Misc Flashcards
Give 4 stages of reversal in GA
- Stop anaesthetic vapors
- Give oxygen
- Perform throat suction
- Reverse muscle relaxation (neostigmine + glycopyrrolate)
What is the most common anti-emetic for prevention of PONV?
Ondansetron
When would you give a vasoactive during surgery?
think BP
If the mean BP drops by 20%
What is mean BP?
Diastolic plus 1/3 of the pulse pressure
What should CO2 be on the monitor?
<6
What are the 4 ‘points’ for increased risk of PONV?
Female
Non-smoker
Previous PONV/ travel sickness
Opioids
What anti-emetic(s) do you give for low, moderate, high and v high risk of PONV?
Ondansetron
Ondansetron or dex
Both
Both plus cyclizine
Give some surgical factors which increase the risk of PONV
eye surgery, middle ear surgery, gynae surgery
Management of patients with tablet-controlled diabetes
Omit medication before surgery (e.g. the dose for that day whilst they are fasting)
Management of patients with insulin-controlled diabetes or poor diabetic control
Sliding-scale (variable rate insulin infusion + potassium)
Management of patients on oral steroid therapy
Switch to IV hydrocortisone for the op
WHO surgical checklist (7 parts)
Patient identity and procedure Site marked Anaesthetics safety check Pulse oximeter Allergies Difficult airway Risk of blood loss (>500ml?)
What BM do you aim for in a type one diabetic in surgery?
6-10
What receptor does metaraminol work on?
alpha 2
How do metaraminol and phenylephrine work?
What is the effect on HR?
Increase blood pressure by increasing systemic vascular resistance
Reflex bradycardia
