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general threads (Day Surgery (PONV Prophylaxis, Sedation score, Vital Sign…

- - - - Facial foam
      - Tegaderm and gel
      - Mirrored undersurface
- - - - Radiation
      - Working alone
  - - - Vision
- - - - Bair Hugger
      - Fluid Warmer
      - Reduce Exposure
      - Prewarming
- - - - Metabolic syndrome
        central obesity, hypertension, insulin resistance, hypercholesterolaemia
      - Ischaemic heart disease
      - Heart Failure
    - - Reduced FRC
      - Atelectasis and shunting
      - Increased WOB
      - Minute O2 demand higher --> rapid desaturation
      - Wheeze due to airway closure
      - Sleep disordered breathing
        OSA --> obesity hypoventilation syndrome
        
        STOPBANG
        Snoring, Tired during daytime, Observed apnoea, BP high, BMI >35, Age >50, Neck circa >41 or 43cm, Gender Male
        = 5 = high risk
      - Difficult airway
    - - Increased BP
        Increased CO
        Increased cardiac workload
      - Untreated OSA and pulmonary hypertension
      - Arrhythmias increased
        RR for AF 1.5
        Increased sudden cardiac death
        Increased QT
    - - Prothrombotic: VTE, stroke, AMI,
    - - Insulin resistance
        Diabetes
      - NASH
      - Increased reflux/aspiration
  - - - NMT monitoring
      - TCI models unreliable
        Marsh <150
        Schneider <35 or <42
      - Vd can be changed for lipid soluble drugs
        Use TBW for most drugs
    - - Unpredictable IM route
    - - Fatty liver
    - - Hypoventilation