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Anesthesia- Antiarrythmics > Basics Module 1 > Flashcards

Basics Module 1 Flashcards

1
Q

What is the number 1 cause of morbidity & mortality?

A

Airway Events

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2
Q

In a patient that has been put to sleep is now a difficult airway, what medication can you give to wake the patient?

A

Epi

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3
Q

What group of patients have less pliable lungs?

A

Old & Obese

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4
Q

In the aging process, the airway becomes?

A

Less pliable, mobile, & flexible

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5
Q

It becomes an airway emergency when you are unable to

A

Ventilate

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6
Q

How much water is needed to get chest rise?

A

20-25cm of water

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7
Q

A BMIn greater than____will cause a leak

A

50

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8
Q

What happens to the vocal cords when the patient is given a paralytic?

A

Vocal cords relax

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9
Q

Characteristics of a child’s epiglottis?

A

Shorter, stiffer, & white

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10
Q

What connects the nasal & oral cavities?

A

The pharynx connects the nasal & oral cavities to the larynx & esophagus

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11
Q

Name order of pharynx from head to toe

A

Naso, Oro, & Hypo

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12
Q

What is the job of the larynx?

A

Prevent aspiration

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13
Q

The larynx is also called the…

A

Voicebox, located in the neck

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14
Q

Name the innervation of the airway from head to toe

A

Trigeminal, Glossopharyngeal, Vagus

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15
Q

The superior laryngeal nerve (internal) is…

A

Sensory

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16
Q

The superior laryngeal nerve (external) is…

A

Motor

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17
Q

The recurrent laryngeal nerve controls what?

A

Vocal Cords

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18
Q

BMI greater than____can cause airway difficulty

A

30

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19
Q

What is prognathic?

A

Extension/bulging of lower jaw

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20
Q

What is retrognathic?

A

Growth deficiency

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21
Q

The ULBT assesses what?

A

Mobility of mandible

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22
Q

A TMD_____is a cause of concern

A

Less than 6

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23
Q

The 3-3-2 rules assesses what?

A

Mouth opening, tip of mentum to hyoid bone, &TMD

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24
Q

What 2 things should you not use with an LMA?

A

Aspiration risk & no MAC

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25
Q

How long does it take Roc to work?

A

3-5 min

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26
Q

Pressure control should be ____ to mask ventilate

A

Less than 20

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27
Q

Standard size oral airway for male & female?

A

M=6
F=5

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28
Q

What is the end tidal oxygen goal with pre-oxygenation?

A

Above 90%
8 breaths, 60 sec each
3 min of breathing 100% oxygen

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29
Q

Positioning aligns what?

A

The oral, pharyngeal & laryngeal axes (ramped up)

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30
Q

With repositioning, the ear should be level with the…

A

Sternal Notch

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31
Q

The sniffing position involves…

A

Flexing the neck and extending the head

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32
Q

A supraglottic Airway (SGA), is also known as…

A

An LMA

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33
Q

With placement of a SGA, where does the tip of the cuff sit?

A

The upper esophageal sphincter

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34
Q

How are the SGA sized?

A

By weight

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35
Q

What are the adult sizes for SGAs?

A

3,4, & 5

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36
Q

What are the PED size SGAs?

A

0, 1,2, & 2.5

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37
Q

What amount of pressure will seal a SGA?

A

A pressure less than 20cm of H2O

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38
Q

What body weight should be used when sizing a SGA?

A

Ideal body weight

39
Q

SGAs are good for…

A

Reactive Airway
Less Stimulating
Smoother wakeup
Less coughing
Less trauma
Does not require paralysis

40
Q

SGAs do not protect against…

A

Aspiration

41
Q

What are LMA complications?

A

Sore Throat
Bronchospasm
Edema
Nerve Injury
Tongue numbness
Aspiration risk

42
Q

What is the most common method of intubation?

A

Direct Laryngoscopy (DL)

43
Q

The table height should be where?

A

At your xiphoid

44
Q

Using the Cormack & Lehane classification, a grade 1 view means…

A

Full view of the glottis

45
Q

RAEs tubes are used when?

A

For eye & face cases (this type of tube is bent in half)

46
Q

The Murphys eye is only seen in…

A

Adult population

47
Q

Reinforced tubes…

A

Do not kink

48
Q

When should you perform a rapid sequence induction?

A

Patient is vomiting, has uncontrolled GERD, or has a full stomach

49
Q

Do you ventilated during RSI?

A

NOO

50
Q

Is the glidescope good in PEDs population?

A

NOO

51
Q

When is the VL useful?

