Crises Flashcards
1
Q
VF/VT
A
- call for help
- compressions 100/min
- shock
- epi 1 mg IV q 3-5 min
2
Q
PEA/asystole
A
- call for help
- compressions 100/min
- epi 1 mg IV q 3-5 min
3
Q
Cardiac arrest
reversible causes
A
5H / 5T Mg 1-2g IV over 3 min CaCl 10% - 5 mL IV NaHCO3 Amiodarone 300 mg IV
4
Q
PALS
A
- commonly d/t hypoxia or vagal stim
- epi 10 mcg/kg IV/IO
- defib with 4 J / kg
5
Q
Intraoperative MI
A
- 100% O2
- control HR (60-80)
- if inc BP -> B-blockers
- if dec BP -> volume, RBC
- consider inotrope, PCI, NTG infusion
coronary perfusion = DBP - LVEDP
6
Q
Massive hemorrhage
A
- 100% O2
- warm fluids, pt, and room
- call for blood
- rapid infuser, cell saver
- call hematology
- consider tranexamic acid, Calcium, FFP, cryo (fibrinogen), F-VIIa, platelets
7
Q
Anaphylaxis
A
S/S: dec BP, hypoxia, bronchospasm - rash, urticaria, angioedema, erythema ABC, IV, O2, monitors - stop triggers: NMB, Abx, latex, colloid - elevate legs - epi 1 mcg/kg IV (or 0.5 mg IM) (if CV collapse ->10 mcg/kg) - consider aminophylline, hydrocortisone
8
Q
hemolytic transfusion rxn
A
S/S: urticaria, wheeze, edema, dark urine STOP the blood - maintain u/o w/ diuretics - treat coagulopathy - ICU admission
9
Q
air embolism
A
S/S: dec SpO2, dec ETCO2, dec BP
- “mill wheel murmur”, pulm edema
- Talk to surgeon
- flood the operative field
- 100% O2, avoid N2O
- head down, lateral position
- consider PEEP, CVC aspir’n, hyperbaric O2
10
Q
difficult BMV
A
- optimize positioning, oral airway
- wake pt if possible
- attempt LMA x 2
- succ & attempt to intubate
11
Q
Difficult intubation
A
- BMV if possible, if not: (CICV)
- optimize laryngeal view: positioning, BURP, Glidescope
- attempt intubation x 2-3
- attempt LMA x 2
- can’t intubate can’t ventilate (CICV)
- > cannula or surgical cricothyrotomy
12
Q
Laryngospasm
A
S/S:
- 100% O2
- CPAP w/ jaw thrust
- deepen anesthesia
- succ + CPAP
- intubate if low SpO2
- atropine for bradycardia
13
Q
High airway pressure
A
1) Manual vent to confirm high pressure
2) Check tube/circuit
3) Deepen anesthesia
- Muscle relaxation
4) Chest exam
5) Replace LMA with ETT
DDx: laryngospasm, bronchospasm, hemo/pneumothorax, edema
14
Q
Bronchospasm
A
- manual ventil’n
- deepen anesth
- 100% O2
- ETT: salbutamol, ipratropium
- IV: Ventolin, epinephrine
- vent settings: long exp phase, low PEEP
& intermittent circuit disconnect - consider Mg, cortisol, aminophylline
15
Q
ETT medications
NAVEL-2
A
2 - double IV dose for ETT Naloxone Atropine Ventolin / Valium Epinephrine Lidocaine