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Anesthesia Principles > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Peds: fasting recs for clear liquids

A

2 hours

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2
Q

What is the fasting recommendation for breast milk in peds?

A

4 horus

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3
Q

What is the fasting recommendation for infant formula in pediatrics?

A

6 hours

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4
Q

In pediatrics, what is the fasting recommendation for solids (fatty or fried food)?

A

8 hours

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5
Q

What pediatric age range is there minimal stress for the kid?

A

0-6 months

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6
Q

When does max fear of separation occur in pediatris?

A

6 months - 4 years

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7
Q

When do pediatrics have magical thinking?

A

6 months to 4 years

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8
Q

What should be removed prior to procedures in teens?

A

peircings

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9
Q

What age group interprests every thing literally? (peds)

A

8 years- adolsescnce

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10
Q

What physiologic change happens with croup?

A

subglottic narrowing

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11
Q

What could cause a heart murmur in kids?/

A

septal defects, avoid air bubles in IV

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12
Q

What causes cyanosis in kids

A

right to left shunt

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13
Q

A history of squatting indicates what?

A

tetralogy of fallot

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14
Q

What is a s/s of coarctation or renal dx in kids?

A

HTN

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15
Q

Valvular heart dx in kids can manifest as what?

A

rheumatic fever

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16
Q

What genitourinary symptom can be r/t hypercalcemia?

A

frequncy

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17
Q

In pediatrics, routine ___ testing and a ___ test is no indicated for most elective procedures

A

hemoglobin

urinalysis

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18
Q

Diazepam premed dose in Peds (PO)

A

0.1-0.5 mg/kg

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19
Q

Diazepam premed rectal dose in peds

A

1 mg/kg

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20
Q

Versed PO premed dose in peds

A 
0.25-0.75 mg/kg 
Other class syas 0.5 mg/kg max of 20 mg
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21
Q

Versed nasal premed dose in peds

A

0.2 mg/kg

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22
Q

versed rectal premed dose in peds

A

0.5-1 mg/kg

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23
Q

versed IM premed dose in peds

A

0.1-0.15 mg/kg

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24
Q

Lorazepma PO premed dose peds

A

0.025-0.05 mg/kg

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25
Q

Ketamine premed PO dose in peds

A

3-6 mg/kg

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26
Q

Ketamine premed dose in peds (nasal)

A

3 mg/kg

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27
Q

Ketamine rectal premed dose in peds

A

6-10 mg/kg

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28
Q

IM ketamine premed dose in peds

A

2-10 mg/kg

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29
Q

What is an important consideration when administering benzos nasally?

A

must use preservative free

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30
Q

Why must you use preservative free nasal benzos?

A

neurotoxicity risk

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31
Q

what type of drug is scopolamine

A

anticholinergic

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32
Q

What drug class inhibits sweating

A

anticholinergics

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33
Q

Which 2 anticholinergics cross the BBB

A

atropine and scopolamine

34
Q

PEDS recommended dose of Atropine?

A

0.01 - 0.02 mg/kg

35
Q

PEDS recommended dose of Scopolamine?

A

0.005 to 0.01 mg/kg

36
Q

What does atropine block?

A

vagus nerve

37
Q

Scopolamine is better at what than atropine?

A

sedation
antisialagogue
amnestic

38
Q

Atropine is better at what than scololamine

A

blockign vagus nerve

39
Q

What type of chemical makeup is glycopyrrolate?

A

synthetic quaternary anmmonium

40
Q

Does glycopyrrolate cross the BBB?

A

no

41
Q

What works longer: Robinul or Atropine?

A

Robinul

42
Q

What is the recommended dose of Robinul in peds?

A

0.01 mg/kg

43
Q

What is one of the most essential monitors used during the induction in pediatrics?

A

precordial stethoscope

44
Q

What is the traditional mask induction of anesthesia in a child?

A

N2O:O2 in a 2:1 ratio for 1-2 minutes, then starting Sevo

45
Q

Will Sevo cause a signfiicant decrease in HR or BP in otherwise healthy kids?

A

no

46
Q

What is the recommended initial dose of Sevo for induction in kids?

