anaesthetics 1 Flashcards
consequences of untreated pain
increased BP
increased HR
perip MI nausea
inability to cough and clear secretions - pneumonia
inability to move around - DVT, pressure sores
WHO pain ladder
paracetoma
NSAIDs
IM opioids
PCA patient controlled analgesia when can’t give oral opiods
complications of opiods
nausea and vom
over sedation
hypotension
resp depression - late in spinal/epidural
resp depression if RR <10
RR< 8
v drowsy
oxygen 6L/min
Oxygen 6L/min and stop opiod
nagoxon 1ml every min till RR >10
peripheral nerve blockade lasts how long
12-48 hours
epidural infusion anaesthesia hypotension management
elevation of legs oxygen fluids stat if severe IV ephedrine 3-6mg if low pressure metaraminol 0.5mg if fast HR
Epidural infusion cx
resp Depression itch - low dose nagoxon or chlorppheramine urinary retention - catheter motor block inadequate analgesia
post op care
hypotension resp - low oxygen GI n/v CNA - delayed return of consciousness urinary - post op oliguria
hypovalaemic shock
loss of blood
plasma - burns
fluid - GI obstruction
cariogenic shock
post MI - pump failure severe arrhthmias PE tension pneumothorax cardiac tamponade
vasogenic shock
anaphylaxis
severe sepsis
neurogenic shock
high spinal cord transaction
vaso vagal attack - fainting
brain death common causes
head injury
intracranial team
cerberal hypoxia
brain death diagnosis
two senior doctors
two sets of tests
brain death clinical signs
no pupillary response to light absent corneal reflexes absent caloric reflexes no motor responses in the distribution of cranial nerves no cough or gag reflex
GA induction
IV propofel GABA agonist
muscle relaxant
recronium
to reverse - anticholinersterase neostigmine and atropine
endotracheal tube placement
end tidal co2
sats
chest moving
steam on mask
CO
SV times HR
BP
CO times SVR
MAP
DP and [ (SBP-DBP) / 3]
70-110 normla
min 60 to perfused heart kidneys and brian
pH is what
logarithmic scale
minimum urine output
0.5ml/kg/hour
bowel surgery is associated with what
third space fluid loss
normal dose of naloxone
40mcg increments titrated to effect and reassess patient
warfarin should be stopped how many days before surgery
5 days
poor control of blood glucose in the peri op period is assoc w what 3 things
increased risk of wound infection
increased cardiovascular complications
irreversible brain damage
anaphylaxis can cause
bronchoconstriction and airway obstruction
dose of adrenaline in cardiac arrest
1mg IV
how are morphines analgesic effects measures
mu opiod receptors - its an agonist for these receptors
lignocaine
blocks the activity of sodium channels
morphone causes
histamine release
epidural space contains
adipose tissue
venous plexus
spinal roots
respiratory depression and epidural
not commonly associated
bradycardia
atropine 500mcg
HDU patient - very ill how to measure BP
intra arterial
