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APA/Foundations 1 > Induction for Sim Lab > Flashcards

Induction for Sim Lab Flashcards

1
Q

When are we allowed to give premeds?

A

AFTER the consents are signed!

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2
Q

What is the dose of Versed?

A

0.5-5 mg IV

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3
Q

What is the concentration of Versed?

A

1 mg/mL

Total vial= 2 mg/2mL

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4
Q

What is the dose of Fentanyl (combo)?

A

1-2 mcg/kg IV

Say, “I am going to give 1 mcg/kg and my patient is 100 kg, so 100 mcg of fentanyl.”

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5
Q

What is the concentration of Fentanyl?

A

50 mcg/mL
Total vial= 100 mcg/ 2mL

or 250 mcg/5 mL

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6
Q

What is the dose of Lidocaine

A

1-2 mg/kg IV
use higher because helps propofol burn and circumoral numbness
NOT for patient with seizure hx because lowers threshold

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7
Q

What is the concentration of Lidocaine

A

20 mg/ml

Total vial= 100mg/5mL

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8
Q

What is the dose of Propofol?

A

1-3 mg/kg average
depends on patient* (small for old/unhealthy, high for neonate- high metabolism)
higher for LMA

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9
Q

What is the concentration of Propofol?

A

10 mg/mL

Total vial= 200mg/ 20mL

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10
Q

What do you do after giving propofol?

A

Check for responses to see if sedated: lash, talk (hearing last to go), touch face
-now know okay to ventilate patient

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11
Q

What do you do if ventilating and not moving air?

A

1) readjust mask
2) turn head
3) place oral airway with tongue blade

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12
Q

What do you do if not moving air after placing an oral airway?

A

2 hand masking with CRNA

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13
Q

What is the dose of Rocuronium?

Onset, DOA?

A

0.6 mg/kg for normal induction paralyze cords
1.2 mg/kg for RSI
non-depolarizing neuromuscular blocker
Onset 60-90 seconds
DOA: 20-35 minutes
know you can mask ventilate them before giving Roc

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14
Q

What it the concentration of Rocuronium?

A

10 mg/mL

Total vial= 50 mg/ 5 mL

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15
Q

What do you do after intubating?

A
  • inflate cuff
  • attach circuit
  • bag and look for chest rise, mist in tube
  • look for EtCO2
  • listen
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16
Q

In what order are monitors applied?

A

1) Pulse ox
2) BP cuff + cycle!
3) EKG leads
then pre-oxygenate!

17
Q

What is the dose for succinylcholine?

Onset, DOA?

A

1-2mg/kg
short-acting depolarizing neuromuscular blocking agent
Onset 30-60 seconds
DOA 3-5 min

18
Q

What it the concentration of succinylcholine?

A

20 mg/mL

200 mg/ 10 mL

19
Q

Maintenance dosing for Vecuronium

A 
Intermediate-acting NDNMB
If goal= 0/4 twitches and have..
4 twitches= give 4 mg
3 twitches= give 3 mg
2 twiches= give 2 mg
1 twitch= give 1 mg
20
Q

What is the concentration of zofran?

A

4 mg/ 2mL

21
Q

What is the intubating dose of fentanyl?

A

5-10 mcg/kg, up to 100 mcg/kg

22
Q

Prior to intubation of a cardiac pt, what should be noted on ECG?

A

leads II and V

ST segment

23
Q

What is special about sufantanil?

A

5-10x more potent that fentanyl

24
Q

What is special about remifantanil?

A

different metabolism by esterases => shortest 1/2 life (DOA 9-20 min)
Synergistic with propofol

25
Q

What can cause rebound hyperalgesia?

Treatment?

A

Remifentanil because quick 1/2 life- pt needs addition pain meds for post op.
Rebound hyperalgesia tx with
1) Magnesium sulfate and
2) Ketamine

26
Q

What is Etomidate/ dosing?

A

0.2-0.3 mg/kg

GABA-A agonist

27
Q

Pro/Cons of etomidate?

A

Pro: hemodynamic stability
Cons: Highest rate of PONV!!
Adrenocortical suppression=> ↓ corticosteroids=> extreme refractory hypotension (esp with pts on chronic steroid)

28
Q

What is ketamine/dosing?

Causes a _____ anesthesia.

A

Ketamine= non-competitive NMDA receptor antagonist that causes a DISSOCIATIVE anesthesia.
Induction: 2 mg/kg
Combo: 0.1-0.5 mg/kg (0.5!)

29
Q

What kinds of patients would you NOT want to use ketamine as the sole induction agent/why?

A

Not for HTN or CHF because it acts as an indirect sympathomimetic by causing release of catecholamines and ↑ HR/inotropy = ↑ myocardial O2 consumption

↑ ICP pt, because ↑ BP will ↑ ICP

30
Q

What is precedex/dosing?

A

Precedex- alpha 2 agonist=> ↓ sympathetic outflow by negative feedback (false NE)
Induction dosing:
1 mcg/kg over 10 minutes loading dose, then 0.2-1.5 mcg/kg/hr

31
Q

Vecuronium dosing?

A

intermediate-acting NMBA
0.1 mg/kg
Onset: 3-5 minutes
DOA: 20-35 minutes

32
Q

What are the MC short, intermediate, and long acting NMBAs?

A

Short: succinylcholine
Intermediate: Roc, vec, cisatricurium
Long: pancuronium

APA/Foundations 1 (9 decks)

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