confusionabounds

you risk not being able to deflate your balloon if you 'rip' or pull your cuff off instead of deflating. when you pull a cuff off, it stretches the plastic. this stretching of the plastic generates heat. due to the narrowness of the diameter, pulling the cuff off can generate enough heat to immediately seal the end of the cuff access. doesn't happen all the time, but it is a definite possibility.

wow, good stuff, folks. thanks for the replies to my original question. i really did mean it as a simple question, and my intention was not to have anyone nerd out on me with a million scenarios, but i always do that as well when i am asked a question-i ask for more info. anyway, to satisfy the curious, my pt. was a middle aged male, middle of surgery, actively being cut, gas has already been turned down, very well hydrated already, not much blood loss to speak of, no tourniquet was used, yada, yada, yada. His bp just dropped on me, and i did everything i could to raise it before i gave ephedrine or neo. as i was reaching for my drug of choice (in this case) i ran through all the pros and cons of using both in my now hypotensive beta blocked pt. just thought i would get some opinions as to what everyone thought. By the way, i used neo (if anyone cares) ephedrine would have worked as well if not better (competition for sites and all that) but i chose not to use it due to the reasoning mentioned earlier - they were beta blocked for a reason and i didn't want to counter act too much of that if i could help it. anyway, thanks for all the replies.

why neo? as for fluid status, etc. -- ignore it. it does not factor into my question. this is low bp caused by beta blockade and nothing else. based on the beta blockade being the cause - my question is neo or ephedrine?

looking for opinions - let's say you have a pt. on beta blockers. they come in for surgery and their HR is in the 60's-70's (which is their baseline) and their pressure is in the 70's/40's range. you've given fluid, blah, blah blah. my question is, which would be more appropriate for a pt on beta blockers to get, ephedrine or neosynephrine - to increase their bp? neo is of course a direct alpha agonist, so you have that going for you. ephedrine has some alpha action as well as beta action which would compete with the beta blockers for sites and reduce their effect, yada, yada, yada. any opinions?

not using any peep other than physiologic. my theoretic low bp is not due to the vent itself. my question is what adjustment to the vent(tidal volume, resp. rate, etc) can i alter to affect my bp?

Okay, here is a dumb question that I have recently become confused about as i am in clinicals. if my pt. has a low BP, what can i do respiratory wise to raise it? (i know i would do many other things first, but this is like a last ditch thing before pressors) would increasing my resp. rate on my vent. raise the bp? (due to neg. pressure of each respiration 'pulling' blood from lower body to increase return to heart) or would it lower my bp due to blowing off too much co2? I know, i know, a simple and probrably stupid question, but i can't remember and can't seem to find it in my literature. any ideas? (and please don't tell me 'look it up' - it is not something someone has asked, it just popped into my head today and i couldn't remember and can't seem to find the answer) thanks for any responses.