11/30 Flashcards
Normal intraocular pressures range from ________ mmHg
8 to 21 mmHg
Intraocular pressures associated with orbital compartment syndrome and retinal ischemia are _____________
> 40 mmHg
Lateral Canthotomy Steps
- clean
- numb
- devascularize with clamp ~ 1 min
- Cut horizontally from the lateral canthus to the lateral orbital rim using scissors
- “strum” the inferior crus
- Sever the inferior crus with scissors
- Recheck IOP
Equipment for surgical airway
- # 10 scalpel
- 6.0 cuffed endotracheal tube
- Bougie
- 10-mL syringe to inflate cuff
Steps for surgical airway
- PPE (glasses)
- stand on patients right
- Extend the neck
- grasp the lower aspect of the thyroid cartilage firmly
- initial vertical incision from the mid thyroid cartilage to the cricoid cartilage
- anticipate large blood spray
- Horizontal incision of membrane
- Pass bougie
- Load tube/ inflate
- Suture in place
Transvenous Pacemaker Steps
- R IJ cordis
- Advance wire to 20 cm
- Inflate the balloon
- Advance catheter while looking for wide QRS complexes
- Deflate the balloon and lock the wire
- Pull the sterile sheath over the proximal catheter and lock.
Sedative for transcutaneous pacing
Midazolam - 1-2.5 mg , total dose > 5 mg is not needed.
Ketamine 1-2 mg/kg
Transcutaneous pacing
- Attach transcutaneous pacer pads
- Turn on pacing mode.
- Set rate to 80 beats/min.
- Increase output until there is capture, start with 40 mA
Initial mechanical ventilation settings- general
Volume-assist control
Rate 8-12/min
Tidal volume: 5-8 cc/kg
FiO2 100% (1.0) and ween down
PEEP 0-5 mmH20
Hs and Ts
T
Tension pneumothorax
Tamponade – Cardiac
Toxins
Thrombosis (pulmonary embolus)
Thrombosis (myocardial infarction)
Management of open pneumothorax (“sucking chest wound”)
Cover with occlusive dressing on 3 of 4 sides
Watch for tension pneumothorax
Place chest tube at separate site
