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Crisis Management in the Perioperative Setting

Anesthesiologists play a fundamental role in patient safety, particularly in emergent situations or during a crisis in the perioperative setting. Adequate knowledge and constant preparation is required to manage these events appropriately. This chapter discusses the common intraoperative crises that anesthesia residents encounter, especially during the first few months of residency; these include laryngospasm, oxygen failure, anaphylaxis, local anesthetic systemic toxicity, malignant hyperthermia, surgical site infections, and operating room fires. We also review the presentation and pathophysiology and provide step-by-step corrective actions to manage these crises until help arrives, including the use of medications, supplies, and equipment. A stepwise therapeutic approach to cardiac arrest in the operating room is also addressed.