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Surgery EOR (billie) > pain medicine > Flashcards

pain medicine Flashcards

1
Q

acute vs subacute vs chronic pain

A

acute: less than 1 month
subacute: 1 month to 3 months
chronic: > 3-6 months

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2
Q

how long to prescribe opioids for acute pain

A

3-7 days

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3
Q

somatosensation

A

sensory neurons activated by physical stimulus (perception of touch, pressure, pain)

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4
Q

Nociception

A

first step in pain signal due to tissue damage or potential tissue damaging stimuli - neurologic receptor capable of differentiating noxious + innocuous stimuli

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5
Q

A-beta afferent fibers

A

fastest, thick myelination, light touch, pressure, hair movement, not usually pain

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6
Q

A-delta afferent fibers

A

thinly myelinated, sharp and intense pain sensation, high and low threshold mechanical and thermal receptors

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7
Q

C afferent fibers

A

slowest, unmyelinated, free nerve endings, high threshold to thermal, mechanical, or chemical insults, prolonged burning that follows initial A-delta stimulus

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8
Q

Nociceptive pain

A

noxious stimulus of somatic or visceral structures
mediated by receptors in viscera, bone, dermis, muscle, and CT
exacerbated by position change

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9
Q

Neuropathic pain

A

damaged for dysfunctional nerve tissue or damage to CNS
from tissue injury or pathology induced injury

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10
Q

Nociceptive pain ____ receptive to opioids
Neuropathic pain ____ receptive to opioids

A

IS
IS NOT

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11
Q

Pain diagnostics

A

Wong-Baker FACE scale, McGill pain questionnaire, Brief pain impact questionnaire, rate 1-10

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12
Q

Opioid management for chronic pain

A

immediate release first
prescribe lowest effective dose
reevaluate in 1-4 weeks
urine drug testing
NO benzos or other opioids

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13
Q

What symptoms might a patient experience when using LSD?

A

The patient may want to hurt himself, state they have been ‘freaking out,’ and experience hallucinations.

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14
Q

what are inhalant-related disorders

A

inhalation of certain gasses found in pain, petroleum, toluene, glues, and nail polish produce the same effects of a volatile anesthetic

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15
Q

Opioid-related disorders

A

mu receptor agonist - examples: morphine, heroin, methadone

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16
Q

Endotracheal intubation indications

A

respiratory failure, apnea, LOC/GCS <8, rapid change in mental status, airway injury, airway compromise, high aspiration risk, trauma to larynx, surgery

17
Q

Pre-oxygenation for endotracheal intubation

A

administer 100% oxygen for at least 3 minutes with NRB at 15+ L/min to increase safe apnea time to 8 minutes

18
Q

MAC blade is _____ traumatic, but provides _____ of a view

A

Miller blade is _____ traumatic, but provides ______ of a view

19
Q

ET tube selection

A

7.5-8 mm for women
8-8.5 mm for men

20
Q

Rapid Sequence Intubation steps

A
  1. get all supplies organized
  2. administer induction agent (IV Etomidate, propofol, ketamine)
  3. administer paralytic (Succinylcholine, Rocuronium)
  4. Insert blade, visualize cords, advance ETT
  5. inflate balloon
  6. confirm placement
  7. secure ETT
21
Q

types of intravenous line placement

A

peripheral
central

22
Q

what to avoid in peripheral IV placement

A

distal to areas of infection/injuries/potential vascular disruption
avoid extremities with AV fistulas or grafts, or previous LN dissections

23
Q

complications of IV

A
  • infiltration
  • thrombophlebitis
  • phlebitis
  • hypervolemia
  • hematoma
  • infection
24
Q

peripheral IVs replacement timeline

A

usually every 72-96 hours

25
Q
A
25
Q

cites of central IV placement

A

internal jugular, subclavian, femoral veins

26
Q

Local anesthesia

A

anesthesia used to numb a specific area without causing loss of consciousness

27
Q

MC drugs used for local anesthesia

A

Lidocaine (+/- epi), Bupivocaine

28
Q

Areas to avoid using epi

A

distal end points: penis, nose, fingers, and toes

29
Q

What do you always need to check before injecting the local

A

make sure you aren’t in a vessel!

30
Q

Regional anesthesia

A

anesthesia applied to a limb or an entire section of the body

31
Q

Difference between spinal and epidural anesthesia

A

Spinal: anesthetic injected into L3-L4 CSF
Epidural: injected anywhere along the vertebral column into the epidural space

32
Q

Medications used for regional anesthesia

A

Lidocaine or Bupivocaine

33
Q

Side effects of regional anesthesia

A

Hypotension, sedation, respiratory depression, infection, headache, cauda equina

34
Q

Contraindications to regional anesthesia (spinal/epidural)

A

Back abnormalities, infections at insertion site

35
Q

T/F Epidural anesthesia has less potential for SE than spinal anesthesia

A

True

Surgery EOR (billie) (23 decks)

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