Common Anesthetic Procedures Flashcards
What are the muscle relaxation meds?
Succinylcholine
Curare-like
What are the analgesic meds?
Nacros
NSAIDs
Nitrogenous
Inhalation agents
What are the drugs that are used in amnesia?
Benzodiazepines Barbiturates Propofol Inhalation Nitrous
What is the most important bit to anesthesia?
Maintain physiology
What are the three indications for putting in an endotracheal tube?
- Patent airway
- Control airway if paralysis
- Improve ventilation/oxygen
What are mallampati classes? (1-4/)
1= tonsillar pillars, soft palate, and uvula are visible 2 = Uvula at base of tongue 3= Only soft palate visible 4 = Only base of tongue and hard palate visible
What are the oral findings that may complicate intubation?
Macroglossia
Loose or prominent dentition
What is the thyromental distance?
3 fingers from lower border of mandible to thyroid
Greater than what diameter of the neck may indicate difficult intubation?
18 in
Why do you oxygenate pts prior to intubation?
Denitrogenation
What are laryngeal mask airways? What is the issue with these?
There is nothing to stop regurgitation
What is the miller blade that is used for intubation?
Straight blades
What is the MacIntosh blade?
Curved blades for intubation
What is a glidescope?
Camera with a laryngoscope
What is the position of the head and neck when intubating?
Neck flexed, head extended
Laryngoscope is placed in the mouth how?
Directed toward the right tonsillar pillar and base of the tongue
What are the five things you look for when intubating someone?
- Chest rise
- Steam in the tube
- Bilateral breath sounds
- Sustained tidal ETCO2
- PO2 stays above 92%
What are the indications for an epidural?
Surgical procedures
C sections
Cath placement
What are the absolute contraindications to epidurals? (5)
Patient refusal Localized infection Sepsis Coagulopathy Raised IC pressure
Why are anticoagulants a contraindication to epidural?
Can cause epidural hematoma
Why is hypovolemia a relative contraindication to epidurals?
Will cause lower BP
What is the needle used for epidurals?
Touhy needle
How do you tell when you’re in the right space for an epidural?
Loss of resistance once past the ligamentum flavum
Why is there epi in the sample dose of an epidural?
Will cause tachycardia, and indicate if you’re in an artery/vein. (could cause arrhythmias if inject lidocaine)
Intrathecal blocks are also called what?
Spinal blocks
What are the contraindications (5) for intrathecal blocks?
Same as for epidurals
Between what vertebrae do you do a spinal tap?
L3/L4
What spinal level does the spinal cord end?
L2/3
Headache with movement after an LP indicates what?
Hole in the thecal sac, causing a loss of CSF
Why are smaller needles used for intrathecal injections?
Lower risk for headaches
What happens if a pt jumps with an intrathecal injection?
Move back–you’re in the cauda equina
What are the indications for a central line?
Measure right sided heart filling pressure
Drug/fluids
If you have to remove an air emboli in the right atrium, what type of line will you use?
Central line
What are the common sites of central lines?
Right IJV
Left subclavian
How can you find the IJV?
Between the SCM heads
Where is the carotid relative to the IJV?
Just medial
How should you aim your needle with inserting a needle into the IJV?
Aim at the ipsilateral nipple
What are the guide wires used for?
How is the needle inserted in the subclavian vein?
At the outer 1/3 of the clavicle inferiorly, and directed towards the sternal notch
What is the complication of guide wires in the heart with central lines?
Arrhythmias
Pericardial tamponade
Why is the pt placed in the trendelenburg position with central line placement?
reduces risk of air embolism
What are the indications for arterial lines?
Monitor beat to beat blood pressure
BG draws
When are femoral art lines indicated?
WHen peripheral arteries are vasoconstricted secondary to meds
What are the complications with arterial lines? (4)
Infection
Hematoma
Loss of circulation
Nerve damage
