NDH (in-hospital) Learning Points Flashcards

1
Q

APFEL score - what is it?

A
  1. Predicts risk of PONV
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2
Q

APFEL score - Scoring system + interpretation:

A

Score:

  1. Female - 1 point
  2. Smoker - 1 point
  3. Hx of motion sickness or PONV - 1 point
  4. Use of post-op opioids - 1 point

1: 20% risk
2: 39% risk
3: 60% risk
4: 78% risk

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3
Q

Absolute contra-indications of spinal:

A
  1. Pt. refusal
  2. Raised ICP/ active neurological disease
  3. Fixed CO states
  4. Coagulopathies: Plt < 80; INR > 1.5; PTT
  5. Septic pt.
  6. Unstable pt.
  7. Infection over site of injection
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4
Q

Indications of spinal:

A
  1. Surgeries of lower limbs, perineum, pelvis
  2. Obstetric anaesthesia
  3. Renal failure
  4. Elderly pt.
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5
Q

APFEL score w/ Rx:

A

1 - Dexamethasone 4 mg

2 - Dexamethasone 4 mg + Ondansetron 4 mg

3 - Dexamethasone 4 mg + Ondansetron 4 mg + Propofol infusion

4 - Dexamethasone 4 mg + Ondansetron 4 mg + Propofol infusion + Scopolamine patch

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