“His arterial BP was 40s/20, HR 90s. Soon the arterial waveform was lost. Both carotid and radial pulses were difficult to palpate. Both IVs were infusing wide open.”
Patient: older adult male Ht: not provided Wt: not provided
Presenting diagnosis: carotid stenosis
Planned procedure: right carotid endarterectomy
Past medical history: hypertension, previous TIAs, and a stroke within last 3 days leaving no residual effects
Preoperative meds: difficult to determine due to illegible handwriting and the patient could not recall specifics
Other pertinent details: Carotid studies revealed 70% occlusion of his right internal carotid artery and 15% occlusion of his left internal carotid artery. He denied cardiac history and EKG was within normal limits. The most recent blood pressure was 129/67 mmHg. However there was documentation referring to “moderate hypotension” and a blood pressure of 106/58 mmHg had previously been recorded. An 18 gauge peripheral IV was placed and a radial arterial line was secured with difficulty after multiple attempts.
Anesthetic plan: general anesthesia