Introduction

The patient, the central figure in health care services, who seek surgical, and anesthesia service or other health care service for their health problems may need an urgent and emergency care to maintain life or may not require an immediate attention and planned for the patient convenience. Anesthetist is challenged daily with emergency situation which the patient may come on life threatening condition such as poly trauma, clinical shock of different origin, and other or a condition of relatively stable patient under anesthesia and surgery may change to a situation which requires immediate action, otherwise a patient may die within a minute.

Emergency surgery is one that must be performed without delay; the patient has no choice other than immediate surgery, if not the risk will be permanent disability or death. An urgent surgery is one that can wait until the patient is medically stable, but should generally be done today or tomorrow. Elective surgery is done to correct a non life threatening condition which is scheduled in advance because it does not involve a medical or surgical emergency. For all types of surgical procedure anesthetist has central role for maintenance of the patient life performance of successful surgical procedures.

Many patients have died or develop permanent damage from lack of access to the surgical service as well as from inappropriately performed procedures for which lack of resource and preparation might be the cause of damage. In a resource deficient hospital most surgical and anesthetic procedures are performed on emergency bases.

In this module, the appropriate management emergency surgical patient, shocked patient and trauma are explained in general as a health care team member as well as the anesthetic consideration during surgical and anesthesia procedure. Session one and two explain the general anesthetic management of emergency and shocked patient respectively with sample of emergency surgical procedures on acute abdomen. Session three to seven, the general assessment and management as well as anesthetic consideration for trauma patient are explained.

Patients who need emergency surgery pose numerous challenges for the anesthetists. Frequently volume status, cardio vascular stability, and air way management are in question. The choice of anesthesia technique, preoperative stabilization of vital signs and rapid assessment of the clinical situation are important considerations in the preoperative period. Preoperative preparation is undertaken at a time when the patient is in crisis. For this reason, all anesthetists caring emergency patients need to understand the anesthetic considerations that pertain and initiate therapy that will improve the course of anesthesia.