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Thank you Ling Jun for carefully organizing topic 1: Many tragedies in medical aesthetics occur because of unprofessional anesthesia.
Key topic: At the moment of "appearance economy", the medical aesthetics industry has become a bright spot driving economic development, and it is also an expression of people's needs for a better life
.
However, the complications of surgical anesthesia make the people feel insecure and worry the government
.
Through this special discussion, we can achieve "beauty and safety at the same time" and advocate safe anesthesia.
This is the bottom line
.
1.
Status and anesthesia of medical aesthetic surgery
.
The current cosmetic plastic surgery is mostly eye and nose surgery, and the body shape includes liposuction breast sagging; male plastic surgery is increasing, private plastic surgery is increasing, and medical beauty is common in the seventies
.
Plastic and cosmetic surgery also covers the treatment of diseases, including pediatric congenital deformity plastic surgery, cleft palate, breast CA and so on
.
Most of them are safe, and risks are predicted in advance
.
General anesthesia surgery is risky and requires high experience of anesthesia machines and anesthesiologists
.
80% of cosmetic surgery is performed under local anesthesia
.
What medical surgery requires general anesthesia? The pain level is high and the area is large, requiring no pain and no fear, consider general anesthesia
.
Meet the three needs of safety, effectiveness and comfort
.
2.
How to choose a medical beauty hospital and the positioning of anesthesiologists in medical beauty surgery
.
According to your own needs, the operation is large and requires anesthesia.
It is recommended to consider a general hospital, because there is an anesthesiology department with a fixed anesthesia doctor, and the operating room is more fully equipped, which can undertake larger medical and aesthetic operations
.
Four types of mandibular surgery need to go to a large hospital
.
Medical cosmetology, medical-led, beauty in the back, choose a hospital, we must pay attention to qualifications, equipment, professional and standardized training of surgeons, anesthesiologists and nursing staff are very important
.
The anesthesiologist provides standard anesthesia, standardized analgesia, and comfortable post-operation according to the patient's needs
.
At present, the innovation of anesthesia in the medical aesthetics industry is proposed, and the mask-like anesthesia products are used for facial application to extend the action time of local anesthetics
.
3.
What are the causes of medical cosmetic anesthesia accidents? Anesthesia factors: ①The construction of anesthesiologists in private medical institutions is weak, there is a shortage of anesthesiologists, and it is common to hire anesthesiologists temporarily.
Some surgeons even serve as anesthesiologists; ②In order to control costs, an anesthesiologist is often responsible for In the case of multiple operations, it is a serious violation of medical regulations; ③ In order to meet the needs of beauty seekers as much as possible and control costs, intravenous general anesthesia without intubation has become the preferred method of anesthesia for medical cosmetic surgery in most private hospitals
.
The risks of unintubated IV general anesthesia are severely underestimated
.
Topic 2: Painless childbirth and accidental childbirth anesthesiologists rely on 1.
The techniques and doubts of labor analgesia
.
Both non-drug analgesia and drug analgesia have their own advantages and disadvantages
.
Non-drug analgesia includes music, stimulators, companionship, massage, hydrotherapy pools, etc.
, but we choose drug analgesia for severe pain that cannot be suppressed by mental treatment
.
By implementing intraspinal labor analgesia, the anesthesiologist uses low-concentration and small-dose drugs to act on the painful area, achieves individualized and standardized medication, and provides safe, accurate, and continuous intrapartum analgesia
.
2.
When can labor analgesia be given? As long as the puerpera needs, according to personal wishes and the purpose of comfortable medical treatment, the obstetrician can evaluate the puerpera who can try to give birth through the vagina, eliminate the contraindications of spinal anesthesia, the cervix disappears, and the operation can be started after entering the delivery room
.
Is it possible to relieve pain in labor when the fetal heart is not working? The plan needs to be discussed with the obstetrician, as well as with the mother and family
.
Labor analgesia is relatively safe, and even if you go to cesarean section, it also provides convenience for the implementation of cesarean section anesthesia indwelling catheter
.
3.
Does it affect urination? It is related to your own situation.
Difficulty in urination may also be caused by physiological problems, not necessarily the effects of anesthesia
.
Urinary catheterization can be resolved
.
Urinary retention prevents fetal head descending, so urination before analgesia is instructed
.
A large bladder, oxytocin use, prolonged labor, infections, etc.
can all cause difficulty urinating
.
4.
