[Verse 1]
The airways tell a story written long before the blade,
Asthma coils like bronchospasm waiting in the shade,
Reactive, hyperactive, mast cells primed to fire,
We pre-treat with albuterol and raise the baseline higher,
COPD's a different beast — emphysema, chronic wheeze,
Air trapping, barrel chest, FEV1 on its knees,
Obstruction on the flow loop, auto-PEEP's the hidden trap,
Slow your rate, extend expiration, give the lungs a gap
[Chorus]
A-R-I-S-C-A-T, count the score before the day,
Saturation, surgical site, anemia in the way,
Preop stay beyond two days, respiratory infection near,
Seven factors, seven chances — pulmonary risk is clear,
Obstruct, restrict, hypertense, the lungs demand respect,
Optimize before the knife, then monitor and protect
[Verse 2]
Restrictive lungs are stiffened — fibrosis, scoliosis, obesity's weight,
Low compliance, small tidal volumes, pressures that inflate,
The pulmonary hypertensive — RV perched upon a cliff,
Avoid hypoxia, hypercarbia, any vasoconstrictive riff,
Nitric oxide on the ready, phosphodiesterase in check,
One acute RV failure and you're catching a full wreck,
These patients need invasive monitoring, ICU planned tight,
And regional beats general when the physiology's not right
[Chorus]
A-R-I-S-C-A-T, count the score before the day,
Saturation, surgical site, anemia in the way,
Preop stay beyond two days, respiratory infection near,
Seven factors, seven chances — pulmonary risk is clear,
Obstruct, restrict, hypertense, the lungs demand respect,
Optimize before the knife, then monitor and protect
[Verse 3]
The snoring child with adenoids, the adult with the STOP-BANG,
OSA carries collapsing pharynx, opioid sensitivity pang,
Screen them early — CPAP at home means bring that device in,
Postop prone to obstruction, so you watch them close again,
Continuous monitoring, oximetry the sentinel,
And regional anesthesia keeps the opioid dose gentle,
Recent URTI in the pediatric case — elective? Postpone six weeks,
Secretions, bronchospasm risk, a volatile airway leaks
[Bridge]
Here's your rare word — call it borborygmus? No, today we learn: inspissate,
When mucus thickens, desiccates, grows viscous — inspissated sputum blocks the gate,
Humidify your circuits, chest physiotherapy, mucolytics advocated,
Smoking cessation eight weeks prior keeps the secretions less coagulated,
And another gift of language — the word is nidus, meaning breeding ground,
The inflamed, infected airway is a nidus where complications compound,
Know your nidus, treat your nidus, optimize the terrain,
Before you press that induction drug and enter their domain
[Chorus]
A-R-I-S-C-A-T, count the score before the day,
Saturation, surgical site, anemia in the way,
Preop stay beyond two days, respiratory infection near,
Seven factors, seven chances — pulmonary risk is clear,
Obstruct, restrict, hypertense, the lungs demand respect,
Optimize before the knife, then monitor and protect