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Introduction to Anesthesia > Choice of Anesthesia > Flashcards

Choice of Anesthesia Flashcards

1
Q

Stage 2

A

Excitement or delerium phase

  • Uncontrolled movements
  • Pupillary dialation
  • Irregular respirations, HR
  • Breath holding
  • Vomiting
  • Delerium
  • Stimulation
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2
Q

Types of regional anesthesia (3)

A

Spinal, epidural, caudal

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3
Q

Preoxygenation?

A
  • 100% O2 10L/min flow

- 3 min or 8VC/min

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4
Q

Four types of anesthesia?

A
  1. General
  2. Regional
  3. Monitored anesthesia care (MAC)
  4. Peripheral
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5
Q

CPAP

A

Continuous Positive Airway Pressure (CPAP)

  • Decreased functional residual capacity
  • Mask held tightly 5-25 cmH20 for 3 min
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6
Q

Stage 4

A

Overdose or bulbar paralysis

  • Impending death
  • Dialated and nonreactive pupils
  • Hypotension
  • Bradycardia
  • Cardiac arrest
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7
Q

Epidural space

A

Potential space between Ligamentum flavum and dura

  • Widest at L2 (5-6mm)
  • Narrowest at C5 (1-1.2mm)
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8
Q

Quicker onset, spinal or epidural?

A

Spinal (5-10sec) compared to epidural (15-20min)

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9
Q

Indications for ETT intubation

A
  1. Need of positive airway pressure
  2. Protection from aspiration
  3. Head or neck procedures or in non-supine procedures
  4. Neuromuscular paralysis
  5. Surgery involving cranium, thorax, or abdomen
  6. “Presence of trachea??”
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10
Q

Spinal/epidural contraindications

A
  • Hypovolemia
  • Increased intracranial pressure
  • Coagulopathy (thrombocytopenia)
  • Sepsis
  • Infection at the cutaneous puncture site
  • Pre-existing neurological disease (Multiple sclerosis?)
  • PATIENT REFUSAL
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11
Q

(MAC) Ramsay Scale

A
  1. Anxious, agitated, restless
  2. Cooperative, oriented and tranquil
  3. Drowsy, but responds to commands
  4. Asleep, brisk response to stimuli
  5. Asleep, sluggish response to stimuli
  6. Asleep, no response
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12
Q

Anesthesia check for all types

A
  1. Anesthesia machine check
  2. Ensure breathing system is functional, attach a properly sized facemask
  3. Check CO2 absorbent for color change
  4. Liquid level of vaporizers
  5. Proper functioning of mechanical ventilator
  6. Suction working and available
  7. Final position of all flowmeters, vaporizers, and monitors
  8. Monitors (blood pressure, pulse ox, ECG, capnography, temperature)
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13
Q

90% of cases are?

A

Balanced anesthesia, combination of IV and inhalation techniques

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14
Q

Three most important factors?

A
  1. Type of surgical procedure
  2. Patients coexisting disease
  3. Patient preferences
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15
Q

Why do a RSI?

A
  • Prevention of aspiration
  • Anyone not NPO, trauma victims, unknown NPO, longstanding diabetics, pregnant patients after 9-12 weeks, GERD, morbidly obese patients
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16
Q

Stage 3

A

Surgical or operative phase

17
Q

Two types of induction?

A
  1. Mask induction (usually pediatric patients)

2. IV induction (faster 10-20 seconds)

18
Q

How to do an RSI?

A
  • Pre-oxygenate
  • Induction agent/Narcotics
  • Succinylcholine (60sec)
  • Hold cricoid pressure and don’t let go until proof of intubation unless you want to get showered and compromise the airway
19
Q

Drug check for all types

A

-Local anesthetic, induction drug, opioid, benzos, anticholinergics, sympathomimetic, succinylcholine, nondepolarizing muscle relaxant, anticholinesterase, catecholamines, anti-hypertensives

20
Q

Once a patient cannot protect their airway, what type of anesthesia are they in?

A

General

21
Q

Equipment check for all types

A

-IV solution and connective tubing, IV catheter, suction catheter, OAW/NAW, LMA, ETT/laryngoscope

22
Q

How to confirm proper placement of the ETT?

A
  1. > 20mmHg during exhalation at peak
  2. Upper chest expansion
  3. Emptying of reservoir bag during inspiration
  4. Bilateral breaths
  5. > 95% O2 saturation after 2 min
  6. Humidity in tube
23
Q

Stage 1

A

Analgesia or induction phase

  • Conscious
  • Voluntary movements
  • Sense of reality
  • Increased sense of hearing

Introduction to Anesthesia (15 decks)

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