Labor analgesia and postpartum depression
.
Whether neuraxial labor analgesia reduces postpartum depression has mixed results and needs to be confirmed
.
As the implementer of labor analgesia, anesthesiologists should pay attention to and treat persistent postpartum birth canal injury, incision pain, breastfeeding pain, back pain and headache, which have been confirmed to be closely related to postpartum depression
.
At the same time, obstetricians are recommended to screen and treat maternal anxiety and depression at all stages of the perinatal period, and to identify and pay attention to high-risk depressive mothers early
.
5.
How to handle obstetric emergencies? Hemorrhage is currently the number one cause of maternal death, followed by amniotic fluid embolism
.
When the maternity haemorrhage occurs in the delivery room, open the vein, call for help, the obstetrician is present, the anesthesiologist is present, and advanced life support, airway management, and circulatory support are performed
.
Childbirth is a challenging and dynamic process, and emergencies that endanger the safety of mother and baby may arise at any time
.
If there is an emergency such as umbilical cord prolapse during childbirth, it is necessary to perform a cesarean section immediately to save the life of the mother and child.
The expectant mother who has implemented labor analgesia has a "life" channel - epidural catheter in advance, and anesthesia Doctors can add drugs directly from the catheter to achieve rapid anesthesia, saving time for surgical preparation, providing comfortable anesthesia and analgesia, and improving surgical safety
.
Therefore, driven by labor analgesia, the modern delivery room has formed a multidisciplinary medical team medical model with maternal and child safety as the center, obstetric anesthesia stationed in the delivery room, and neonatal department collaboratively participating
.
Topic 3: The speed of life and death experienced by anesthesiologists teaches you how to save your life 1.
Causes of cardiac arrest The causes of cardiac arrest are wide and varied
.
Cardiac arrest is usually secondary to prolonged decompensation of ventricular fibrillation
.
In addition, defibrillation for ventricular tachycardia or ventricular fibrillation can cause asystole
.
However, if left untreated, any cause of cardiac arrest can eventually lead to cardiac arrest
.
Reversible causes must be considered when evaluating patients with an initial heart beat rhythm
.
For reversible causes of cardiac arrest, a useful mnemonic taught by Advanced Cardiac Life Support (ACLS) is 5H and 5T
.
5H includes hypovolemia, hypoxia, acidosis, hypokalemia/hyperkalemia, and hypothermia
.
5T includes tension pneumothorax, cardiac tamponade, poisoning, pulmonary embolism, and myocardial infarction
.
2.
Topic 4 of emergency cardiac arrest procedures in adults: Can anaphylactic shock be fatal in surgical anesthesia? Anesthesia is a relatively unique way of administering drugs, which usually requires the use of multiple drugs in a short surgical procedure
.
However, the use of any drug can cause allergic and anaphylactoid reactions
.
With the improvement of medical level, the incidence of such reactions is on the rise worldwide, making allergy and anaphylactoid reactions one of the hot topics in the current perioperative discussion
.
1.
Briefly understand allergic reactions
.
Allergic reactions in the awake state can cause skin changes, digestive tract reactions, and in severe cases, changes in breathing and circulation
.
Sometimes patients will be told that there are multiple drug allergies, but in fact, it may be caused by the side effects of the drug itself rather than an allergic reaction, and a detailed medical history needs to be asked for identification
.
The body's allergic reaction to itself due to strenuous exercise also requires attention
.
2.
The difference between allergic reactions under anesthesia and non-anesthesia
.
Perioperative hypersensitivity reactions usually occur after multiple drug use during anesthesia induction, most commonly due to muscle relaxants
.
3.
What should I do if I have an allergic reaction during surgery? Due to preoperative fasting and fasting, blood pressure dropped slightly during the induction process.
After the establishment of artificial ventilation, blood pressure still decreased.
After excluding the situation of insufficient volume, the first reaction is to consider allergic reactions to anesthetic drugs, and check whether it is combined with rash or whole A neurovascular edema state of skin redness if hypersensitivity is highly suspected
.
Adrenaline was given, blood pressure went back up, things got better, and surgery continued
.
In another case, blood pressure is still unstable, anaphylactic shock, severe allergic reaction, consider the postponement of surgery
.
Depending on the duration and severity of the allergic reaction, the decision to proceed with surgery is made
.
Change the drug for the next anesthesia
.
Allergic reactions during surgery, careful investigation of infusion, blood transfusion, antibiotics, surgical consumables, latex allergy,
etc.
