8. NORA

Question 1

NORA deaths could be prevented by

Answer 1

substandard anesthesia care
preventable by improved monitoring

Question 2

NORA deaths most common cause

Answer 2

respiratory events

Question 3

NORA deaths most common case

Answer 3

MAC

Question 4

each OR minute costs

Answer 4

36$

Question 5

NORA limitations

Answer 5

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

Question 6

ASA NORA minimum reqs

Answer 6

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

Question 7

ASA basic monitoring

Answer 7

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

Question 8

ASA BP repetede every

Answer 8

5 mins

Question 9

EGD/ERCP airway

Answer 9

ETT
(st lukes is a MAC)

Question 10

EGD/ERCP complication

Answer 10

upper airway obstruction
loss of airway is common

Question 11

EGD/ERCP position

Answer 11

prone/semi-prone

Question 12

cath lab SE

Answer 12

HD changes
arrythmias

Question 13

which anesthetic has better outcomes in TAVR pts

Answer 13

MAC

Question 14

IVF anesthetic options

Answer 14

paracervical
epidrual
spinal
MAC
GA

Question 15

MRI zone 1

Answer 15

general public

Question 16

MRI zone 2

Answer 16

unscreened MRI pts

Question 17

MRI zone 3

Answer 17

screened MRI pts
personnel

Question 18

MRI zone 4

Answer 18

screened MRI pts
under constant direct supervision of trained MRI personnel

Question 19

what actions happen in zone 3

Answer 19

induction
extubation
code management

Question 20

what can cause contrast-induced nephropathy

Answer 20

iodinated contrast medium
- non ionized
- ionized

Question 21

prevention of contrast-induced nephropathy

Answer 21

adequate hydration
mx adequate UOP
sodium bicarb

Question 22

hypersensitivity: immediate

Answer 22

< 1 hr

Question 23

hypersensitivity: non-immediate

Answer 23

> 1 hr

Question 24

hypersensitivity is more common with

Answer 24

iodine

Question 25

hypersentivity can also occur with

Answer 25

gandolinium (MRI)

Question 26

which pts are at higher risk of hypersensitivity from gandolinium?

Answer 26

renal insufficiency

Question 27

pretreat mild/mod hypersensitivity

Answer 27

hydrocortisone prednisone diphenhydramine

Question 28

hydrocortisone pretreat

Answer 28

200 mg at 5 and 1 hr prior

Question 29

prednisone pretreat

Answer 29

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

Question 30

diphenhydramie pretreat

Answer 30

50 mg 1 hr prior

Question 31

mild hypersensitivity

Answer 31

urticaria pruritus nasal congestion conjunctivitus

Question 32

treat mild hypersentivity

Answer 32

H1 antihistamine

Question 33

mod hypersensitivity

Answer 33

erythemia edema w/o dyspnea wheezing bronchospasm

Question 34

sev hypersensitivity

Answer 34

edema w/dyspnea hypotension laryngeal edema hypoxia anaphylactic shock

Question 35

treat sev hypersensitivity

Answer 35

IM epi 0.01 mg/kg MAX 500 mcg (0.5 mg)