Common Procedures in Anesthesia

Question 1

What is featured on the Classical Triangle of Gen Anesthesia?

Answer 1

Analgesia: Narc, Inh, NSAIDS, NO
Muscle Relaxation: Succinyl, curare
Amnesia: Benzos, Barbs, Propofol, Inhal, Nitrous

Question 2

What are the types of anesthesia?

Answer 2

General
Regional
Monitored

Question 3

What is the Mallampati Classification?

Answer 3

Class 1: Soft Palate, uvula, fauces, pillars visible. Not Hard
Class 2
Class 3: Soft Palate , base of uvula visible
Class 4: Hard palate only visible. Severe Difficulty

Question 4

What is the Thyromental Distance?

Answer 4

Distance from lower border of mandible to the thyroid notch with neck fully extended

Question 5

What neck circumference will mean Inc Difficulty of intubation?

Answer 5

> 18 in

Question 6

What mouth traits will cause a harder intubation?

Answer 6

Macroglossia, Prominent or loose dentition

Question 7

What are the different types of Intubation Blades

Answer 7

Miller: Straight
Macintosh: Curved

Question 8

How can you avoid chipping teeth while intubating?

Answer 8

Avoid tilting wrist

Pull the direction the handle is pointing

Question 9

What is a glidescope?

Answer 9

A Blade with video assist to increase the ease of intubation.

Question 10

What is the sniffer’s position?

Answer 10

Flex neck all the way forward, then extend head.

Pharyngeal, Laryngeal, and oral axis are all lined up

Question 11

WHat are the 5 things to look for to confirm successful Intubation?

Answer 11

1. Chest Rise
2. Steam in Tube
3. Bilateral Breath Sounds
4. Sustained ETCO2 Wave **
5. Pulse Ox Stays above 92%

Question 12

What is the average depth of intubation in males and females?

Answer 12

M: 24cm
F: 20-22cm at the teeth

Question 13

How is placement of tube confirmed?

Answer 13

X-ray

Question 14

What are the Indications for epidural anesthesia?

Answer 14

Surgical procedures on the lower extremities
OB patients in Active labor of C-section
Post-op pain in abdominal and vascular surgery in lower ext

Question 15

What are the Absolute and Relative Contraindications to Epidural?

Answer 15

Abs: Pt Refusal
Local Infection
Sepsis
Coagulopathy
Raised ICP
Rel: Hypovolemia
CNS dis
Loc infection periph to site
Chronic Back pain

Question 16

What is barbitage?

Answer 16

Back pressure on the plunger when in a ligament and not in the Epidural space yet.

Question 17

What causes a spinal/Post-dural puncture Headache?

Answer 17

Leaked CSF
150ccs normally
Circulated 3x per day
Caused by CSF leking faster than it’s being replaced.
(inject some blood into the area and the hole will heal up. Blood Patch)

Question 18

How can onset of Epidural be sped up?

Answer 18

Go down catheter with a spinal needle and inject a few ccs of Med. Onset 5 min. Lasts until Epidural Onset.

Question 19

What are the other names for Spinal Tap?

Answer 19

Saddle Block
Intra-Thecal block
Lumbar Punture
etc..

Question 20

What are the common sites for central venous line?

Answer 20

Right jugular 
Left Subclavian (less of a sharp angle)

Question 21

What are the Landmarksfor finding the internal jugular vein?

Answer 21

Between the 2 branches of the SCM. Aim straight at the Ipsilateral nipple

Question 22

How is Central line insertion into the Left subclavian done?

Answer 22

Needle paralel to the sternal notch

Question 23

What are the complications of Central line insertion?

Answer 23

infection 
Dysrhythmias
Carotid or subclavian artery puncture
Pneumothorax
Pericrdial Tamponade
Hydrothorax
Air Embolus

Question 24

WHy don’t we do Jugular vein puncture on the left side?

Answer 24

Don’t want to damage the thoracic lymphatic duct