Walker, Texas Kitty (walkertxkitty) wrote in little_details,
Walker, Texas Kitty
walkertxkitty
little_details

General Anaesthetic Procedures

The setting is Dallas in the mid 1990s at a level 2 trauma center.

The MC is an adolescent about to undergo surgery to repair damage done by several .45 caliber bullets. She was already intubated and had chest tubes put in. She's alert and aware of her surroundings, though of course she cannot talk (I already researched this possibility and it IS possible to be intubated and conscious).

I wanted to know more about the general anaesthetic procedure: what drugs they would use on her, given her current condition, and what possible complications might occur. Some of my research indicates that if she's already on mechanical ventilation they'd use a gas or a combination of a gas and one of the water soluble anaesthetics but when I looked up those medications, some of them were contraindicated for her situation. The description of the mechanical ventilation and the job the anaesthetist does were way beyond my layman's abilities to decipher. I also need to know what they'd be watching for post-op which would get her off the vent and have them extubate.

These were the links I looked at:

http://en.wikipedia.org/wiki/General_anaesthetic (and I read all of the associated links in the article, just to be certain)
http://en.wikipedia.org/wiki/Anaesthesiologist
http://en.wikipedia.org/wiki/Mechanical_ventilationa
http://www.nlm.nih.gov/medlineplus/tutorials/generalanesthesia/an079103.pdf
http://www.mayoclinic.com/health/anesthesia/SC00026
http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/anesthesia_general.jsp (this one was actually pretty good but I'm having trouble understanding exactly what it says)
http://health.howstuffworks.com/anesthesia2.htm (I couldn't understand this one either)

I did narrow it down to these possible medications:

http://en.wikipedia.org/wiki/Propofol
http://en.wikipedia.org/wiki/Thiopentone
http://en.wikipedia.org/wiki/Midazolam

However, I am still not entirely certain they're appropriate under the circumstances. I am also not certain, given that there's a decade difference between the present and the time the story takes place, whether or not the more dangerous and common anaesthetics would have already been retired (one article says they're no longer used, another says they're no longer the drug of choice for procedures). None of them explain how this is done with someone already intubated or on a ventilator or which method might be more preferable.
Tags: ~medicine: injuries: gunshot wounds
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