Getting Started

Question 1

What are the steps in preparing the OR for anaesthesia?

Answer 1

• Anesthesia machine and equipment
• Medications
• Intravenous access
• Monitoring procedures
• General anaesthesia induction

Question 2

When preparing for the OR, what do we need to check for with the anesthesia machine and equipment?

Answer 2

STATICS
o Suction
o Tube (ETT)
o Airway (OPA or NPA)
o Tape (for securing ETT)
o Introducer (stylet)
o Circuit (anesthesia machine) or BMV
o Scope (laryngoscope)

Question 3

For the medications step in preparing the OR for anaesthesia, what do we have to do before we administer the medications?

Answer 3

o Before administering medication, confirm patient identity and any known allergies

Question 4

When preparing medications during OR prep, what is the procedure?

Answer 4

 Label syringe first, placing the sticker at the volume to be drawn; if dilution is to occur,
write the final concentration on the sticker
 Read the label on the vial before and after drawing the drug

Question 5

For intravenous access in prepping for the OR, what equipment do we need?

Answer 5

 Disposable gloves, tourniquet, alcohol swab, IV cannula (most commonly 20G), IV
tubing, sterile occlusive dressing, tape, gauze

Question 6

What are the clinical pearls for IV access?

Answer 6

 Tighten the tourniquet enough to restrict venous drainage but maintain arterial flow
 When possible, place the tourniquet above the joint where you wish to place the IV
 For difficult access, replace the tourniquet with a BP cuff inflated to 60mmHg
 Put your gloves on after applying the tourniquet
 Wipe the alcohol swab distally; proximally will empty the vein

Question 7

How do we prepare an IV infusion for intravenous access?

Answer 7

 Hang the IV bag on the IV pole
 Close roller clamp on IV tubing and remove seal on spike without touching the spike
 Insert spike into the IV bag and squeeze the drip chamber until it is half full
 Open roller clamp to flush air out of the IV tubing

Question 8

What are the monitoring procedures that we need to place when prepping for OR anaesthesia?

Answer 8

o BP cuff placed on arm opposite of intravenous access
o Pulse oximeter on arm with intravenous access
o ECG leads (White is right; smoke over fire)

Question 9

What is the procedure for general anesthesia induction for prepping in the OR?

Answer 9

o Prior to induction, ensure the APL valve is fully open
o Loss of consciousness is verified by apnea, loss of response to
verbal commands, and loss of the eyelash reflex
o Ensure O2 flow rate is > 6 L/min before applying the facemask, then adjust the APL valve to 20
cmH2O (pressures > 20 cmH2O risk gastric insufflation with N/V and aspiration)
o Should the reservoir bag become distended, either lift the mask from the patient’s face or open
the APL valve slightly

Question 10

For general anesthesia induction, what do we have to ensure prior to induction?

Answer 10

o Prior to induction, ensure the APL valve is fully open

Question 11

For general anesthesia induction, how is loss of consciousness verified?

Answer 11

Loss of consciousness is verified by apnea, loss of response to
verbal commands, and loss of the eyelash reflex

Question 12

For general anesthesia induction, what do we have to ensure the O2 flow rate is before applying the facemask, and then what do we adjust?

Answer 12

Ensure O2 flow rate is > 6 L/min before applying the facemask, then adjust the APL valve to 20
cmH2O (pressures > 20 cmH2O risk gastric insufflation with N/V and aspiration)

Question 13

For general anesthesia induction, what should we do if the reservoir bag becomes distended?

Answer 13

Should the reservoir bag become distended, either lift the mask from the patient’s face or open
the APL valve slightly