Module 10 Critical care Flashcards
What are the aspects of critical care that need to be managed
An example of a standardised care bundle in an intensive care unit would include
FASTHUG
F: Feeding
A: Analgesia
S: Sedation
T: Thromboprophylaxis
H: Head-of-bed elevation
U: Gastric ulcers
G: Glucose control
What are the 4 major pharmaceutical complications of Anaesthesia
- MH
- Scoline apnea
- Porphyria
- Halothane hepatitis
What is the genetic defect in MH
There is an inherited error with the calcium channel receptors
What are the triggers of MH
- All volitiles
- Sux
What is the early presentation of MH
- Hypercapnia
- Increased O2 extraction
- Tachypnea
What are the late signs of MH
- Cyanosis
- Muscle rigidity
- Hyperthermia
What are the consequences of MH
Renal and hepatic failure and cerebral edema
What is the management of MH
- Discontinue the trigger
- Call for help
- Ventilate the patient at 100%
- Administer Dantrolene
- Cool the patient
What is the abnormality in scoline apneoa
There is absence or abnormal pseudocholinesterase
What are the 4 steps in the treatment of scoline apnea
- Ventilate the patient
- Sedate the patient
- FFP
- Get the patient a mediac bracelet
What are the triggers for an acute attack of porphyria
- Thiopentone
- Pain
- Infection
- Starvation
- Dehydration
What type of hypersensitivity is halothane hepatitis
Type 2
What are the risk factors for PONV related to the patent
- Young
- Female
- Motion sickness
What are the anaestetic agents that cause ponv
- N2O
- Ketamine
- Etomidate
What are the types of surgury that have a high risk of PONV
- Ear
- Eye
- Laparoscopy
What are the 3 possible causes of nerve damage in anaestesia
- Position in of the arms
- Neuroaxial blocks
- Hypoperfusion of the spinal cord
What are the 4 consequences of hypothermia
- Platelet dysfunction
- Delayed drug metabolism
- Arrythmias
- Post op shivers
What are the steps that should be taken in a failed intabation
Call for help!
100% oxygen
Reposition
Difficult airway trolley
Ventilate between attempts
BACKUP AIRWAY
What are the possible differential for rising airway pressures
- Obstructed ETT
- Circut blockage
- Kink
- Bronchospasm
- Mucus plug
- Pneumothorax
What colur is opiods
Blue
What colour is induction agents
Yellow
What colour is a muscle relaxant
Red
What colour is a seditive
Orange
What color is a vasopressor
Purple
What colour is an anticholinergic
Green
What colour is a reversal agent
Red cross hatched
What is naloxone color
Blue and white crosshach
What colour is a hypotensive
Purple crosshatch
What are the 3 most common tiggers of anaohalaxis
- Antibiotics
- Muscle relaxants
- Latex
What is the classical triad seen i anaphylaxis
- CVS collapse
- Bronchospasm
- Skin changes
WHat is the dose of adreniline IM and IV
IM 0.5mg
IV 10-50ug
What is the most common presentation of the intubation response under general anaesthesia?
Tachy and hypertension
What is the most common cause of anaphylaxis in the preoperative setting?
Muscle relaxants
Why is intraoperative hypothermia potentially hazardous?
A higher risk of infections and delayed awakening
High care units (HCUs) and Intensive Care Units (ICUs) share similar features. Which modality is usually only undertaken in an ICU?
Mechanical vent
