A 68-year-old alcoholic is found unconscious in a burning house, with burns to his face, chest and limbs.
How would you manage this man, scheduled for repair of Colles' fracture? How would you calculate how much fluid to give? What type of fluid would you give? Will the burns be painful? If so, what painkiller should be used? How would you diagnose carbon monoxide poisoning? Is there a level of carboxyhaemoglobin (COHb) that is not diagnostic? What are the indications for hyperbaric therapy? What is the half-life of COHb in air, oxygen, hyperbaric oxygen? How would you anaesthetise for repair of Colles fracture? How is a Biers block performed?
Critical incident
You are in theatre, operating on a patient with a bleeding peptic ulcer. The patient suddenly becomes tachycardic, hypertensive and has ST depression. What would you do?
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