4.
Severe allergic reaction treatment process
.
Topic 5: Under what circumstances does the anesthesiologist have the right to stop the operation, and the anesthesiologist stops the operation with a single word after preparing for the surgery for most of the day.
Do the surgeons really understand the reason why the anesthesiologist stopped the operation? If the preoperative evaluation is not timely and thorough, it will lead to postoperative complications of the patient
.
From a practical point of view, how should a reasonable preoperative assessment be faced - for surgeons and anesthesiologists, it is a professional need; for patients, it is related to their health and life
.
1.
Under what circumstances should the operation be stopped? From a safety point of view, preoperative examinations are not perfect, systemic diseases are poorly controlled, and newly discovered diseases such as acute angina pectoris, TIA, etc.
, should be stopped before or on the day of surgery
.
Safety first
.
Impressed to stop the operation: the preoperative examination of the gynecological surgery patient showed that the heart rate was fast, and the previous hyperthyroidism was associated with abnormal thyroid function, so the operation was stopped
.
Anesthesia and surgery respect each other and maximize the interests of patients
.
2.
Blood pressure and anesthesia ① Hypertensive patients are often encountered during anesthesia, and many hypertensive patients have not been well controlled before surgery and are eager to perform surgery, especially those who self-administer antihypertensive drugs, because some drugs can affect anesthesia.
Anesthesiologists need to understand and evaluate the impact on surgery; ② Because of the high risk of anesthesia in patients undergoing hypertensive surgery, it is advisable to control blood pressure within a safe range for patients undergoing elective surgery; ③ With the development of clinical anesthesiology Although it is no longer strictly stipulated in clinical practice that systolic blood pressure exceeds 180 mmHg and diastolic blood pressure exceeds 110 mmHg, anesthesia and surgery must be suspended.
Serious complications such as cerebral infarction, myocardial infarction, heart failure, and even sudden death still occur from time to time
.
Therefore, in order to ensure the safety of patients undergoing this type of surgery during the peri-anesthesia period, it is necessary to strictly check to avoid complications or accidents
.
Antihypertensive drugs were taken regularly before surgery and continued on the day of surgery
.
After entering the room, sedative drugs were given, and the blood pressure dropped to a relatively safe level, and the operation continued
.
Through sedative intervention, the high blood pressure caused by sympathetic nerve excitation is relieved
.
3.
Smoking and anesthesia Smoking is harmful to health.
Smoking affects anesthesia.
Whether it is active smoking or passive smoking, the risk of breathing problems in the perioperative period is higher than that of non-smokers
.
The only way to reduce the risks associated with smoking is to quit smoking
.
The study found that smoking cessation for at least 8 weeks before surgery reduced the incidence of respiratory complications to levels similar to those of non-smokers
.
If it is too late, you do not have such a long time to quit smoking before surgery, such as tumor surgery, etc.
, or you are so addicted to smoking that you cannot completely quit smoking for 8 weeks, then even starting 12 hours before surgery has certain benefits
.
4.
Fasting and fasting before surgery
.
Follow the rules of fasting and fasting before surgery to avoid aspiration caused by reflux of gastric contents during the perioperative period
.
If there is insufficient fasting time for elective surgery, the surgery is delayed
.
5.
Painless gastroenteroscopy and anesthesia
.
Gastrointestinal endoscopy often causes discomfort in patients due to mechanical stimulation and psychological stress
.
Anesthesia creates comfortable medical conditions for patients, and the painless technology enables patients to have no obvious discomfort during the endoscopic operation, which is conducive to eliminating the patient's fear and anxiety about the endoscopic operation, increasing the compliance of the endoscopic operation, and thus ensuring the endoscopic operation.
The operation was completed successfully
.
Can anyone play "painless"? Patients with the following diseases should be cautious: 1.
Respiratory system: acute respiratory infection, severe pneumonia, chronic obstructive pulmonary emphysema, acute exacerbation of asthma; 2.
Heart failure, myocardial infarction, stroke, coma, renal failure, liver failure, When the signs of anemia, aging and frailty are unstable; 3.
People with mouth opening disorder, neck or mandibular movement limitation; 4.
People with digestive system diseases such as esophagus, cardia, pylorus and intestinal obstruction, vomiting or hematemesis have reflux of retained fluid and aspiration into the trachea Because of the risk of aspiration pneumonia, painless endoscopy should be performed only after pretreatment such as gastrointestinal decompression to drain the retained fluid
.
