8. NORA Flashcards

1
Q

NORA deaths could be prevented by

A

substandard anesthesia care
preventable by improved monitoring

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2
Q

NORA deaths most common cause

A

respiratory events

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3
Q

NORA deaths most common case

A

MAC

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4
Q

each OR minute costs

A

36$

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5
Q

NORA limitations

A

room layout/size
equipment
environment
staff
radiation exposure
ASA status
ad hoc requests

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6
Q

ASA NORA minimum reqs

A
  1. O2 source
  2. O2 backup
  3. suction
  4. scavenging/WAGD/machine for VA
  5. ambu bag w/90% FiO2
  6. basic monitoring
  7. electrical outlets
  8. lights and battery-powered lumination
  9. sufficient space for access to patient
  10. code cart/defib
  11. staff trained to support anesthesia
  12. adequate PACU
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7
Q

ASA basic monitoring

A
  1. qualifier personnel in ROOM
  2. FiO2 measurements
  3. pulse Ox w/pitch tone
  4. capnography
  5. tidal volume measurements
  6. EKG
  7. BP q 5 m
  8. temp
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8
Q

ASA BP repetede every

A

5 mins

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9
Q

EGD/ERCP airway

A

ETT
(st lukes is a MAC)

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10
Q

EGD/ERCP complication

A

upper airway obstruction
loss of airway is common

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11
Q

EGD/ERCP position

A

prone/semi-prone

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12
Q

cath lab SE

A

HD changes
arrythmias

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13
Q

which anesthetic has better outcomes in TAVR pts

A

MAC

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14
Q

IVF anesthetic options

A

paracervical
epidrual
spinal
MAC
GA

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15
Q

MRI zone 1

A

general public

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16
Q

MRI zone 2

A

unscreened MRI pts

17
Q

MRI zone 3

A

screened MRI pts
personnel

18
Q

MRI zone 4

A

screened MRI pts
under constant direct supervision of trained MRI personnel

19
Q

what actions happen in zone 3

A

induction
extubation
code management

20
Q

what can cause contrast-induced nephropathy

A

iodinated contrast medium
- non ionized
- ionized

21
Q

prevention of contrast-induced nephropathy

A

adequate hydration
mx adequate UOP
sodium bicarb

22
Q

hypersensitivity: immediate

A

< 1 hr

23
Q

hypersensitivity: non-immediate

A

> 1 hr

24
Q

hypersensitivity is more common with

A

iodine

25
Q

hypersentivity can also occur with

A

gandolinium (MRI)

26
Q

which pts are at higher risk of hypersensitivity from gandolinium?

A

renal insufficiency

27
Q

pretreat mild/mod hypersensitivity

A

hydrocortisone
prednisone
diphenhydramine

28
Q

hydrocortisone pretreat

A

200 mg at 5 and 1 hr prior

29
Q

prednisone pretreat

A

50 mg
- 13 hr
- 7 hr
- 1 hr prior

30
Q

diphenhydramie pretreat

A

50 mg 1 hr prior

31
Q

mild hypersensitivity

A

urticaria
pruritus
nasal congestion
conjunctivitus

32
Q

treat mild hypersentivity

A

H1
antihistamine

33
Q

mod hypersensitivity

A

erythemia
edema w/o dyspnea
wheezing
bronchospasm

34
Q

sev hypersensitivity

A

edema w/dyspnea
hypotension
laryngeal edema
hypoxia
anaphylactic shock

35
Q

treat sev hypersensitivity

A

IM epi
0.01 mg/kg

MAX 500 mcg (0.5 mg)