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Mar: TXWES reference guide > Other Randoms on the Guide > Flashcards

Other Randoms on the Guide Flashcards

TXWES REFERENCE GUIDE

1
Q

List some symptoms of LAST.

Local Anesthetic Systemic Toxicity

A

Analgesia, lightheadedness, tinnitis, tongue/circumoral numbness, tingling of mouth, funny/metallic taste, SZ, LOC, respiratory arrest, cardiovascular arrest.

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2
Q

Explain the lipid rescue for LAST.

A

In addition to CPR -
1. bolus 20% intralipids 1.5ml/kg
2. start infusion at 0.25mg/kg/min
2. circulate lipids w/ CPR
3. repeat bolus q3-5 mins UP TO 3ml/kg total dose until ROSC.
4. ⬆ infusion to 0.5ml/kg/min if BP declines - continue infusion until hemodynamically stable.

*MAX DOSE: 8ml/kg

If you dont have 20% lipids immediately handy - give what you have until you obtain the 20%.

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3
Q

List the formula for Farenheit from Celcius.

A

°F = [(9/5) x °C) + 32]

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4
Q

If my patient’s temp is 96.8°F, what is it in °C?
94°F?

A

36°C
34.5°C

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5
Q

What is the formula for Celcius from Farenheit?

A

°C = [(5/9) x (°F - 32)]

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6
Q

If my patients temp is 38°C, what is it in °F?
40°C?

A

100.4 °F
104 °F

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7
Q

A nice pattern to help do quick temp conversions.

A
  1. If you start at 95°F - celcius is 35.
  2. As you increase in 0.9°F, each °C goes up by 0.5°
    :)
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8
Q

AIRWAY CLASSIFICATION

Describe a Mallampati 1.

A

Soft palate, fauces, uvula, anterior & posterior tonsilar pillars

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9
Q

AIRWAY CLASSIFICATION

Describe a Mallampati 2.

A

Soft palate, fauces, & uvula only.

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10
Q

AIRWAY CLASSIFICATION

Describe a Mallampati 3.

A

Soft palate & base of uvula.

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11
Q

AIRWAY CLASSIFICATION

Describe a Mallampati 4.

A

Soft palate only.

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12
Q

AIRWAY CLASSIFICATION

Describe a Mallampati 5.

A

Lolz, gotcha.

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13
Q

AIRWAY CLASSIFICATION

List the Cormack-Lehane view grade: Full view of entire glottic opening.

A

Grade 1

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14
Q

AIRWAY CLASSIFICATION

List the Cormack-Lehane view grade:
Neither glottis nor epiglottis seen.

A

Grade 4.

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15
Q

AIRWAY CLASSIFICATION

List the Cormack-Lehane view grade:
Only epiglottis seen.

A

Grade 3.

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16
Q

AIRWAY CLASSIFICATION

List the Cormack-Lehane view grade:
Only posterior portion of glottic opening.

A

Grade 2.

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17
Q

List the normal blood gas values:
pH
PaO2
PaCO2

A

pH: 7.35-7.45
PaO2: 90-100
PaCO2: 35-45

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18
Q

List the normal blood gas values:
HCO3-
BE
SaO2

A

HCO3-: 22-26
BE: -2 to 2
SaO2: 95-98%

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19
Q

Formula for VO2

A

10 x kg(3/4) = VO2

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20
Q

Formula for VCO2

A

8 x kg(3/4) = VCO2

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21
Q

What does this formula describe?

[FiO2 x (Pb - PH2O)] - PaCO2 / 0.8

A

Alveoar Gas/Air Equation

https://youtu.be/vrjK4gxa-48

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22
Q

Formula for arterial O2 content/dL

A

(hgb x 1.34 x SaO2) + (PaO2 x 0.003)

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23
Q

PBW (predicted body weight) equation for a male.

AKA IBW

A

50 + 0.91(cm height - 152.4)kg = male PBW

This is Dr. T’s equation:
- 50 + (2.3 x each inch above 5ft)

PBW is used to determine your tidal volume (5 - 8cc/kg).

