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Specialties > Anaesthetics > Flashcards

Anaesthetics Flashcards

1
Q

Levels of care

A
  1. Primary care
  2. Ward based
  3. HDU
  4. ICU
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2
Q

Who is HDU for

A

Single organ support

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3
Q

Who is ICU for

A

Those with requiring multi-organ support

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4
Q

Describe Type I Resp. failure

A

Low O2

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5
Q

Describe Type II Resp. failure

A

Decreased O2 AND increased CO2

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6
Q

What is a very sensitive marker of a deteriorating patient

A

RR

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7
Q

Potential Rx for oxygenation problems

A

Give O2
High flow nasal cannula CPAP
Intubation and invasive ventilation
ECMO (very severe)

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8
Q

Steps in preparation of anaesthetics

A 
Planing 
Right patient 
Right operation 
Right or left side 
Pre-medication 
Right equipment 
Right personnel 
Drugs drawn up 
IV access 
Monitoring
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9
Q

What type of noise environment is crucial in anaesthetic induction

A

Quitness

In the UK often separate dedicated anaesthetic room

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10
Q

What IV agents are used in induction of anaesthetic

A

Propofol

Thiopentone

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11
Q

Are propofol and thiopentone rapid or slow

A

Rapid

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12
Q

Things to note about Propofol and Thiopentone

A

Easy to overdose
Generally rapid loss of airway reflexes
Apnoea common

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13
Q

Which agent is used in gas induction

A

Sevoflurane (Halothane)

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14
Q

Who is gas induction more common in

A

Children

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15
Q

Is gas induction slow or rapid

A

Slower than IV

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16
Q

How do you monitor conscious level during induction

A

Loss of verbal contact
Movement
Respiratory pattern (v. diff. in anaesthetised patient compared to conscious patient)
Processed EEG

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17
Q

What does the Triple Airway Manoeuvre consist of

A

Head tilt
Chin lift
Jaw thrust

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18
Q

Which medical devices can be used to aid airway maintenance

A

Face mask
Laryngeal Mask Airway
ETT

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19
Q

What is a laryngeal mask airway

A

More advanced management
Cuffed tube with mask sitting over glottis
Maintains but DOES NOT protect the airway

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20
Q

Describe a maintained airway

A

An airway which is open and unobstructed

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21
Q

What protects the airway from contamination

A

Cuffed tube in the trachea

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22
Q

Name 2 airway complications of anaesthesia

A

Obstruction

Aspiration

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23
Q

What can cause airway obstruction

A

Ineffective triple airway manoeuvre
Airway device malposition or kinking
Laryngospasm

24
Q

Risks to the unconscious patient

A 
Airway
Temperature 
Loss of other protective reflexes (e.g corneal, joint position)
Venous thromboembolism 
Consent and identification 
Pressure areas (wounds)
25
Q

What is the most common route for putting intubating

A

Oral

26
Q

Triad of anaesthesia

A

Hypnosis
Relaxation
Analgesia

27
Q

Definition general anaesthetic

A

Produces insensibility in the whole body, usually causing unconsciousness.
Using centrally acting drugs

28
Q

Definition local anaesthetic

A

Producing insensibility in only relevant part of the body

Applied directly to the tissue

29
Q

What is a necessary component of GA

A

Hypnosis

30
Q

What does TCI stand for

A

Target Controlled infusion

31
Q

Which calculations and assumptions does TCI use about the patient

A

Age
Sex
Size

32
Q

Definition regional anaesthetic

A

Producing insensibility in an area of region of the body
Applied to nerve supplying relevant area
Site distal to will be anaesthetised

33
Q

What type of anaesthetic is an epidural

A

Regional

34
Q

Why does modern practice use balance anaesthesia (i.e not a single agent)

A

Allows great degree of control over the individual components of the triad
Allows different drugs to achieve each of the targets
Titrate doses separately and therefore more accurately to requirements
Avoid overdosage
Enormous flexibility

35
Q

What is the major problem with muscle relaxation

A

Requirement for artificial ventilation

36
Q

Physiology of GA on respiratory system

A

All anaesthetic agents are respiratory depressants

Reduce hypoxic and hypercarbic drive

Decreased tidal volume & increase rate

Paralyse cilia

Decrease FRC
Decrease lung volumes
VQ mismatch

37
Q

Which pre-op assessment would be given to someone with COPD

A

ETT (exercise tolerance test)

38
Q

Describe ASA1

A

Otherwise healthy patient

39
Q

Describe ASA2

A

Mild to moderate systemic disturbance

40
Q

Describe ASA3

A

Severe systemic disturbance

41
Q

Describe ASA4

A

Life threatening disease

42
Q

Describe ASA5

A

Moribund patient

43
Q

Describe ASA6

A

Organ retrieval

44
Q

What does the ASA grading system assess

A

the fitness of a patient before surgery

45
Q

What does the Cardiac Risk Index assess

A

The patients risk of perioperative cardiac complications

46
Q

What are the 6 components of the cardiac risk index

A 
High risk surgery 
Hx ischaemic heart disease
Hx congestive HF 
Hx Cerebrovascular disease
Diabetic 
Renal failure
47
Q

Cardio Pre-op Ix

A 
ECG 
ETT 
ECHO 
Myocardial perfusion scan 
Stress ECHO 
Cardiac catheterisation 
CT coronary angiogram
48
Q

Resp. Pre-op Ix

A 
Sats
ABG
CXR
Peak flow 
FVC/FEV
Gas transfer
CT chest
49
Q

Which are the exception drugs which may get change pre-op

A

Anti-diabetic

Anticoagulants

50
Q

Which drugs will especially stay the same pre-op

A

Inhalers
Anti-anginals
Anti-epileptics

51
Q

What does ETT measure

A

Activities the person can do without getting breathless

52
Q

Which organ systems are depressed in GA

A

CNS
Cardiac
Respiratory

53
Q

Which maintenance agents are used

A

IV infusion Profolol

54
Q

Describe emergence

A

Waking the patient up

55
Q

Steps in emergence

A

100% O2
Stop infusion
Remove ETT when awake/start breathing again

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