Miscellaneous - Midterm Wrap Up Flashcards
What can happen if CVC is placed in RA?
Dysrythmias
Thrombus Formation
Cardiac Peforation
Complications of Floating PA Catheter
- PA Rupture
- RBBB
- Complete Heart Block if pre-existing LBBB
- Dysrhythmias
How many days til an increase in catheter related infection?
3 Days
What is most common complication of obtaining CVC access?
Dysrhythmias
What is best way to treat PACs/PVCs when placing CVC?
Withdraw catheter and start over
Transducer above Phlebostatic axis _________ CVP and below th axis _______ CVP
Above = Decreases CVP
Below = Increases CVP
Swan Parts:
Proximal Injecate Port
Blue - Right Atria
Swan Parts:
Thermistor
Calculates CO by thermodilution
Swan Parts:
Red Port
Balloon Inflation Port
How to know when Swan tip is not in correct Lung Zone
PAOP > LVEDP
Non Phasic PAOP Tracing
Cant aspiration blood when Wedged
Factors of ECG Monitoring
Electrode Location
Conduction Pathway & Speed
Muscle Mass
What converts electrical energy to acoustic energy in an Ultrasound?
Piezoelectric Material
What are the Three Ultrasound Probes
- Phased Array - narrow Probe
- Curved Linear Array - wider probe, convex view
- Linear Arraw - rectangular, for surface structures
Ultrasound Modes
B Mode
M Mode
Color Flow Doppler
Continuous Wave Doppler
Pulsed Wave Doppler
What does ultrasound gain correspond to?
Brightness
What is Echogenicity?
Measure of ability to reflect sound waves
Hyperechoic
White
EX: Bones, tendons, upper nerves
Hypoechoic
Gray
EX: Fat, Lower nerves
Anechoic
Black
Ex: Arteries & Veins
Absolute Contraindications for TEE
Peforated Viscus
Esophageal Abmormalities
Active Upper GI Bleed
Patient position for TEE
Left Lateral Decubitus
PreOP TEE Considerations
Detailed PreOp Workup
Most recent EF
Reason for TEE
Low EF = difficult sedation
Chromosome Associated w/ Malignant Hyperthermia
Ryanodine 1 Receptor on Chromosome 19
Malignant Hyperthermia
Can occur > 1 hr after emergence
Fam. hx plays big role
Rarely happens w/o triggering agents
Test for diagnosing Malignant Hyperthermia
Caffeine Halothane Contracture Test
Symptoms of Malignant Hyperthermia
Tachycardia
↑ETCO2
Metabolic Acidosis
Muscle Rigidity
Hyperkalemia
↑Temperature
How to Treat Malignant Hyperthermia
Stop Gas
Give IV Dantrolene
Hyperventilate w/ 100% O2
Treat Electrolytes
ABG
Cool Patient
What part of the brain controls body temperature?
Hypothalamus
How does the body attempt to release heat when hot?
Sweat and Relax Muscles
How does the body try to retain heat in a cold environment?
Shivering, Tense Muscles, and Arrector Pilli muscles raise hair
Common Intraoperative Complications of Hypothermia
Shivering
Vasoconstriction
Bleeding