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24
Q

PBW (predicted body weight) equation for a female

AKA IBW

A

45.5 + 0.91 (cm height -152.4)kg = female PBW.

This is Dr. T’s equation:
- 50 + (2.3 x each inch above 5ft)

PBW is used to determine your tidal volume (5 - 8cc/kg).

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25
Q

Formula for MAP.

What is the normal adult range?

A

1/3(SBP) + 2/3(DBP)
Normal range: 70-105mmHg

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26
Q

Normal CO

A

4-8 L/min

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27
Q

Formula for CI

Normal range for CI?

A

(CO / BSA)

2.5 - 4 L/min

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28
Q

Normal CVP range?

A

2-6 mmHg

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29
Q

Normal PCWP?

What does PCWP measure?

A

8-12 mmHg

Helps measures LA pressure, along with L heart function (mitral valves & LV filling pressure).

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30
Q

Normal PVR?
(pulmonary vascular resistance)

A

50 - 350 dynes/cm/sec^-5

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31
Q

Normal SVR?

A

700 - 1400 dynes/cm/sec^-5

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32
Q

Normal EF?

A

55-70%

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33
Q

Normal mPAP? sPAP? dPAP?

A

mPAP: ~15mmHg
sPAP: 15-30 mmHg
dPAP: 5-15 mmHg

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34
Q

Formula for Shock Index

A

(HR / SBP)

> 1 = increased M&M & chance of Mass Transfusion protocol (MTP)

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35
Q

EBV of preemie

A

95ml/kg

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36
Q

EBV of term infant

A

85ml/kg

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37
Q

EBV of infant - 12mo

A

80kg/ml

38
Q

EBV of male adult/child

A

75ml/kg

39
Q

EBV of female adult/child

A

65ml/kg

40
Q

EBV of morbid obese (BMI >40)

A

60ml/kg

41
Q

Allowable blood loss (ABL) formula

A

[(initial Hct - final Hct) x EBV / initial Hct]

42
Q

Fluid Replacement Equivalent

Crystalloids

A

3ml / 1ml EBL

43
Q

Fluid Replacement Equivalent

Colloids

A

1ml / 1ml EBL

44
Q

Fluid Replacement Equivalent

Whole Blood

A

1ml / 1ml EBL

*same as colloids

45
Q

Fluid Replacement Equivalent

PRBC

A

0.5ml / 1ml EBL

PRBC Hct = 70%

46
Q

Fluid Replacement Equivalent

How much EBL is in a fully soaked 4x4 guaze?

A

10 ml

47
Q

Fluid Replacement Equivalent

How much EBL is in a fully soaked ‘lap’ pad?

A

100-150cc

48
Q

What is the 4-2-1 rule for maintenance fluids?

A

1st 10kg = 4cc/kg/hr
2nd 10kg = 2cc/kg/hr
Every kg >20 = 1cc/kg/hr

49
Q

How do you accomodate for an NPO deficit with maintenance fluids?

A

(maintenance rate x #hrs NPO)

50
Q

What are the estimated evaporated losses?
(minimal, moderate, severe)

A

Minimal = 0.2 mL/kg/hr
Moderate = 2 - 4 mL/kg/hr
Severe = 4 - 8 mL/kg/hr

51
Q

BMI formula(s)

A

1in = 0.025meters

52
Q

Healthy BMI range

A

18.5 - 25

53
Q

Overweight BMI

A

> 25

54
Q

Obese BMI

A

> 30

55
Q

Morbidly obese BMI

A

> 35-40

56
Q

Super morbidly obese

A

> 55

57
Q

List the IBW formulas.
(male, female)

A

Male: (cm Ht - 100)=kg
Female (cm Ht - 105)=kg

1in = 2.5cm

58
Q

LABS

Hct (male, female)

A

male: 42-52 g/dL
female: 37-47 g/dL

59
Q

LABS

Hgb (male, female)

A

male: 14-18 g/dL
female: 15-16 g/dL (seems high…I use 13-16 lolz)

