Conduct Flashcards
phases of anaethetic
Pre-operative assessment and planning
Preparation
Induction
Maintenance
Emergence
Recovery
Post-operative Care
standardized WHO sign in
Correct patient
Correct procedure
Correct (and marked) site
Consent
Association of Anaesthetists minimum standard monitoring
ECG
02 sats
NI bp monitoring
end tidal CO2
airway pressure monitoring
what is the net step after completing monitoring
IV access and pre oxygenate
why do we preoxygenate
Increase time to desaturate
Reduced Functional Residual Capacity under anaesthesia
induction of anaesthesia forms
analgesic combined with hypnotic + or minus muscle relaxant
analgesic drug examples
Fentanyl
Alfentanil
hypnotic drug examples
Propofol
Thiopentone
Ketamine
planes of anaesthesia
1: Analgesia and amnesia
2: Delirium to unconsciousness
3: Surgical anaesthesia
4: Apnoea to death
how is a patients airway managed
Loss of airway reflexes
Relaxation of tissues
Open aiway:
triple airway manoeuvre and 02 mask
Oropharyngeal airway
“Guedel”
Laryngeal Mask Airway (LMA)
Endotracheal Tube (ETT) via laryngoscope
what are reasons to intubate
Protection from aspiration
Need for muscle relaxation
Shared airway
Need for tight C02 control
Minimal access to patient
options for patient breathing
Spontaneous ventilation
Controlled ventilation
Supported ventilation
how should circulation be controlled by an anaesthetist
Control of haemodynamics
BP at least every 5 minutes
Vasoactive drugs
Risks of anaesthesia
Anaphylaxis
Regurgitation and aspiration
Airway obstruction and hypoxia
Laryngospasm
Cardiovascular instability
Rarely, cardiac arrest
awareness under anaesthesia
monitored through EEG monitor
eye injuries under anaesthetic
corneal abrasion most common
eye taping during surgery as preventative measure
hypothermia
temperature management during surgery - air warmers, warmer theatre, covered up everywhere other than vital site
particularly abdomindal surgery
pressure injury
anaesthetist must check
gel pads, cables,
venous thromboembolism
use intraoperative VTE prophalyxis
TED stockings
massage boots
nerve injury
ulnar nerve and perineal nerve at risk of damage
positioning of patient important
supine
prone
deckchair
maintenance phase
Vapour (“gas”)
Intravenous anaesthesia (TIVA)
Constant adjustment
Anticipation (blood loss/fluid shifts/major events)
Key moments in surgery
additional roles of anaesthetist
Analgesia
Anti-emesis
Documentation
Communication
Advocacy
analgesia criteria
Long-acting
Multi-modal
Intravenous vs local vs regional
anti-emetics criteria
Multi-modal
Pharmacological vs non-pharmacological
Risk assessed
