IV sedation

Question 1

What is the minimal number of available personnel that should be around when doing sedation?

Answer 1

-Three

the operator, the assistant, and the monitor

Question 2

The doctor must be certified how when doing sedation?

Answer 2

-ACLS

Question 3

What happens to the airway when doing minimal sedation?

Answer 3

-It is unaffected

Question 4

In spontaneous ventilation what occurs in minimal sedation?

Answer 4

-It is unaffected

Question 5

What occurs with cardiovascular function in minimal sedation?

Answer 5

-It is unaffected

Question 6

What type of responsiveness is seen in minimal sedation?

Answer 6

-Normal response to verbal stimulation

Question 7

What is the responsiveness in moderate sedation?

Answer 7

-Purposeful response to verbal or tactile stimulation

Question 8

What happens to the airway in moderate sedation?

Answer 8

-No intervention required

Question 9

What type of spontaneous ventilation do you get in moderate sedation?

Answer 9

-Adequate

Question 10

What occurs with cardiovascular function in moderate sedation?

Answer 10

-Usually maintained

Question 11

What occurs with cardiovascular function in deep sedation?

Answer 11

-Usually maintained

Question 12

What occurs with cardiovascular function in general anesthesia?

Answer 12

-May be impaired

Question 13

What type of spontaneous ventilation do you get in deep sedation?

Answer 13

-May be inadequate

Question 14

What type of spontaneous ventilation do you get in general anesthesia?

Answer 14

-Frequently inadequate

Question 15

In deep sedation what might you need to do with the airway?

Answer 15

-You may need intervention

Question 16

In general anesthesia what might you need to do with the airway?

Answer 16

-Intervention is often required

Question 17

What is the responsiveness of someone under deep sedation?

Answer 17

-Purposeful response following repeated or painful stimulation

Question 18

What is the responsiveness of someone under general anesthesia?

Answer 18

-Unarousable even with painful stimulus

Question 19

What may accentuate hemodynamic/respiratory depression caused by sedatives and analgesics?

Answer 19

-Cardiopulmonary disease

Question 20

If a person has cardiopulmonary disease what might that require?

Answer 20

-decreased drug dosages and EKG monitoring

Question 21

What increases airway irritability and risk of bronchospasm during sedation?

Answer 21

-Tobacco use

Question 22

What classification system is used to asses airways?

Answer 22

-Mallampati

Question 23

If a person is a Mallampati Class I what do you see?

Answer 23

• Soft palate
• Uvula
• Pillars visible

Question 24

What can you see in a Mallampati Class II?

Answer 24

• Soft Palate

- Uvula

Question 25

What can you see in a Mallampati Class III?

Answer 25

- Soft palate | - Base of uvula

Question 26

What can you see in a mallampati Class IV?

Answer 26

-Soft palate not visible at all

Question 27

What thyromental distance is a nonreassuring finding during airway PE?

Answer 27

-less than 3 ordinary finger breadths

Question 28

How long should you not eat before being sedated?

Answer 28

- 8 hours if fried fatty foods/ meat | - 6 hours if a light meal

Question 29

What things are required when monitoring the pt under sedation?

Answer 29

- Pulse oximeter - Sphygmomanometer - EKG - Capnography

Question 30

What is normal ETCO2?

Answer 30

35-45mmHg

Question 31

What are medications used for sedation?

Answer 31

- Opioids - Benzodiazepine - Barbiturates - Propofol - Ketamine - Reversal agents

Question 32

What do opioids provide?

Answer 32

- Analgesia | - Sedation

Question 33

Where can opioids acccumulate?

Answer 33

-Reservoirs of fate potentially producing long lasting effects

Question 34

Morphine is how many times more potent than meperidine?

Answer 34

-10 x

Question 35

Morphine is how many time less potent than hydromorphone?

Answer 35

-10 x

Question 36

Morphine is how many times less potent than fentanyl?

Answer 36

-100x

Question 37

What is the average dose of Fentanyl?

Answer 37

50-100 mcg

Question 38

What is the duration of Fentanyl?

Answer 38

-.5 to 1 hour

Question 39

What are the effects of benzodiazepines?

Answer 39

- Amnesia - Anticonvulsant - Anxiolytic - Behavioral disinhibition - Muscle relaxant

Question 40

What might cause thrombophlebitis?

Answer 40

- Diazepam | - Lorazepam

Question 41

What is likely to produce apnea?

Answer 41

-Midazolam

Question 42

What drug carries an increased risk of progression to deep sedation?

Answer 42

-Propofol

Question 43

What does propofol do?

Answer 43

- Sedation - Amnesia - NO analgesia

Question 44

What is a dissociative anesthetic?

Answer 44

-Ketamine NMDA antagonist

Question 45

What is ketamine a derivative of?

Answer 45

-Phencyclidine

Question 46

T/F Ketamine is a potent pain reliever.

Answer 46

True

Question 47

What might ketamine cause?

Answer 47

- Nystagmus - Vocalizations - Myoclonus

Question 48

What is an opioid antagonist which binds to CNS opioid receptors to displace opioid agonists?

Answer 48

-Naloxone

Question 49

What is a reversal agents that binds to GABA receptors in the CNS to reverse effects of benzodiasepines

Answer 49

-Flumazenil

Question 50

What dose of flumazenil do you need to give to reverse benzodiazepines?

Answer 50

-.1 and .2 mg

Question 51

What dose of Naloxone do you need to give to reverse opioids?

Answer 51

-.02 to .04 mg

Question 52

What sedatives have no reversal agents?

Answer 52

- Propofol | - Ketamine