60
Q

LABS

WBCs

A

4k-11k microL

61
Q

LABS

Plts

A

150k-450k microL

62
Q

LABS

K+

A

3.5-5 mEq/L

63
Q

LABS

Mg

A

1.5-2.5 mEq/L

64
Q

LABS

Ca++

A

8.5-10.5 mg/dL

65
Q

LABS

iCa++

A

4.8 - 5.3 mg/dL (easy to remember bc it’s 1/2 of normal Ca++ level)
or
1.1 - 1.3 mmol/L (used often)

66
Q

LABS

Phos

A

1.8 - 2.6 mEq/L

67
Q

LABS

Cl-

A

100-108 mEq/L

68
Q

LABS

BUN
&
Creatinine

A

BUN: 10-20 mg/dL
Creatinine: 0.6-1.3 mg/dL

69
Q

LABS

Albumin

A

3.5-5.5 g/dL

70
Q

LABS

PT

A

11-14 sec

WEPT (warfarin, extrinsic, PT level)

71
Q

LABS

INR

A

1 sec

Normal INR on Warfarin: 2-3secs

72
Q

LABS

PTT

A

21-34 sec

On heparin = varies (~60-100 secs) depending on your coag goals!

73
Q

LABS

ACT

Activating Clotting Time

A

80-120 secs

> 160-180sec for ECMO

> 400sec for CPB

Used for large heparin doses.

74
Q

LABS

FSP

Fibrin Split Products

A

<10 µ/dL

Fragments from dissolved clots. Used often for DIC

75
Q

LABS

Fibrinogen

A

160-450 mg/dL

(the netting that covers the clot)

76
Q

LABS

Plasminogen

A

62-130%

Plasminogen makes Plasmin. Plasmin degrades fibrin (or clots)

77
Q

LABS

FDP

Fibrin Degredation Products

A

<10 µ/mL

basically FSP but resulted in different units.

78
Q

LABS

D-Dimer

A

<250 ng/dL

Only detectable if you are currently breaking down lots of clots.

79
Q

LABS

TSH
T3
T4

A

TSH: 0.4 µ units/mL
T3: 90 -230 ng/dL
T4: 13 - 15 µ/dL

Control metabolism, temp, mood, weight, neuro fxn, & muscle strength.

T3 = MORE active, 7%, majority made in cells.
T4 = main circulating thyroid hormone, 93%, can be converted to T3 using iodinase.

80
Q

LABS

AST
ALT

A

<35 IU/L

Liver function - ALT more specfic to liver, AST involves other organs including the liver.

81
Q

LABS

Fill in the blanks:

A
82
Q

LABS

Fill in the blanks:

A
83
Q

LABS

Fill in the blanks:

A
84
Q

List triggers for MH.

A

Volatile Anesthetics & SCh

85
Q

List signs of MH crisis

A
  1. tachycardia
  2. rapidly increasing ETCO2
  3. skin mottling
  4. tachypnea
  5. increase in temp
86
Q

List the treatment regimen for MH.

A
  1. STOP THE TRIGGER
  2. 100% O2 hyperventilation
  3. Dantrolene 2.5mg/kg IV (repeat 5-10mins; MAX 10mg/kg)
  4. Actively cool pt
  5. correct hyperkalmia and metabolic acidosis
  6. Monitor labs and maintain UO >2cc/kg/hr (hydration, mannitol, lasix) watch for rhabdo
87
Q

PEDI ETT

How can you determine the ETT length?

A

(Tube size x 3)

88
Q

PEDI ETT

List the ETT sizes:
Preemies (≤ 1kg)
Preemies (1-2.5kg)
Term Neonate

A

2.5
3
3-3.5

89
Q

PEDI ETT

List the ETT sizes:
6mo-1yr
1-2yr

A

3.5-4
4-4.5

90
Q

ETT SIZING

How do you determine ETT for >2yrs?

A

[(age + 16) / 4]

91
Q

PEDI LMA SIZES

List the size & max cuff air volume:
0-5kg
5-10kg
10-20kg
20-30kg
>30kg
Adult

A

1 (4cc)
1.5 (7cc)
2 (10cc)
2.5 (14cc)
3 (20cc)
4 (30cc)

Mar: TXWES reference guide (2 decks)

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