of the more complex aspects of our job.
Specifics for anaesthesia for anterior mediastinal mass:
1) Important of diagnosis prior to intervention
2) Assessment of resp compromise, cardiovascular compromise, 5Ms (see frameworks video)
3) Don't rush to GA
4) 3 groups of patients
- severe sx and severe compromise = preanaesthesia ECMO
- mild symptoms and minor compromise = spont vent induction, lower limb iv art line, patient prepped and draped for immediate sternotomy
5) resp or cvs crisis
= treat the usual causes of these
AND then
awaken patient
manoeuvre to least symptomatic position
for resp = rigid bronch
for cvs/resp = sternotomy and lift mass off structures
Please post any comments or questions below.
Check out www.anaesthesiacollective.com and sign up to the ABCs of Anaesthesia facebook group for other content.
Email me at abcsofanaesthesia@gmail.com
good luck!
Disclaimer:
This contains general information about medical conditions and treatments. The information is not advice and should not be treated as such.
The medical information in this course is provided “as is” without any representations or warranties, express or implied.
The presenter makes no representations or warranties in relation to the medical information on this video.
You must not rely on the information as an alternative to assessing and managing your patient with your treating team and consultant
This document was created using a Contractology template available at www.contractology.com.
Informed consent was gained from the patient where relevant
Love your videos. absolutely gold for fellowship exam Thank you so much. Your videos helped me through primaries and now fellowship!
Excellent summary!
Glad you liked it!
Thank you very useful
Amazing! Thanks Lahiru
Vaish Sridhar thanks so much :)
Thanks you so much
Most welcome
If anterior mediastinum mass is reduced completely and moved towards the sternum bone, what is the way to get recovered.
Hi there, I have a small 2.7cm thymoma, im waiting for the 23rd to see a thoracic surgeon, I also have a chest infection but I scored 31 on the shuttle walk, will they still be able to operate on me if I still have the infection?
Amazing 💋🌿🌿🍀🥰🥰🥰🥰🥰🥰🍷🍷🥰thanks for nice lecture
My pleasure :)
I’m going to have a sternotomy within the next two weeks. I have a “tennis ball sized thymoma”. I just want to know what to tell my anesthesiologist: Im 35, I drink 12+ beers a day, my father allegedly had a reaction when he was younger (in the 1980s) and allegedly “died on the table” as he puts it… which I doubt
Would love your thoughts
Hi. I have a 3.2 X 2.1 mass on my aorta. I just had bowel surgery in December 2019. The pulmonary doctor told me that the mass is what is causing my problems so I will be having surgery soon. It is benign. I am scared because I do not know what to expect. But I have been through worse. I just hope thos surgery is it. It will be my 7th and final surgery God willing.
Can you explain me sister my father suffer same problem
@@j.sswaly3346 Hi. Which situation? The mass is up against my aorta causing exhaustion and shortness of breathe. I also feel like someone is sitting on my chest. I lave leukopenia and Neutopenia. Basically low white blood cells and low bone marrow. So I am prone to infection. They thought I had lymphoma but I do not. I do have all of the symptoms of it though. I did a Pet CT to make sure it was not cancer. The mass grew and that is why it has to be removed. I have a team who will be working on me at University of Maryland hospital center. They have a thoracic unit there.
As far as bowel obstructions, I have had at least 30 bowel obstructions. I didn't know I was having them and doctor's thought I had gastritis or vertigo when I would go to the doctor. They never did the CT. Once they did that they realized I wlhave been having bowel obstructions all along... I had appendicitis and the scar tissue is what is causing the obstructions. This last surgery has cleared the path thankfully but I have incontinence and nerve damage on my stomach 🙃 I am thankful I can go to the restroom now. I guess you get what you need. I hope this helps
I am so sorry for what you are going through. Unfortunately i can't comment due to restrictions in giving specific medical advice, but i wish you all the best for your surgery
@@ABCsofAnaesthesia I went to my thoracic doctor and the mass has shrunk thank God so we are watching for 6 months again
ABC Anesthesia boadcast ☘️☘️☘️☘️🍀👌👌👌🍀