Key topic: At the moment of "appearance economy", the medical aesthetics industry has become a bright spot driving economic development, and it is also an expression of people's needs for a better life
.
However, the complications of surgical anesthesia make the people feel insecure and worry the government
.
Through this special discussion, we can achieve "beauty and safety at the same time" and advocate safe anesthesia.
This is the bottom line
.
1.
Status and anesthesia of medical aesthetic surgery
.
The current cosmetic plastic surgery is mostly eye and nose surgery, and the body shape includes liposuction breast sagging; male plastic surgery is increasing, private plastic surgery is increasing, and medical beauty is common in the seventies
.
Plastic and cosmetic surgery also covers the treatment of diseases, including pediatric congenital deformity plastic surgery, cleft palate, breast CA and so on
.
Most of them are safe, and risks are predicted in advance
.
General anesthesia surgery is risky and requires high experience of anesthesia machines and anesthesiologists
.
80% of cosmetic surgery is performed under local anesthesia
.
What medical surgery requires general anesthesia? The pain level is high and the area is large, requiring no pain and no fear, consider general anesthesia
.
Meet the three needs of safety, effectiveness and comfort
.
2.
How to choose a medical beauty hospital and the positioning of anesthesiologists in medical beauty surgery
.
According to your own needs, the operation is large and requires anesthesia.
It is recommended to consider a general hospital, because there is an anesthesiology department with a fixed anesthesia doctor, and the operating room is more fully equipped, which can undertake larger medical and aesthetic operations
.
Four types of mandibular surgery need to go to a large hospital
.
Medical cosmetology, medical-led, beauty in the back, choose a hospital, we must pay attention to qualifications, equipment, professional and standardized training of surgeons, anesthesiologists and nursing staff are very important
.
The anesthesiologist provides standard anesthesia, standardized analgesia, and comfortable post-operation according to the patient's needs
.
At present, the innovation of anesthesia in the medical aesthetics industry is proposed, and the mask-like anesthesia products are used for facial application to extend the action time of local anesthetics
.
3.
What are the causes of medical cosmetic anesthesia accidents? Anesthesia factors: ①The construction of anesthesiologists in private medical institutions is weak, there is a shortage of anesthesiologists, and it is common to hire anesthesiologists temporarily.
Some surgeons even serve as anesthesiologists; ②In order to control costs, an anesthesiologist is often responsible for In the case of multiple operations, it is a serious violation of medical regulations; ③ In order to meet the needs of beauty seekers as much as possible and control costs, intravenous general anesthesia without intubation has become the preferred method of anesthesia for medical cosmetic surgery in most private hospitals
.
The risks of unintubated IV general anesthesia are severely underestimated
.
Topic 2: Painless childbirth and accidental childbirth anesthesiologists rely on 1.
The techniques and doubts of labor analgesia
.
Both non-drug analgesia and drug analgesia have their own advantages and disadvantages
.
Non-drug analgesia includes music, stimulators, companionship, massage, hydrotherapy pools, etc.
, but we choose drug analgesia for severe pain that cannot be suppressed by mental treatment
.
By implementing intraspinal labor analgesia, the anesthesiologist uses low-concentration and small-dose drugs to act on the painful area, achieves individualized and standardized medication, and provides safe, accurate, and continuous intrapartum analgesia
.
2.
When can labor analgesia be given? As long as the puerpera needs, according to personal wishes and the purpose of comfortable medical treatment, the obstetrician can evaluate the puerpera who can try to give birth through the vagina, eliminate the contraindications of spinal anesthesia, the cervix disappears, and the operation can be started after entering the delivery room
.
Is it possible to relieve pain in labor when the fetal heart is not working? The plan needs to be discussed with the obstetrician, as well as with the mother and family
.
Labor analgesia is relatively safe, and even if you go to cesarean section, it also provides convenience for the implementation of cesarean section anesthesia indwelling catheter
.
3.
Does it affect urination? It is related to your own situation.
Difficulty in urination may also be caused by physiological problems, not necessarily the effects of anesthesia
.
Urinary catheterization can be resolved
.
Urinary retention prevents fetal head descending, so urination before analgesia is instructed
.
A large bladder, oxytocin use, prolonged labor, infections, etc.
can all cause difficulty urinating
.
4.
Labor analgesia and postpartum depression
.
