Anesthesiology and Intensive Care

1. Establish large bore IV access and titrate FiO2 to SpO2 ≥ 90%. 2. Place right radial arterial line and use left arm for NIBP. 3. Use fentanyl and esmolol as first line therapy to control pain, keep HR < 60 and reduce SBP < 120 mmHg. 4. If additional control is needed, use the agents listed (in order of preference) in the table opposite. 5. Prepare for rapid CT angiogram but use bedside TEE or TTE as alternatives if unstable or while waiting for CT.

1. Eliminate any allergy triggers 2. Get ready for intubation as edema can progress shortly. 3. Provide oxygen flow. 4. Provide reliable intravenous access with large bore cannula. 5. Give 20-30 mL/kg crystalloid iv.

Pulse pressure mathematically   is the difference between systolic and diastolic blood  pressure .  Pulse pressure reflects the stroke volume and compliance of the arterial system.