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Anaesthetics > Conduct of GA and LA > Flashcards

Conduct of GA and LA Flashcards

1
Q

Example of 2 drugs used for IV induction

A

Propofol

Thiopentone

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2
Q

Roughly how long does one ‘arm-brain’ circuit take

A

20 seconds

Rapid loss of airway reflexes

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3
Q

Disadvantages of IV induction

A

Easy to overdose - slower circulation in older patients

Apnoea very common

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4
Q

Example of drug used for gas induction

A

Sevoflurane (Halothane)

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5
Q

Gas induction is most commonly used in which groups of patients?

A

Children

Adults with special needs

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6
Q

Rate of gas induction

A

Slow

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7
Q

Describe the planes/stages of anaesthesia

A

1- Analgesia/Sedation
2- Excitation/delirium
3- Anaesthesia Light to Deep
4- Overdose/Respiratory arrest

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8
Q

On which plane does surgery take place?

A

3- surgical anaesthesia

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9
Q

What signs/features are monitored when administering anaesthetic?

A 
Loss of verbal contact
Movement
Respiratory pattern
Processed EEG
Stages/Planes
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10
Q

Specifically monitored during induction?

A

 Quietness
 Gas/IV
 Monitor conscious level
 Airway maintenance

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11
Q

What happens to the airway in supine unconscious patients?

A

Obstructed

Loss of muscle tone- tongue will rest on pharyngeal wall

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12
Q

What is used to manage airway?

A

Simple manoeuvres
Triple Airway manoeuvre
Apparatus

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13
Q

Apparatus used for oropharyngeal airway?

A

Guedel

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14
Q

What occurs if guedel inserted in ‘light’ patient?

A

Vomiting or laryngospasm

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15
Q

Examples of supraglottic airway devices

A

Laryngeal mask

Igel - developed after

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16
Q

Benefit of Igel

A

Easy insertion

17
Q

Disadvantage of Igel

A

Doesn’t protect from aspiration

18
Q

Complications during induction

A

Obstruction

Aspiration

19
Q

Why might obstruction occur during induction?

A

Ineffective triple manoeuvre
Airway device malposition or kinking
Laryngospasm - airway stimulated in light patients

20
Q

In which group of patients is obstruction a more common complication?

A

Children - smaller airways

21
Q

What substances are commonly aspirated under GA?

A

Gastric contents
Blood
Surgical debris

22
Q

Indications to intubate

A

 Need muscle relaxation therefore artificial ventilation eg laparotomy
 Shared airway with risk of blood contamination eg tonsillectomy
 Tight control of blood gases – CO2 levels in neurosurgery
 Restricted access eg maxfax surgery

23
Q

What risks are known in the unconscious patient?

A 
Airway
Temperature
Loss of protective reflexes - corneal, joint position
VTE
Pressure Areas
Consent and Identification
24
Q

Basic monitoring during maintenance

A 
SpO2
ECG
Non-invasive Blood Pressure
FiO2
ET CO3
25
Q

Other features to monitor during maintenance

A 
Respiratory parameters
Agent
Temperature, Urine output, NMJ
Invasive venous/ Arterial monitoring
Processed EEG
Ventilator disconnection
26
Q

Complications - Maintenance

A

ABC
Techniques, positions
Dreaming
Awareness

27
Q

Risk factors for complications

A 
Paralysed and ventilated
Previous episode of awareness
Chronic CNS depressant use
Cardiac surgery
Major trauma
GA/C section
28
Q

Conduct of LA

Safety compared to GA?

A

Morbidity and mortality the same

29
Q

Key requirements during LA

A

IV access
Anaesthetist present
Monitoring

30
Q

Examples of LA procedures

A

Spinal
Epidural
Nerve block
Plexus block

31
Q

Where would patient undergo recovery if complications after anaesthetic?

A

Post Anaesthesia Care Unit

32
Q

Indications for Post Anaesthesia Care Unit admission

A

o Patient not regained consciousness or airway control
o Continuing responsibility of anaesthetist
o ABC Problems
o Pain control
o Post op nausea and vomiting
o Set criteria for discharge back to ward

Anaesthetics (3 decks)

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