Whether neuraxial labor analgesia reduces postpartum depression has mixed results and needs to be confirmed
.
As the implementer of labor analgesia, anesthesiologists should pay attention to and treat persistent postpartum birth canal injury, incision pain, breastfeeding pain, back pain and headache, which have been confirmed to be closely related to postpartum depression
.
At the same time, obstetricians are recommended to screen and treat maternal anxiety and depression at all stages of the perinatal period, and to identify and pay attention to high-risk depressive mothers early
.
5.
How to handle obstetric emergencies? Hemorrhage is currently the number one cause of maternal death, followed by amniotic fluid embolism
.
When the maternity haemorrhage occurs in the delivery room, open the vein, call for help, the obstetrician is present, the anesthesiologist is present, and advanced life support, airway management, and circulatory support are performed
.
Childbirth is a challenging and dynamic process, and emergencies that endanger the safety of mother and baby may arise at any time
.
If there is an emergency such as umbilical cord prolapse during childbirth, it is necessary to perform a cesarean section immediately to save the life of the mother and child.
The expectant mother who has implemented labor analgesia has a "life" channel - epidural catheter in advance, and anesthesia Doctors can add drugs directly from the catheter to achieve rapid anesthesia, saving time for surgical preparation, providing comfortable anesthesia and analgesia, and improving surgical safety
.
Therefore, driven by labor analgesia, the modern delivery room has formed a multidisciplinary medical team medical model with maternal and child safety as the center, obstetric anesthesia stationed in the delivery room, and neonatal department collaboratively participating
.
Topic 3: The speed of life and death experienced by anesthesiologists teaches you how to save your life 1.
Causes of cardiac arrest The causes of cardiac arrest are wide and varied
.
Cardiac arrest is usually secondary to prolonged decompensation of ventricular fibrillation
.
In addition, defibrillation for ventricular tachycardia or ventricular fibrillation can cause asystole
.
However, if left untreated, any cause of cardiac arrest can eventually lead to cardiac arrest
.
Reversible causes must be considered when evaluating patients with an initial heart beat rhythm
.
For reversible causes of cardiac arrest, a useful mnemonic taught by Advanced Cardiac Life Support (ACLS) is 5H and 5T
.
5H includes hypovolemia, hypoxia, acidosis, hypokalemia/hyperkalemia, and hypothermia
.
5T includes tension pneumothorax, cardiac tamponade, poisoning, pulmonary embolism, and myocardial infarction
.
2.
Topic 4 of emergency cardiac arrest procedures in adults: Can anaphylactic shock be fatal in surgical anesthesia? Anesthesia is a relatively unique way of administering drugs, which usually requires the use of multiple drugs in a short surgical procedure
.
However, the use of any drug can cause allergic and anaphylactoid reactions
.
With the improvement of medical level, the incidence of such reactions is on the rise worldwide, making allergy and anaphylactoid reactions one of the hot topics in the current perioperative discussion
.
1.
Briefly understand allergic reactions
.
Allergic reactions in the awake state can cause skin changes, digestive tract reactions, and in severe cases, changes in breathing and circulation
.
Sometimes patients will be told that there are multiple drug allergies, but in fact, it may be caused by the side effects of the drug itself rather than an allergic reaction, and a detailed medical history needs to be asked for identification
.
The body's allergic reaction to itself due to strenuous exercise also requires attention
.
2.
The difference between allergic reactions under anesthesia and non-anesthesia
.
Perioperative hypersensitivity reactions usually occur after multiple drug use during anesthesia induction, most commonly due to muscle relaxants
.
3.
What should I do if I have an allergic reaction during surgery? Due to preoperative fasting and fasting, blood pressure dropped slightly during the induction process.
After the establishment of artificial ventilation, blood pressure still decreased.
After excluding the situation of insufficient volume, the first reaction is to consider allergic reactions to anesthetic drugs, and check whether it is combined with rash or whole A neurovascular edema state of skin redness if hypersensitivity is highly suspected
.
Adrenaline was given, blood pressure went back up, things got better, and surgery continued
.
In another case, blood pressure is still unstable, anaphylactic shock, severe allergic reaction, consider the postponement of surgery
.
Depending on the duration and severity of the allergic reaction, the decision to proceed with surgery is made
.
Change the drug for the next anesthesia
.
Allergic reactions during surgery, careful investigation of infusion, blood transfusion, antibiotics, surgical consumables, latex allergy,
etc.
4.
Severe allergic reaction treatment process
.