A

8%

47
Q

IV induction dose of Thiopental or Thiamylal in peds

A

5-8 mg/kg

48
Q

IV induction dose of Methohexital in peds

A

1-2.5 mg/kg

49
Q

IV induction dose of Propofol in peds

A

2.5-3.5 mg/kg

50
Q

IV induciton dose of Etomidate in peds

A

0.2-0.3 mg/kg

51
Q

IV induction dose of ketamine in peds

A

1-2 mg/kg

52
Q

In peds, what is most likley the cause of airway obstruction during anesthesia?

A

Loss of muscle tone in the pharyngeal and laryngeal structure

53
Q

What is the sniffing position?

A

extension of the head at the atlantooccipital joint with anterior displacement of the cervical spine

54
Q

What position improves airway dimensions in pediatrics?

A

Lateral positioning

55
Q

What is the most effective way to improve airway patency and ventilation in kids undergoing adenotonsillectomy?

A

jaw thrust maneuver

56
Q

What age group has increased risk of laryngospasm?

A

infants (greatest in infants than older kids and adults)

57
Q

Secretionsi n the oropharynx, recent URTI within 2 weeks, and inhaled anesthesia (Des adn Iso) are all associated with laryngospasm. T/F

A

true

58
Q

What is reflex closure of the false and true vocal cords?

A

Laryngospasm

59
Q

What is a complete laryngospasm?

A

closure of the false vocal cords adn apposition of the laryngeal surface of the epiglottis adn interarytenoids.

60
Q

Complete cessation of air movement occurs with complete larygospasm. T/F

A

ture

61
Q

What is a partial laryngospasm?

A

incomplete apposition of the vocal cords w/ a residual small gap between the cords posteriorly that permits a persistent inspiratory stridor

62
Q

What is the first step of laryngospasm management?

A

apply CPAP and 100% O2 - AP valve at 30

63
Q

What medications are given to pediatrics that experience a laryngospasm (in proper order)

A

IV or IM atropine 0.02 mg/kg
IV propofol 1 mg/kg
IV or IM Sux 1-2 mg/kg or 4-5 mg/kgIM

64
Q

What kind of IV fluid managmenet should be used in pediatrics?

A

buretrol to minmize inadvertently overinfusing

65
Q

What size LR bag should be hung in young kids?

A

500 mL w/ graduated buretrol

66
Q

What size LR bag should be hung in infants <1 year?

A

250 mL w/ buretrol

67
Q

What fluid should be hung in kids over 8?

A

1L balanced salt solution w/ macro or micor gtt w/o buretrol

68
Q

What is the rate of fluid replacement of blood loss in peds?

A

3 mL for every 1 mL blood loss

69
Q

For 3rd space loss, what is the replacemnt volume for minor surgery?

A

1-2 ml/kg/hr

70
Q

For 3rd space loss, what is the replacemnt volume for moderate surgery?

A

2-5 ml/kg/hr

71
Q

For 3rd space loss, what is the replacemnt volume for major surgery?

A

6-10 ml/kr/hr

72
Q

PRBC cannot be rapidly infused through ___ gauge IV

A

24

73
Q

What is the smallest IV cannula that PRBC can be rapidly infused?

A

22 g

74
Q

What is the 4-2-1 rules

A

4 ml/kg/hr - 1st 10 kg
2 ml/kg/hr -2nd 10 kg
1 ml/kg/hr - each kg after

75
Q

What is estimated deficit

A

maintenance rate x hours NPO

76
Q

How you you replace estimated deficits?

A

1/2 in 1st hour
1/4 in 2nd hour
1/4 in 3rd hour

77
Q

In order to extubate the trachea deep, the depth of inhalational anesthesia should be turned down by 50%. T/F

A

False - MAC should be 1.5-2 x MAC

78
Q

What is the optimal position for transfer of a kid after surgery?

A

Recovery position - lateral decubitius

79
Q

What agents causes emergence agitation in peds?

A

Sevo and Des and Iso

80
Q

When is the peak of emergence delirium in kids?

A

2-6 years

81
Q

How do you treat emergence delirium in kids?

A

it will either spontaneously resolve or you can give IV prop, versed, clonidine, precedex, ketamine, or opioids

Anesthesia Principles (10 decks)

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