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A2025 anaesthetics > anaesthetics equipment > Flashcards

anaesthetics equipment Flashcards

1
Q

What is mean arterial pressure?

A

The average arterial pressure throughout one cardiac cycle.

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2
Q

What is the target mean arterial pressure for adult anaesthetised patients?

A

≥65 mmHg.

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3
Q

What is capnography?

A

Capnography is a graphical representation of the expired carbon dioxide concentration.

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4
Q

What does ETCO2 stand for?

A

ETCO2 stands for end-tidal carbon dioxide.

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5
Q

What does ETCO2 measure?

A

ETCO2 measures the partial pressure of CO2 detected at the end of expiration.

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6
Q

What is the normal range for ETCO2 in mmHg?

A

The normal range for ETCO2 is between 35 - 45 mmHg.

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7
Q

What is systolic pressure variation (SPV)?

A

The difference between the maximum and minimum values of systolic blood pressure following a single positive-pressure breath.

SPV is used to assess hemodynamic status in patients.

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8
Q

What is pulse pressure variation (PPV)?

A

The difference between the maximal and minimal pulse pressures during the respiratory cycle divided by the mean of these two values.

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9
Q

What does a PPV >10% indicate?

A

The patient is likely to be fluid-responsive.

This is particularly relevant in anaesthetised patients.

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10
Q

What is the relationship between SPV, PPV, and fluid responsiveness?

A

SPV and PPV can be viewed as predictors of fluid responsiveness in anaesthetised patients.

Monitoring these parameters helps guide fluid management.

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11
Q

What does NMT stand for?

A

Neuromuscular Transmission monitoring

NMT is crucial for assessing muscle paralysis levels when neuromuscular blocking agents are used.

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12
Q

What is the purpose of NMT?

A

To evaluate the level of neuromuscular block

It is particularly important when neuromuscular blocking agents are administered.

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13
Q

How does NMT work?

A

By stimulating a peripheral nerve and evaluating muscle response

Typically, the ulnar nerve in the hand is stimulated.

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14
Q

What is the common colloquial term for NMT?

A

The twitcher

This term refers to the device used for monitoring.

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15
Q

What is the most common mode of NMT?

A

Train of four (TOF)

This mode delivers 4 consecutive supramaximal stimuli at 0.5-second intervals.

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16
Q

What does TOFC stand for?

A

Train of four count

It represents the number of detected responses or muscular twitches to stimuli.

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17
Q

What is the range of TOFC?

A

0 - 4

A TOFC of 0 means no detected twitches, while a TOFC of 4 means 4 detected twitches.

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18
Q

What does a TOFC of 1 indicate?

A

> 95% of receptors blocked

This reflects a significant level of neuromuscular blockade.

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19
Q

What does a TOFC of 4 indicate?

A

70-75% of receptors blocked

This shows a mild level of neuromuscular blockade.

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20
Q

What does TOF% stand for?

A

Train of four ratio

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21
Q

How is the train of four ratio (TOF%) calculated?

A

By dividing the amplitude of the fourth muscle twitch by the amplitude of the first muscle twitch

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22
Q

What TOF% value indicates ongoing residual neuromuscular block?

A

TOF% <90%

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23
Q

What is required if TOF% is less than 90%?

A

The use of a reversal agent

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24
Q

Name two reversal agents that can be used prior to extubation.

