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Final clinical short case 36

Created: 16/11/2012
1. A patient presents with recurrent inguinal hernia and end-stage renal failure, and is on dialysis.
- How would you anaesthetise him?
- Would you carry out spinal anaesthesia?
- Why would you want to know the cause of his renal failure?
- Would you transfuse him if his preoperative haemoglobin level is 8 g/dl?

2. A 5-year-old child presents with a bleeding tonsil.
- How would you manage him? (discuss resuscitation, assessing volaemic status, airway oedema, rapid sequence induction)
- Why would you give him 3 mg/kg thiopentone?
- Do you think he will be easy to anaesthetise?
- How would you assess blood loss?
- How would you assess urine output?
- Is he likely to pass urine while in recovery?
- Are children catheterised in your hospital in recovery?

3. A tension pneumothorax is seen on chest X-ray. Discuss your treatment.

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