Conduct of anaesthesia Flashcards
5 minimum standards of equipment
ECG - for arrhythmia that acan occur under GA
- oxygen saturations
Non-invasive blood pressure
- BP often drops as agents are vasodilators
End Tidal C02
- around of co2 in the gas patient blows out, can show co2 in blood and patency of patients airway
Airway Pressure Monitoring
what is end tidal co2
small plastic tube attached to breathing circuit which is used to give oxygen to the patient
almost every patient will need what before they under go GA?
IV access - cannula
why do you give more oxygen?
100% oxygen - for a couple of minutes
- Increase time to desaturation
- Reduced Functional Residual Capacity under anaesthesia
- total volume of lungs reduces
induction - when may you use gaseous?
- children
- takes longer
with an IV induction - what drugs are given (2 classes)
Analgesic
Hypnotic
muscle relaxant
examples of analgesic? (2)
short acting opiates
Fentanyl
Alfentanil
examples of hypnotics (3)
Propofol (white substance)
Thiopentone
Ketamine
Planes of Anaesthesia - number 1 (gaseous)
Analgesia and amnesia (relaxed)
Planes of Anaesthesia - number 2
Delirium to unconsciousness
- wriggly in children, upset
Planes of Anaesthesia - number 3
patient won’t respond to stimulus
Planes of Anaesthesia - number 4
Apnoea to death
Airway Management causes (2)
Loss of airway reflexes
Relaxation of soft tissues
what is the triple airway maneuver?
head tilt, jaw thrust and open mouth
Oropharyngeal airway (guedel's) are used to?
splint open the upper airway and draw the tongue forward
anatomical landmarks for guedels?
incisors and tragus muscle of ear
- angle of Jaw to level of incisors
4 steps for guedels?
invert insert rotate and locate
if a patient needs more definitive airway management or protection - what do you use?
Endotracheal Tube (ETT)
Reasons to Intubate (5)
- Protection from aspiration
- Need for muscle relaxation
- Shared airway
- Need for tight C02 control
- Minimal access to patient
how can a patient breathe under an anaesthetic? (3)
Spontaneous ventilation - by themselves
Controlled ventilation - patient paralysed- take over breathing
Supported ventilation
Circulation - Control of haemodynamics - what must be done every 5 mins?
blood pressure
drugs used In circulation
Vasoactive drugs - tighten blood vessels
Risks of induction? (6)
- Anaphylaxis
- Regurgitation and aspiration (fasting)
- Airway obstruction and hypoxia
- Laryngospasm - vocal chords constricting
- Cardiovascular instability
- Rarely, cardiac arrest
other risks of GA? (6)
- awareness - patients may recall periods of being in theatre
- eye injury - cornea dries out from lack of blinking
- hypothermia - increase bleeding and pain etc - will naturally drop core temperature
- pressure injuries - patients don’t move
VTE - depends on operation and patient factors - TED stockings
Nerve injury - ulnar and common perineal
