Crises Flashcards

1
Q

VF/VT

A
  • call for help
  • compressions 100/min
  • shock
  • epi 1 mg IV q 3-5 min
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2
Q

PEA/asystole

A
  • call for help
  • compressions 100/min
  • epi 1 mg IV q 3-5 min
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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
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4
Q

PALS

A
  • commonly d/t hypoxia or vagal stim
  • epi 10 mcg/kg IV/IO
  • defib with 4 J / kg
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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
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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
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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
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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
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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
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10
Q

difficult BMV

A
  • optimize positioning, oral airway
  • wake pt if possible
  • attempt LMA x 2
  • succ & attempt to intubate
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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
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12
Q

Laryngospasm

A

S/S:

  • 100% O2
  • CPAP w/ jaw thrust
  • deepen anesthesia
  • succ + CPAP
  • intubate if low SpO2
  • atropine for bradycardia
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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

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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
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15
Q

ETT medications

NAVEL-2

A
2 - double IV dose for ETT
Naloxone
Atropine
Ventolin / Valium
Epinephrine
Lidocaine
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16
Q

Aspiration

A
  • Position: head down & lateral
  • Remove airway, suction pharynx
  • ETT -> bronch & suction
  • 100% O2
  • NG tube to suction
  • ICU admission
17
Q

Total spinal

A
  • 100% O2
  • elevate legs, IV fluid
  • vasopressors
  • atropine for bradycardia
  • deliver baby after 4 min
18
Q

PPH

post-partum hemorrhage

A
  • 100% O2
  • large-bore IV x 2
  • uterine massage, oxytocin
  • cross-match, O neg blood
  • Hemabate 250 mg IM
  • ergot 0.2 mg IM
  • misoprostol 200 mcg PO/PR
19
Q

Local anesth toxicity

A
  • STOP drug
  • ABC, IV, O2, monitors
  • amiodarone for VF/VT
  • intralipid 20% bolus 100 mL IV
    then infusion at 1000 mL / h
  • anticonvulsants
20
Q

hyperK+

A
  • hyperventilate
    1) Calcium chloride
    2) NaHCO3
    3) glucose
    4) insulin
    5) Ventolin
21
Q

Malignant hyperthermia

A
  • STOP volatiles, change soda lime
  • 100% O2 at 15L/min
  • IV dantrolene 2.5 mg/kg
  • maintain anesth w/ TIVA
  • cool patient (fluids, ice)