A

Routinely
Difficult airway
Improves first attempt
In patients w/ limited ROM
Can be further away from patient

52
Q

When using a glidescope for adults & children, should you sweep the tongue?

A

NOO

53
Q

Which blade should you use in VL?

A

D blade

54
Q

Do you need the 3 patient alignment when using a VL?

A

NOO

55
Q

Can you jet ventilate through the Cook Exchange?

A

YES

56
Q

How do you check placement of the Cook Exchange?

A

Perform a laryngoscopy during procedure

57
Q

When should an awake fiberoptic be used?

A

If there is an unstable spine
Difficult airway

58
Q

Fiberoptic allows for__________ and_______

A

Preservation of muscle tone & airway reflexes

59
Q

What is easier? Nasal or Oral fiberoptic?

A

Nasal, but caution with bleeding risk of oral passage

60
Q

What can be used to prep the nasal passage of a patient getting ready for a fiberoptic?

A

Give Oxymetazoline (Affrini)
Glyco for secretions

61
Q

What is the maximum dose of lidocaine?

A

7mg/kg

62
Q

What 2 blocks can be performed to initiate intubation?

A

Superior Laryngeal Block (bilaterally)
Transtracheal Block

63
Q

What are 4 types of invasive Airways?

A

Trach
Crico
Retrograde
Transtracheal Jet Ventilation

64
Q

When is it appropriate to extubate?

A

Spontaneous breathing
Stability
Norm acid/base balance
NMB is reversed
Extubating off 100% FIO2

65
Q

When is deep extubation performed?

A

During Stage 3

66
Q

What are the benefits of extubating during stage 3?

A

Less coughing
Fewer hemodynamic changes
Avoids bleeding, increased ICP/IOP

67
Q

When should you not deep extubate?

A

Morbid obese
Difficult Mask
Risk of Aspiration
Airway edema
OSA
Restricted access to the airway

68
Q

Laryngoscopy can be…

A

Stimulating

69
Q

What is the most common cause of death iin securing the airway?

A

Aspirationo

70
Q

If you suspect an esophageal intubation, you can check…

A

BBS & ETCO2

71
Q

Airway complication are mostly related to…

A

Bronchospasm, Laryngospasm, and Pulmonary Edema

72
Q

What causes subglottic stenosis?

A

High cuff pressure

73
Q

How can you treat pulmonary edema?

A

Sit the patient up and give 100%

74
Q

How can you tell a laryngospasm is happening?

A

Rigid ABD
Trying to take a breath

75
Q

Who is more prone to laryngospasms?

A

Infants & children (they go in and out of stage II frequently)

76
Q

How can you treat laryngospams?

A

Positive Pressure
Paralyze
Supportive Care
Mask/Oral airway
May give versed if partially awake

77
Q

In PEDs, what is the narrowest part of the airway?

A

Cricoid Cartilage

78
Q

What are the characteristics of a child’s airway anatomy?

A

More Anterior
Large Tongue
Epiglottis is large & omega shaped
Stiff or floppy
Larger head
Usually have more loose teeth

79
Q

Do PEDs have a higher metabolic rate?

A

YES

80
Q

What is the oral dosage of versed for a PED patient?

A

0.5-1mg/kg (20mg max)

81
Q

In PEDs, what dose of Ketamine can you give IM?

A

3mg/kg & add glyco or versed

82
Q

What medication can you give intranasally to Peds?

A

Precedex

83
Q

What do Peds usually get for induction?

A

Mask induction with N2O & Sevo

84
Q

How do you calculate ETT size?

A

(Age/4) + 4

OR

(Age+16)/4

85
Q

Which ETT is preferred in Peds?

A

Microcuff (there is no Murphy’s eye)

86
Q

Microcuffs have…

A

Low volume & low pressure cuff

87
Q

When extubating in the Peds population, they are at a higher risk for…

A

Stridor

88
Q

How is stridor treated?

A

Humidified Oxygen
Steroids
Racemic Epi

89
Q

You can give Sux or Atropine IV to help treat a laryngospasm. What is the dose?

A

Sux 1.5-2mg/kg
Atropine 0.02mg/kg
IM

90
Q

In Peds, if you have an IV, how can you treat a laryngospasm?

A

Deepen with Propofol

91
Q

What difficult airway devices are available for Peds?

A

look up

92
Q

Depth of

A

Ett??

93
Q

Note Calculations

A

…

94
Q

To prevent gag reflex, which nerve must be blocked?

A

Superior Laryngeal Nerve Internal branch

Anesthesia- Antiarrythmics (4 decks)

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