Anaesthesiology Flashcards
Difficult intubation BONES
beard, obesity, no teeth, elderly, sleep apnea
Mallampati
full view uvula
body and base uvula
base uvula
hard palate only
ASA class
1 = healthy 2 = controlled systemic illness 3 = disable activity illness 4 = incapacitating illness threat to life 5 = death in 24 hr without surgery
Advantage of ETT 5P’s
patent, protect (aspiration), positive pressure, pulmonary toilet, pharmacological admin
Spinal insertion route encounters layers
skin, subcu fat, spuraspinous lig, interspinous lig, ligamentum flavum, dura, arachnoid
Fluid loss a day
200 ml GI
800 ml insensible
1500 ml urine
Maintenance fluid
4:2:1, Na > 3 mEq/kg/day; K > 1 mEq/kg/day
Na K Ca Cl HCO3 in Ringer’s lactate
130 4 3 109 28
Na in NS
154
Lidocaine toxicity presentation
Tongue numb Lighthead Sensory abnormal Muscle twitch Unconscious Convulsion Cardioresp arrest
Tx Malignant hyperthermia
O2
Dantrolene
Bicarb
Cool
Propofol
Hypnotic iv induction
Contra = egg/soy allergy, hypotension
Thiopental
Hypnotic iv induction
Contra = hypotension, liver disease, heart failure
Ketamine
Hypnotic iv induction
use in trauma, hypovolemia
Volatile inhalation agents in increasing MAC
Halothane, isoflurane, sevoflurane, desflurane, N2O
Duration of succinylcholine
30s onset, 10 min duration; clear by plasma cholinesterase
Rocuronium duration
1.5 min onset, 45 min duration, liver clear, also renal
Reversal agents for non-depolarizing relaxants
Edrophonium, neostigmine, pyridostigmine
given with atropine or glycopyrrolate
Codeine
Tylenol 1, 2, 3
10:1 morphine
Oxycodone
Oxycontin
1.5:1 morphine
Hydromorphone
Dilaudid
1:5 morphine
Meperidine
Demerol
10:1 morphine
Fentanyl
Sublimaze
iv only
1:100 morphine
Levorphanol
Levodromoran
1:5 morphine
Midazolam
Versed
conscious sedation
Chlorprocaine
Max 11, 14epi, 30 min duration
Lidocaine
Max 5, 7epi, 2 hr duration
Bupivicaine
Max 2.5, 3epi, 8 hr duration
Ropivacaine
Max 2.5, 3epi, 8 hr duration