1.4. Anaesthesia - Conduct of Anaesthesia Flashcards
What are Anaethetists responsible for?
- Pre-Op Assessment and Care
- Critical Care / Intensive Care
- Pain Management
- Anaesthesia
- Post-Operative Care
What is the Process of Anaesthesia?
- Pre-Operative Assessment
- Preparation
- Induction
- Maintenance
- Emergence
- Recovery
- Post-Operative Care and Pain Management
How is General Anaesthesia induced? And what Agents are used?
- Gas Agent - Sevoflurane (Halothane)
- I.V. Agent - Propofol / Thiopentone / Other
Note - This is often done in a separate room
What are the Features of IV Induction of Anaesthesia?
- Rapid - One “Arm-Brain” Circulation = 20s
- No obvious planes
- Easy to Overdose
- Generally Rapid Loss of Airway Reflexes
- Apnoea is very common
What are the Features of Gas Induction of Anaesthesia?
- Common in Young Children
- Slow
- Considerably more obvious “planes” of Anaesthesia
What are the Planes of Anaesthesia?
- Analgesia
- Sedation
- Excitation
- Anaesthesia - Light - Deep
- Overdose
How is Conscious Level monitored, in a patient under General Anaesthetic?
- Loss of Verbal Contact
- Movement
- Respiratory Pattern
- Processed EEG
How is the Airway Maintained in General Anaesthesia?
- Simple Manoeuvre
- Triple Airway Manoeuvre: Head Tilt / Chin Lift / Jaw Thrust
- Simple Apparatus - Face mask / Oropharyngeal Airway / Nasopharyngeal Airway
When can an Oropharyngeal Airway be used?
Unconscious Patients
Does a Laryngeal Mask Airway protect the Airway?
No
What are some Airway Complications?
- Obstruction - Ineffective Triple Airway Manoevre / Airway Device Complication / Laryngospasm
- Aspiration - Anaesthesia causign loss of Protective Ariway Reflexes / Foreign Body
What are the features of Endotracheal Intubation?
- Placement of a Cuffed Tube in the Trachea
2. Laryngeal Reflexes must be abolished
Why might Intubation occur?
- Protect the airway from Gastric Contents
- Need for Muscle Relaxation / Artificial Ventilation
- Shared Airway risk of Blood Contamination
- Need for Tight Control of Blood Gases
- Restricted Access to Airway
What are the main risks of an Unconscious Patient?
- Airway
- Temperature
- Loss of other Protective Reflexes
- Venous Thromboembolism
- Consent and Identification
- Pressure Areas
What are the main categories of Anaesthetic Complications?
- Airway
- Breathing
- Circulation
- Related to Technique or Position
- Awareness
