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MSA S2015 > 460: Laryngoscope, Intubation, Extubation > Flashcards

460: Laryngoscope, Intubation, Extubation Flashcards

1
Q

Criteria for Extubation (9 Considerations)

A
  1. Adequate oxygenation
  2. Adequate ventilation
  3. Hemodynamically stable
  4. Full reversal of muscle relaxation
  5. Neurologically intact
  6. Appropriate acid-base status
  7. Normal metabolic status
  8. Normothermic
  9. Other considerations
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2
Q

Adequate Oxygenation

Criteria for Extubation

A

SpO2 > 92%

PaO2 > 60mmHg

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3
Q

Adequate Ventilation

Criteria for Extubation

A

VT > 5mL/kg
Spontaneous RR > 5bpm
etCO2

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4
Q

Hemodynamically stable

Criteria for Extubation

A

Proper blood circulation

Within -/+20% of baseline

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5
Q

Full Reversal of Muscle Relaxation

Criteria for Extubation

A

Sustained tetany
TOF ratio > 0.9 (4 twitches)
Sustain 5 second head lift or hand grip

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6
Q

Neurologically Intact

Criteria for Extubation

A

Responds to commands

Intact gag and cough relex

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7
Q

Normal Acid-Base Status

Criteria for Extubation

A

pH > 7.25

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8
Q

Normal Metabolic Status

Criteria for Extubation

A

Normal electrocytes

Normovolemic

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9
Q

Normothermic

Criteria for Extubation

A

temp > 35.5 degrees C

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10
Q

Other considerations

Criteria for Extubation

A
  1. Aspiration risk
  2. Airway edema
  3. Deep (i.e. NOT phase II) or awake extubation
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11
Q

Stage 1

Stages of Anesthesia

A

Sedated
Intact lid reflex
Can follow commands

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12
Q

Stage 2

Stages of Anesthesia

A

Excited/disinhibited
Unconscious
Unable to follow commands/unable to exhibit purposeful movement
Irregular breathing/breath holding
Dilated/disconjugate pupils, conjunctival injection (blood shot eyes)
Increased incidence of laryngospasm, arrhymthia, vomiting

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13
Q

Stage 3

Stages of Anesthesia

A

Surgical anesthesia

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14
Q

Stage 4

Stages of Anesthesia

A

Medullary depression

Cardiovascular/ respiratory collapse

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15
Q

Halothane

1 MAC Equivalent

A

0.75%

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16
Q

Isofluorine

1 MAC Equivalent

A

1.15%

17
Q

Enfluorine

1 MAC Equivalent

A

1.6%

18
Q

Sevofluorane

1 MAC Equivalent

A

2.1% (1.8%)

19
Q

Desfluorane

1 MAC Equivalent

A

6.0%

20
Q

Nitrous Oxide

1 MAC Equivalent

A

105%

21
Q

ED 95

MAC Effectiveness

A

Prevents 95% of patients from moving during surgical stimulus
1.2-1.3 MAC

22
Q

MAC-Awake

MAC Effectiveness

A

0.15-0.5 MAC

23
Q

MAC-Recall

MAC Effectiveness

A

Patient cannot recall/ amnesia

0.4-0.5 MAC

24
Q

MAC-Bar

MAC Effectiveness

A

Dangerous!!

1.5 MAC

MSA S2015 (7 decks)

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