Medications, dilutions, and machine Flashcards
Ampule
Glass vile. Use filter needle to draw up. Edges can be sharp
Vial
Plastic top with rubber stopper. Can be multi-dose but only with the same patient. Not sterile under the cap.
What must be on every drug label
1.) Medication name
2.) Medication concentration
3.) Date it was drawn
4.) Time it was drawn
5.) Initials of who drew it
Induction agent label color
yellow
Paralytic label color
red
narcotic label color
blue
sedative label color
orange
sympathomimetics label color
purple
Anti-muscarinic label color
green
local anesthetic label color
gray
Process for drawing medication
1.) retrieve med from drawer
2.) look/read/confirm medication name and concentration
3.) draw up medication
4.) reconfirm medication and concentration
5.) replace needle with syringe cap
6.) place filled out medication label
Phenylephrine dilution
Vial - 10mg/ml
Dilute to 100mcg/ml (bolus)
Dilute to 40mcg/ml (infusion)
Sufenta dilution
Vial 50mcg/ml
Dilute to 5mcg/ml
Precedex dilution
Vial 200mcg/2ml
Dilute to 4mcg/ml or 10mcg/ml (bolus)
Dilute to 4mcg/ml
Levophed
Vial 16mg/4ml
Don’t bolus levophed
Dilute to 64mcg/ml (infusion)
Epinephrine dilution
Ampule 1:1000 or 1mg/ml
Dilute to 10mcg/ml (little epi)
Dilute to 4mcg/ml (infusion)
Nicardipine dilution
25mg/10ml vial
Dilute to 0.25mg/ml
Dilute to 0.1mg/ml
Ephedrine
Vial or ampule 50mg/ml
Dilute to 5 or 10mg/ml
No infusion
Syringe sizes for induction
Versed: 3ml syringe
Lidocaine: 5ml syringe
Fentanyl: 100mcg vial 3ml syringe
Fentanyl: 250mcg vial 5ml syringe
Propofol: 20ml syringe
Rocuronium: 5ml syringe
Succinylcholine: 10ml syringe
Ancef 10ml syringe (if needing 3g use 20ml)
Anesthesia checkout check list
1.) check auxiliary oxygen cylinder
2.) Verify suction
3.) Turn on anesthesia machine and confirm AC power
4.) verify availability of required monitors and alarms
5.) Verify that pressure is adequate in the spare cylinders on the back of machine
6.) verify piped gas pressure greater than or equal to 50psig
7.) verify that vaporizers are adequately filled
8.) Verify no leaks in gas supply line between flow meters and common gas outlet
9.) test WAGD on back of machine
10.) Calibrate oxygen monitor
11.) verify carbon dioxide absorbent isn’t exhausted
12.) breathing system pressure and leak testing
13.) verify gas flows through the circuit (make sure ventilator works)
14.) document completion of checkout procedures
15.) confirm ventilator settings and evaluate readiness to deliver anesthesia care
How to very pressure in spare tanks on back of machine
1.) disconnect wall supply
2.) flush the O2 system
3.) turn key on O2 tank to open it
4.) verify pressure is adequate in tank
5.) close valve on tank
6.) bleed system via flush
7.) reconnect pipeline
How to verify there are no leaks in the gas supply lines and flow meters and common gas outlet
1.) verify flowmeter is off, vaporizers closed, machine is on manual/spon, and bypass is flipped
2.) connect bulb to CGO and squeeze to empty bulb
3.) allow bulb to remain negative for 10 seconds
4.) remove bulb
5.) FLIP BYPASS SWITCH BACK
How to test breathing system pressure and leak test
1.) turn APL valve to 40cmH2O
2.) ensure vaporizers and flowmeters are closed
3.) Use your finger to occlude the Y piece of circuit
4.) Press the flush button until 40cmH2O is achieved
5.) hold that pressure for 5-10 seconds
6.) open APL valve to ensure rapid release of pressure
Steps that need checked between each case
1.) verify suction
2.) verify required monitors
3.) verify vaporizers are adequately full
4.) verify CO2 absorbent is not exhausted
5.) breathing system pressure and leak testing
6.) verify gas flows properly through circuit
7.) document completion of checkout process
8.) confirm vent settings and evaluate readiness to deliver anesthesia care
