University of Colorado Global Anesthesiology Fellowship
August 2025 episode of Global Health Equity Ask the Experts
Professionalism in Pediatric Anesthesiology
New PAINTS episode with Dr. Allison Kinder Ross
Communication and Active Listening
New PAINTS episode with Dr. Allison Kinder Ross
Visit our sponsor IARS for information on complimentary in-training memberships!
Check out the latest OpenAnesthesia Summaries!
More than 470 mini-reviews on high-yield topics in anesthesiology, critical care, and perioperative medicine.
Question of the Day
A 55-year-old woman with seasonal allergies and history of Hepatitis C presents for elective inguinal hernia repair. She has no known drug allergies. General anesthesia is induced with fentanyl, propofol, and lidocaine. Endotracheal intubation is facilitated with succinylcholine after a 5 mg defasciculating dose of rocuronium. After intubation, ventilation is difficult with high pressures with dense wheezes bilaterally. The non-invasive blood pressure cuff reads 55/30 mmHg. The patient's skin appears flushed. Which of the following medications should MOST likely be administered first?
Explanation
This patient is most likely suffering anaphylaxis and epinephrine is the medication of utmost importance during anaphylaxis. It provides vasoconstriction of the vasculature to treat hypotension and bronchodilation to mitigate bronchoconstriction. In the operating room, epinephrine should be titrated in as soon as anaphylaxis is suspected. In addition to giving epinephrine, the presumed inciting agent should be discontinued or removed. The ACLS algorithm should be followed as necessary. Increase FiO2 to 100%. Consider manual ventilation. Intravenous fluids should be administered generously. Other adjuncts such as beta-agonists, corticosteroids, and histamine blockers can then be given.
OA Series: August 2025
Pod
19:04
OA Global Health Equity Ask the Expert
University of Colorado Global Anesthesiology Fellowship
