FINAL Flashcards
What % is nebulized anesthesia and for how long does it last?
where do you not want to administer it and where do you want to administer it?
4% lidocaine will last 15 min.
Do not administer in holding area, administer in the OR or on the table
What would ineffective ventilation with bag mask look like?
no sign of chest rise
no end tidal CO2
no mist in the clear mask
What would you place if ventilation is ineffective with Bag mask?
place an oral or nasal airway to relieve airway obstruction.
Difficult mask ventilation is often found in patients with? (3)
morbid obesity
beards
craniofacial deformities
Difficult airway - Lemon trial, what does LEMON stand for?
Look Evaluate Mallampati Obstruction Neck movement
What are you looking for with the L in LEMON?
facial trauma
large incisors
beard
large tongue
What does the Evaluate for E in lemon mean?
evaluate 3-3-2
interincisor distance 3 fingers
hyoidmental distance 3 fingers
thyroid to floor of mouth 2 fingers
PREPARATION is a must in what type of intubation?
Awake fiberoptic intubation.
What is a Cook retrograde intubation set and what is it used for?
used to assist the placement of an ETT during difficult or emergency airway access procedure.
use seldinger technique via the cricothyroid membrane, go in a cephalad direction (retrograde) with placement of J tipped guide wire exiting orally or nasally.
what is a rare but devastating complication following robotic surgery?
postoperative visual loss
What is a restriction with robotic surgery?
spatial restriction and inability to re position the patient after docking the robot.
cardiovascular increases with robotics?
MAP
CVP
Wedge Pressure
SVR
Unchanged cardiovascular with robotics?
HR
SV
mixed venous oxygen saturation
The most important goal in managing the hyperthyroid patient is to make the patient?
euthryroid before surgery, if possible
If a patient is hyperthyroid and having surgery, what medications should you avoid?
Pancuronium
it is also best to avoid ketamine for induction, even when the patient is clinically euthyroid.
What are complications after thyroidectomy?
RLN damage
Tracheal compression secondary to hematoma or tracheomalacia
hypoparathyroidism
What is normal total serum calcium concentration?
8.8 to 10.4 mg/dL
In general an increase or decrease in albumin by what is associated with a parallel change in total what by what amount?
increase or decrease in albumin by 1 g/dL is associated with a parallel change in total serum calcium of 0.8 mg/dL
What typically accompanies hyperparathyroidism (what is responsible for symptoms)?
hypercalcemia
what is the most common sign of hypercalcemia?
Nephrolithiasis is the most common manifestation, occurring in 60-70% of patients
What needs increased medication dose with hyperparathyroidism (due to the hypercalcemia)?
Vecuronium should be increased, and probably all NDMB, during onset of NMB.
duration of safe tourniquet inflation?
2 hours (this should just be for legs and arms should be an hour) if longer is needed you should be able to let up for 15 min (perfusion break). then restart the process to repeat exsanguination.
what three things can be expected with tourniquet deflation (which is generally well tolerated in a healthy patients.)
transient systemic metabolic acidosis
increased arterial carbon dioxide levels
drop in systemic blood pressure
The mechanical effects of peritoneal insufflation impair ventilation… why?
a) Insufflation of the peritoneum displaces the diaphragm in a cephalad direction,
b) decreases functional residual capacity and vital capacity
c) and in turn induces collapse of the dependent regions of the lungs.