A
  • Neostigmine
  • Sugammadex
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25
What is the definition of Minimum alveolar concentration (MAC)?
The concentration of inhaled anaesthetic (at 1 atm) required to suppress movement to a surgical stimulus in 50% of the patients.
26
How is MAC related to the potency of an anaesthetic agent?
MAC is inversely related to the potency of an anaesthetic agent; higher potency means lower MAC and vice versa.
27
What is the practical intraoperative target for MAC during surgery?
The intraoperative target is to maintain the MAC ≥ 0.7 during the surgery.
28
True or False: A higher MAC indicates a more potent anaesthetic agent.
False
29
What is the significance of MAC in anesthesia?
MAC is used as a measure to guide administration of inhaled anaesthetic agents to balance preventing awareness and avoiding excessive administration.
30
Fill in the blank: The MAC is used to suppress movement to a surgical stimulus in _____ of the patients.
50%
31
List some factors that can affect MAC.
* Age * Temperature * Other drugs * Disease states
32
What is the aim of pre-oxygenation?
To increase the ‘safe apnoea time’ by providing supplemental oxygen to raise oxygen reserves ## Footnote This allows for a longer duration before desaturation occurs once the patient becomes apnoeic.
33
What process occurs during pre-oxygenation?
Denitrogenation of the lungs ## Footnote This involves washing out nitrogen from the lungs with oxygen, increasing alveolar oxygen levels.
34
What is the composition of room air?
79% nitrogen and 21% oxygen
35
How much oxygen is present in the lungs of an average adult breathing room air?
Approximately 450ml
36
What is the oxygen level in the lungs after pre-oxygenation with 100% oxygen?
Approximately 3000ml
37
How does adequate pre-oxygenation affect blood oxygen content?
It ensures the haemoglobin is fully saturated
38
How is the adequacy of pre-oxygenation determined?
By end-tidal oxygen monitoring (ETO2)
39
What ETO2 value indicates optimal pre-oxygenation?
90%
40
What is the purpose of Hudson masks?
To deliver approximately 30-40% of oxygen at flow rates of around 5-10L/min. ## Footnote Hudson masks are simple face masks used in various medical settings.
41
When are Hudson masks typically used in anaesthesia?
To provide supplemental oxygen to a patient post extubation. ## Footnote These masks are important for patient recovery after procedures requiring intubation.
42
What happens to Hudson masks once a patient is transferred to recovery?
They are usually removed once the patient becomes more awake and maintains appropriate oxygen saturation at room air. ## Footnote This indicates a transition from assisted oxygen to self-sustained breathing.
43
Fill in the blank: Hudson masks deliver oxygen at flow rates of around _____ to _____ L/min.
5 to 10 ## Footnote This range is crucial for ensuring adequate oxygen delivery during recovery.
44
What are laryngeal mask airways (LMA)?
Supraglottic devices used to maintain the airway in surgical cases requiring general anaesthesia.
45
How are LMAs inserted?
Inserted blindly through the mouth into the hypopharynx above the glottic opening.
46
Name three benefits of using LMAs.
* Avoidance of muscle relaxants * Reduced overall anaesthetic requirements *Improved haemodynamic stability.
47
What limits the ability of LMAs to protect the lungs from aspiration?
LMAs are considered less secure as they lack an inflated cuff, which limits their ability to adequately protect the lungs from aspiration (e.g. of gastric contents, blood and oral secretions)
48
List three risks associated with LMAs.
* Laryngospasm * Trauma to the airway * Compression of nerves (e.g. lingual nerve, hypoglossal nerve, recurrent laryngeal nerve)
49
In what situations are LMAs particularly used?
When a patient is well fasted, otherwise well, and not predicted to have a difficult airway or in shorter duration surgical cases.
50
What is the basic form of a laryngoscope?
A retraction device with a handle and a blade containing a light source ## Footnote Used to elevate the tongue and other soft tissues to gain a view of the vocal cords.
51
What is the most common laryngoscope used in adult anaesthesia?
Macintosh laryngoscope ## Footnote It is widely preferred in clinical settings.
52
What is the design purpose of the Macintosh laryngoscope blade?
To help easily sweep the tongue during laryngoscopy ## Footnote Features a curved blade and large flange.
53
How does the Macintosh blade lift the epiglottis?
By being advanced into the vallecula, indirectly lifting the epiglottis ## Footnote This is achieved through the engagement of the hyoepiglottic ligament.
54
What type of blade is the Miller laryngoscope?
Straight blade ## Footnote Designed to lift the epiglottis directly during laryngoscopy.
55
In what cases is the Miller laryngoscope particularly useful?
When the epiglottis is either large, floppy, or irregularly shaped ## Footnote This is vital for effective visualization during intubation.
56
Why is the Miller laryngoscope widely utilized in pediatric anaesthesia?
Due to the anatomy of the mouth and tongue in children with a large epiglottis ## Footnote It provides better access and visualization.
57
What is a distinguishing feature of the McCoy laryngoscope blade?
Adjustable hinged tip at its distal end ## Footnote This feature allows for elevation of the vallecula and epiglottis.
58
How does the McCoy blade assist in intubation?
By flexing the tip when pressing down on the handle ## Footnote This helps to elevate structures for better visibility.
59
In which patient population is the McCoy blade particularly useful?
Patients with limited neck extension ## Footnote Examples include patients wearing C-spine collars.
60
What is the main feature of the C-MAC video-laryngoscope?
It has a camera and a light source at the tip of the laryngoscope blade displayed via an attached TFT video monitor.
61
How does video-laryngoscopy differ from direct laryngoscopy?
Video-laryngoscopy enables indirect laryngoscopy, allowing intubation by looking at the monitor display rather than directly visualising the airway.
62
What remains the goal standard for laryngoscopy?
Direct laryngoscopy.
63
In what scenarios is indirect laryngoscopy particularly useful?
In difficult intubation cases where it may improve glottic visualisation and likelihood of successful intubation.
64
Can video-laryngoscopes be used for direct laryngoscopy?
Yes, by ignoring the video output and using the blade for direct line of sight.
65
What is the Murphy’s eye in relation to ETTs?
An opening along the lateral aspect of the ETT that acts as a safeguard against complete occlusion ## Footnote It allows ventilation to occur if the end of the ETT becomes obstructed by the tracheal wall or blocked by mucus or other respiratory secretions.
66
What is the primary function of the Murphy’s eye?
To allow ventilation in the event of complete occlusion of the ETT ## Footnote This is crucial when the ETT is obstructed by the tracheal wall or respiratory secretions.
67
What are Magill forceps used for?
To remove foreign bodies from the upper airway, place pharyngeal packs, aid with nasal intubation, or placement of nasogastric tubes. ## Footnote Magill forceps are specifically designed for use in medical procedures involving the airway.
68
the vocal cords
69
how do you confirm the ETT is in place
The correct positioning of the ETT is confirmed by observing the misting of the ETT, observing rise and fall of the chest bilaterally +/- auscultation of the chest and most importantly confirming that the capnography (ETCO2) trace is present.

A2025 anaesthetics (16 decks)

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