Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

N935 Pathophysiology > Non-Operating Room Anesthesia > Flashcards

Non-Operating Room Anesthesia Flashcards

1
Q

What are types of satellite locations (5)?

A 
Radiology
Cardiac Catheterization Lab
Psychiatric Unit
Endoscopy
Office Based Practice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are equipment requirements per ASA at satellite locations?

A

Reliable O2 source with back-up
Suction source
Waste gas scavenging
Adequate monitoring equipment
Self- inflating hand resuscitator bag
Sufficient safe electrical outlets
adequate patient and anesthesia equipment illumination with battery power back-up
adequate space to freely access patient and anesthesia equipment
emergency cart with defibrillator, emergency drugs and other emergency equipment
reliable two way communication to request for help
adequately trained support staff in procedure room & in post-anesthesia care location
compliance with facility with all applicable safety and building codes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How should monitoring be completed in satellite locations?

A

standard/routines utilized in the OR must be maintained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the ASA/AANA guidelines require evaluation of patient’s

A

oxygenation
ventilation
circulation
temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some general comments about remote locations and anesthesia?

A

design of satellite location is for the procedure (anesthesia is an afterthought)
personnel may be less familiar with management of patient under anesthesia
procedure table limits
pre-procedures assessment/ optimization often not completed in advance= delays + cancelations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are anesthesia implications for endoscopy (EGD)/ esophagogastroduodenoscopy?

A

local oropharygneal anesthesia with opioid + benzo VS general anesthesia with propofol (+/- ETT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are high risk groups for EGDs?

A

obese, OSA, GERD, asthma, obstruction/full stomach, hepatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is an esophagogastrodudenscopy?

A

endoscopic evaluation of the esophagus, pylorus, and stomach

may involve biopsy, mucosal/submucosal dissection, dilation and stenting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is involved in a sigmoidoscopy & colonscopy?

A

biopsy, polypectomy/muscosal resection, stenting, dilation, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What normally occurs in a sigmoidoscopy & colonscopy?

A

benzos + opioids VS propofol (GA)

generally involves insufflation of air, may involve the application of external pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What anesthesia can be performed in a sigmoidoscopy & colonscopy

A

benzos + opioids VS propofol (GA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are common complications of a sigmoidoscopy & colonscopy ?

A

laryngospasm, aspiration, and losing the airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is an endoscopic retrograde cholangiopancreatgraphy? (ERCP)

A

fluoroscopic exam of biliary and pancreatic duct that may involve stenting/removal of stones/laser lithotripsy
commonly in prone position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Who commonly receives ERCP?

A

pateints with cholangitis, pancreatitis, bile duct obstruciton, pancreatic cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is required of the ERCP patient?

A

to be immobile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is an ERCP performed?

A

GA with ETT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are common bronchoscopic procedures?

A

endobronchial stenting, biopsy, laser therapy, dilation, cryotherapy, fiducial marker implant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is common of patients receiving bronchoscopic procedures?

A

patients with signficant CV and pulmonary disease

19
Q

What is the preferred method of bronchs?

A

TIVA

propofol, remifentanil, dexmedetomidine + muscle relaxants

20
Q

what are associated complications of bronchs?

A

airway fire, bronchospams, bleeding and hypoxia

21
Q

What makes up a radiology suite?

A

US
CT
MRI
Interventional (cardiac catheterization, neuroradiology)
non-invasive and don’t normally require anesthesia but may need anesthesia to lay still

22
Q

What are general considerations in the radiology suite?

A

patient remains immobile for long periods

equipment is bulky

23
Q

Why may general anesthesia be necessary in radiology suites?

A

lack of scavenging may limit the options

24
Q

What are problems associated with bulky equipment in radiology suites?

A

impede access to patient
move and collide with anesthesia equipment
lines, pumps, ventilation tubing
will need extensions

25
Q

What should be limited in the radiology suite?

A

radiation exposure

dose related cell death, tissue damage and malignancy (DNA ionization & free radical generation)

26
Q

What is ALARA?

A

as low as reasonable possible

27
Q

How can you decrease radiation exposure?

A 
lead aprons
thyroid shields
moveable leaded glass screens
leaded eyeglasses
remote or video monitoring when appropriate (very briefly stepping out of the room during image)
dosimeters should be worn
(one under lead apron)
(one on collar above lead apron)
28
Q

How does contrast media come?

A

variable osmolarity, ionic or non-ionic

29
Q

When is contrast media used?

A

used in diagnostic and therapeutic radiologic procedures (general radiology and MRI)

30
Q

What are adverse reactions for contrast media?

A

range from mild to life threatening
hypersensitivity
renal toxicity

31
Q

Describe non-ionic contrast media?

A

decrease pain on injection and decrease complications

32
Q

How do you treat a hypersensitivity reaction to contrast media?

A 
prompt recongition
oxygen
bronchodilators
epinephrine
fluid resusitation
corticosteroids
consider pre-treatment with IV corticosteroids a few hours pre-procedure as well as H1 and H2 blockers
33
Q

What is contrast induced nephropathy?

A

direct tubular toxicity due to release of free oxygen radicals and microvascular obstruction

34
Q

What diseases have an increased risk in CIN?

A 
diabetic renal insufficiency
hypovolemia
congestive heart failure
HTN
baseline proteinuria/Renal disease
gout
co-adminstration of other drugs that can cause renal tx
35
Q

When does azotemia start?

A

24-48 hours

36
Q

When does azotemia peak?

A

3-5 days

37
Q

What do you monitor in CIN?

A

creatinine levels (0.5mg/dL within 24 hr is diagnostic)

38
Q

What should you avoid with azotemia and CIN?

A

avoid surgical procedures during this period

39
Q

How do you minimize the effects of contrast media?

A

careful administration and limitation of total dose
hydration 1st line protection administer 1ml/kg of normal saline 4 hours pre-procedure and continue for 12 hours post-procedure (avoid volume overload in susceptible patients)

40
Q

What do you administer to promote renal elimination with CIN?

A

sodium bicarb

41
Q

What should be administered for CIN and for how long?

A

serum creatinine for 72 hours

42
Q

Anesthesia Technique ranges from

A

local only with anesthesia stand-by
sedation/analgesic
general anesthesia

43
Q

What does the anesthesia technique depend on?

A

procedure
desired level of anesthesia
underlying medical condition
open communication with radiologist

N935 Pathophysiology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions