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Chem / Physics II > Laser ppt > Flashcards

Laser ppt Flashcards

Josh's guide to lasers

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1
Q

What does LASER stand for

A 
Light 
Amplification
by
Stimulated
Emission 
of
Radiation
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2
Q

what is a device that controls the way energized atoms release photons

A

Laser

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3
Q

what are the 3 main properties of a laser that make if very different from other lights

A

monochromatic
coherent
directional

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4
Q

what property of a laser is that it contains one specific wavelength of light (one specific color).

A

monochromatic

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5
Q

the wavelength of light is determined by what?

A

the amount of energy released when the electron drops to a lower orbit

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6
Q

what property of a laser describes how it is organized- thus each photon moves in step with the others, this means that all the photons have wave fronts that launch in univision

A

coherent

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7
Q

which laser property is that a laser light has a very tight beam and is very strong and concentrated

A

directional

a flashlight in contrast releases light in many directions, the light is very weak and diffuse

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8
Q

Carbon dioxide laser properties (2)

A

invisible

marked with a helium-neon aiming beam

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9
Q

what is the Carbon dioxide laser used for

A

upper airway sx

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10
Q

is carbon dioxide laser common

A

yes,

very common

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11
Q

Nd-YAG laser stand for what?

A

neodymium-yttrium aluminum-garnet laser

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12
Q

Nd-YAG laser properties (1)

A

short wave length allows transmission by fiberoptics

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13
Q

Nd-YAG laser is used for what sx’s

A

distal tracheobronchial tree and retina sx

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14
Q

KTP laser stand for what?

A

Potassium-titanylphosphate laser

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15
Q

KTP laser can be transmited by what?

A

fiberoptics

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16
Q

KTP laser is used in what sx’s

A

neurosurgical and

otolarygeal

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17
Q

Argon Laser can be transmitted by what

A

fiberoptics

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18
Q

Argon laser is used in what sx’s

A

neurological, retinal, and otolaryngological

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19
Q

7 wavelengths in order of power (weakest to most powerful

A 
radio
microwave
infrared
visible
ultraviolet
x-ray
gamma ray
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20
Q

with laser wavelengths longer wavelengths= what?

A

lower freq and lower energy

all start with L

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21
Q

with laser wavelengths shorter wavelengths= what?

A

higher freq and higher energy

for jake sHorter= Higher and Higher) :

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22
Q

frequancy is inversly proprtional to what??

A

wavelength

the higher the frequency the smaller the wavelength

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23
Q

what has a higher freguency?
KTP Wave length is 532
or
Nd:YAG wave length 1064

A

KTP
remember
freq is inversly proportional to wave length
the longer the wavelength the lower freq

24
Q

which laser is for deep tissue? and why?

A

Nd-YAG

b/c of near infrared I guess????

25
Q

what is the only laser that wet tissue can protect pt (like a wet towel)

A

CO2 laser

26
Q

what 2 lasers are absorbed by Hgb and melanin or other similar pigments? transmitted through clear substances.
tissue penetration 0.5-2 mm

A

Argon

KTP

27
Q

which laser is more readily absorbed by dark tissue?
transmitted through clear fluids
tissue penetration 2-6 mm

A

Nd-YAG

28
Q

which laser is strongly absorbed by water, and thus by all tissue, pigmented or not. tissue penetration <0.5mm

A

CO2

29
Q

the greater the wavelength = the _______ absorption by water

A

greater

CO2 greatest WL 10,600

30
Q

CO2 laser properties?

WL 10,600

A

Longer WL= Low freq= Low energy

31
Q

Nd-YAG laser properties

WL 2064

A

sHorter WL= Higher freq= Higher energy

32
Q

Lasers are freq used in airways for what sx’s

A 
laryngel papillomas
tracheal scaring
vascular malformations
neoplasms
idiopathic subglottic stnosis
33
Q

Risk of lasers in sx

A

loss of AIRWAY
FIRE
burns
eye damage

34
Q

Preoperative preperation for laser sx

A

antisialagogue
Eye protection for personnel and pt
Laser tube or ETT wrapped with laser tape

35
Q

Airway concerns with laser

A 
shared airway
airway obstruction (foreign body, edema, obstructive mass/lesion)
36
Q

Induction concerns?

A 
airway patency
RSI vs smooth IV or mask
OSA
(must preoxygenate (may need oral airway))
(sevo least irritating to airway)
37
Q

OSA is who princilple

A

burnelli’s (spelling???)

thats why we give CPAP they lost pressure

38
Q

Causes of OSA

A

floppy upper airway
redundent fat deposits (in lateral pharyngeal walls)
sleep and anesthesia- increased pharyngeal musculature relaxation and posterior tongue displacement
airway narrowing (bernoulli effect)

39
Q

Maintenance for laser airway sx

A 
PREVENT LOSS OF AIRWAY
with shared airway
-communicate with surgeon
-closely monitor breath sounds and EtCO2
PREVENT BURN INJURY
don't look into laser
confirm standby mode
-know aiming beam vs power beam
don't allow laser on drapes
PREVENT EYE INJURY
PREVENT INHALATION INJURY
40
Q

what do you want to do to protect the pt’s eyes from laser

A

lub eyes
tape shut
saline soaked pads (CO2 only)
Laser goggles (not glasses)

41
Q

how do you prevent inhalation injury? (to yourself and pt)

A

continually assess integrity of cuff

don’t breath laser olume

42
Q

when doing airway sx with a laser what do you want to do with FiO2?

A

40% or less (preferable 21%)

43
Q

When doing airway sx with a laser what VAA do you want to avoid? and why?

A

N2O

supports combustion

44
Q

when doing airway sx with a laser what must you always have immediately available?

A

bottle of saline or water

45
Q

when doing airway sx with a laser what 2 things are important about the OETT tube

A

use a laser or protected ETT
fill endotracheal cuff with saline or dye
use smallest allowable tube for surgical exposure and ventialation
usually 5.5-6.5

46
Q

can you wrap a ETT in laser foil to protect from laser

A

yep

47
Q

what 2 things do you want to be prepared for duing airway laser sx (in case of fire)

A

be prepared to extinguish and treat

be prepared to emergently extubate

48
Q

what do you do for an airway fire?

A

-stop ALL gas flows
-cut pilot tube
-extubate pt
__________________
-extinguish with water or saline
_____________________
-reintubate pt
-ventilate with air only until remaining no remaining fire is confirmed
_______________________
- ventilate with 100% O2
______________________
-assess (DL and FOB) larynx, trachea, bronchiole tree for damage

49
Q

what 3 things are needed for a fire

A

oxidizer (N2O or O2)
fuel (drapes or ETT)
Ignition source (laser or Bovie)

50
Q

what meds do you want to give post airway fire?

A

corticosteroids

Antibiotics

51
Q

No fires back to regular sx with laser

what are poss complications/ concerns of extubation

A
  • possible deep extubation
  • airway blood may remain despite sxn
  • laryngospasm
  • be sure any saline pledgets and throat packs have been removed by surgeon
52
Q

Postop risk of laser sx in airway

A

laryngospasms (due to irritation and remaining blood)

-stridor, coughing, bronchospasm

53
Q

A laryngospasm is caused by what?

A

vocal cord irritation

54
Q

what is the primary muscle responsible to laryngospasms

A

cricothyroid

55
Q

Treatment of laryngospasms

A
  • CPAP by mask (attempt positive pressure ventilation <20cm H2O
  • jaw thrust (at angle of Ramus-accupressure point)
  • Succinylcholine if needed

Chem / Physics II (20 decks)

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