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Primary Viva 16 (Clinical)

Created: 24/11/2005
1. A 41-year-old patient presents with menorrhagia for hysterectomy. The patient is otherwise healthy.
- Would you accept this patient for surgery?
- Would you transfuse blood preoperatively?
- What are the problems associated with a blood transfusion?
- When is a transfusion indicated?
- What are the physiological changes associated with anaemia?
-At what haemoglobin level would you transfuse?
- Discuss the management of this patient; how would you prepare this patient for surgery?
- Which type of anaesthetic would you choose: spinal or general?
- What procedures would you undertake intraoperatively?
- What might be your concerns postoperatively?
- What analgesia would you administer?

2. Critical incident: You are anaesthetising the above patient for her hysterectomy, and there is blood loss, so you begin a transfusion. Shortly thereafter, your operating department assistant informs you that there was an error in the blood crossmatch.
- What would you do?

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