V. Reference basis of action

Method of introduction of air-duct.

Air-duct is entered with the purpose of prophylaxis of mechanical asphyxia, as a result of falling back of language in the surgical stage of intravenous anesthesia, at the comatose state. Stages of implementation:

• throw back head of patient;

• open his mouth and enter returned on 180 degrees of air-duct above a tongue, not pushing the root of tongue back (he can be pushed back a spatula);

• to open out air-duct curvature upwards;

• an end of air-duct must be in a hypopharynx.

A method of sanitation of overhead respiratory tracts by electro-exhaust.

Testimony: an axsufflation, vomit, accumulation of mucus or blood is in overhead respiratory tracts. Sanitation of fauces is conducted a hard tip with plenty of openings on an end by the conduct of him in a mouth and pharynx. Sanitation of nasal motions – by an analogical tip from every nostril separately, closing other here. Sanitationa of nasopharynx by the soft smeared catheter with a recurvate end through a Y-similar reducer or tube with the lateral opening (for creation of the dosed dilution).

System of teaching tasks for verification of eventual level of knowledge.

Situation tasks

1.Patient N., 46 years, it is operated concerning peritonitis. It is discovered during Ftorotan anesthesia, that pupils are narrow, a photoharmose is weak, failure of corneal and pharyngeal reflexes, an arteriotony, bradycardia. What stage of anesthesia has a patient?

1.Answer: patient has III₃ stage of anesthesia.

2.Patient O., 65 years old, hospitalized concerning the perforation of ulcer of 12-falling bowel. In a patient also found out hypertensive illness. What type of anesthesia will you give advantage?

2.Answer: a patient had complication of ulcerous illness (perforation of ulcer), urgent operative interference is rotined him. An operation will be conducted in an abdominal region, that is why for its successful implementation intubation anesthesia is needed. Taking into account hypertensive illness, optimum will be implementation of intratracheal anesthesia.

3.Sick M. 45 years old, delivered to the reception department with complaints about a general weakness, dizziness, nausea and vomit by "coffee-grounds". At an inspection: skin covers are pale. Pulse 110 in 1 min., threadlike. AP 80/40. The acute gastroenteric bleeding is diagnosed. Conservative therapy did not give during a 4 o'clock of effect. On a nasogastric probe "coffee-grounds", blood clots, continued to flow out. A urgent operation is rotined.

What types of anaesthetizing is it better to apply during an operation for this patient?

3.Answer: the general anaesthetizing..

4.During the leadthrough of operative interference (opening of постін'єкційного abscess) under масочним anesthesia for a patient motive activity appeared in extremities.

What stage of anesthesia did come for a patient?

4.Answer: the stage of excitation came for a patient.

5.Sick K., 67 years, entered clinic on a first-aid concerning acute impassability of bowels. He is ill diabetes.

Choose the method of anaesthetizing, diagrammatize anaesthetic providing.

5.Answer: as for a patient acute surgical disease of organs of abdominal region, namely intestinal impassability, operative interference is rotined him for to the vital shows. As an operation will be conducted in an abdominal region, the method of anaesthetizing will be intubation anesthesia. Taking into account a present for a patient concomitant disease (diabetes), in a preoperative period it is needed it will be to conduct the correction of sugar of blood.

6. To surgical separation sick P. entered, 47 years, with a diagnosis there is a carbuncle of the back of head. The state is heavy. Temperature of body is 38,8°. It is ill 5 days.

What anaesthetizing is it necessary to expose for operation?

6.Answer: for the leadthrough of adequate necretomy an operation needs to be conducted under a phlebonarcosis. An infiltration local anesthesia will be uneffective from localization, distribution of process; intubation anesthesia needs more difficult vehicle providing, more long leadthrough of operative interference will last, that he is inadvisable.

7.Operation concerning acute appendicitis decided to conduct under vehicle mask anesthesia. What respiratory contour will apply: reversible or unreversible? Why? Transfer failings and advantages each of them.

7.Answer: most expedient is a leadthrough of operative interference under a half-closed respiratory contour, so however much he unlike closed does not cause a hypercapnia in the organism of patient and unlike opened and half-open does not cause the high concentration of anesthesia preparations midair operating-room.

8.Sick K., 51 year, entered permanent establishment with the signs of dislocation of the left shoulder. What method of anaesthetizing is it expedient to apply in this case?

8.Answer: an embole occupies the small interval of time. For the successful leadthrough of manipulation weakening of muscles of humeral belt is needed. Coming from the transferred terms, most expedient in this case there will be a phlebonarcosis.

Distributing of marks which are appropriated students:

At mastering of theme 11 from rich in content the module # 3 for educational activity an estimation is proposed a student for traditional scale which converted to points as follows:

Estimation	Points
“5”(fine)	6 points
“4” (well)	4 points
“3”(satisfactorily)	2 points
“2” (unsatisfactorily)	0 points