Topic 5: Under what circumstances does the anesthesiologist have the right to stop the operation, and the anesthesiologist stops the operation with a single word after preparing for the surgery for most of the day.
Do the surgeons really understand the reason why the anesthesiologist stopped the operation? If the preoperative evaluation is not timely and thorough, it will lead to postoperative complications of the patient
.
From a practical point of view, how should a reasonable preoperative assessment be faced - for surgeons and anesthesiologists, it is a professional need; for patients, it is related to their health and life
.
1.
Under what circumstances should the operation be stopped? From a safety point of view, preoperative examinations are not perfect, systemic diseases are poorly controlled, and newly discovered diseases such as acute angina pectoris, TIA, etc.
, should be stopped before or on the day of surgery
.
Safety first
.
Impressed to stop the operation: the preoperative examination of the gynecological surgery patient showed that the heart rate was fast, and the previous hyperthyroidism was associated with abnormal thyroid function, so the operation was stopped
.
Anesthesia and surgery respect each other and maximize the interests of patients
.
2.
Blood pressure and anesthesia ① Hypertensive patients are often encountered during anesthesia, and many hypertensive patients have not been well controlled before surgery and are eager to perform surgery, especially those who self-administer antihypertensive drugs, because some drugs can affect anesthesia.
Anesthesiologists need to understand and evaluate the impact on surgery; ② Because of the high risk of anesthesia in patients undergoing hypertensive surgery, it is advisable to control blood pressure within a safe range for patients undergoing elective surgery; ③ With the development of clinical anesthesiology Although it is no longer strictly stipulated in clinical practice that systolic blood pressure exceeds 180 mmHg and diastolic blood pressure exceeds 110 mmHg, anesthesia and surgery must be suspended.
Serious complications such as cerebral infarction, myocardial infarction, heart failure, and even sudden death still occur from time to time
.
Therefore, in order to ensure the safety of patients undergoing this type of surgery during the peri-anesthesia period, it is necessary to strictly check to avoid complications or accidents
.
Antihypertensive drugs were taken regularly before surgery and continued on the day of surgery
.
After entering the room, sedative drugs were given, and the blood pressure dropped to a relatively safe level, and the operation continued
.
Through sedative intervention, the high blood pressure caused by sympathetic nerve excitation is relieved
.
3.
Smoking and anesthesia Smoking is harmful to health.
Smoking affects anesthesia.
Whether it is active smoking or passive smoking, the risk of breathing problems in the perioperative period is higher than that of non-smokers
.
The only way to reduce the risks associated with smoking is to quit smoking
.
The study found that smoking cessation for at least 8 weeks before surgery reduced the incidence of respiratory complications to levels similar to those of non-smokers
.
If it is too late, you do not have such a long time to quit smoking before surgery, such as tumor surgery, etc.
, or you are so addicted to smoking that you cannot completely quit smoking for 8 weeks, then even starting 12 hours before surgery has certain benefits
.
4.
Fasting and fasting before surgery
.
Follow the rules of fasting and fasting before surgery to avoid aspiration caused by reflux of gastric contents during the perioperative period
.
If there is insufficient fasting time for elective surgery, the surgery is delayed
.
5.
Painless gastroenteroscopy and anesthesia
.
Gastrointestinal endoscopy often causes discomfort in patients due to mechanical stimulation and psychological stress
.
Anesthesia creates comfortable medical conditions for patients, and the painless technology enables patients to have no obvious discomfort during the endoscopic operation, which is conducive to eliminating the patient's fear and anxiety about the endoscopic operation, increasing the compliance of the endoscopic operation, and thus ensuring the endoscopic operation.
The operation was completed successfully
.
Can anyone play "painless"? Patients with the following diseases should be cautious: 1.
Respiratory system: acute respiratory infection, severe pneumonia, chronic obstructive pulmonary emphysema, acute exacerbation of asthma; 2.
Heart failure, myocardial infarction, stroke, coma, renal failure, liver failure, When the signs of anemia, aging and frailty are unstable; 3.
People with mouth opening disorder, neck or mandibular movement limitation; 4.
People with digestive system diseases such as esophagus, cardia, pylorus and intestinal obstruction, vomiting or hematemesis have reflux of retained fluid and aspiration into the trachea Because of the risk of aspiration pneumonia, painless endoscopy should be performed only after pretreatment such as gastrointestinal decompression to drain the retained fluid
.
