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Advance Principles I, Exam 4 > Peds Anesthesia > Flashcards

Peds Anesthesia Flashcards

1
Q

Exceptions for dextrose in IVF

A

-

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2
Q

Cortisol level

A

Higher in am than pm

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3
Q

Greater hypoxia brain damage has been found in relation to

A

High blood glucose level

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4
Q

What are the daily fluid requirements based on

A
  1. Metabolic demand (high in peds)

2. High ratio of BSA to weight

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5
Q

Maintenance fluid requirements

A

0-10 kg = (4ml/kg)
11-20 kg = (40ml + 2ml/kg)
>20 kg. = (60 ml + 1ml/kg)

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6
Q

NPO deficit

A

Maintenance IVF x NPO hrs

Replace half in 1st hr and 1/4 over next two hours

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7
Q

Blood loss replacement

A

3: 1 w/crystalloids
1: 1 w/ colloids or blood

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8
Q

Very Minor surgery

IVF

A

BMT, frenulectomy

0.2 ml/kg/h

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9
Q

Minor surgery

IVF calculation

A

Hernia

2-4 ml/kg

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10
Q

Moderate surgery

A

4-6 ml/kg

ENT, lap

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11
Q

Major surgery

A

6-10 ml/kg

Bowel ressection, intra abd surgery

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12
Q

Massive 3rd space fluid loss

A

10-20 ml/kg/hr

Cranialfacial, spinal bifida

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13
Q

ETT size

Length of insertion

A

Age/4 + 4 = ETT

3x tube size = length
Double black lines of ETT should line up with vocal cords
Confirm by auscultation

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14
Q

RBC replacement

A

10-20 ml/kg

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15
Q

FFP replacement

A

10-15 ml/kg

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16
Q

Platelets

A

1unit/10kg

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17
Q

Cryoprecipitate replacement

A

0.1 units/kg (up to 3 units)

18
Q

Symptoms of hypovolemia

A 
Dec urine output
Tachy
Mottled skin
Cold extremities 
Dec BP late sign
19
Q

Peds can maintain BP until what % reduction in volume status

A

25%

20
Q

What is the bolus dose

A

5-20 ml/kg LR

5-10 ml/kg Albumin

21
Q

NPO
CL diet
Milk & solids
Breast milk

A

CL : 2 hrs for all ages
Solid/milk: 4 (3yr)
Breast milk: 3-4 hrs

22
Q

Why uncuffed ETT

A
  • funnel shaped trachea
  • narrowest cricoid
  • risk of subglottic stenosis dec
  • allows for lg diameter ETT - dec in airway resistance
23
Q

Uncooperative or infant induction

A

70% N2O (2L O2+ 6L N2O)

Sevo 8%

24
Q

What age group does not need pre op med

A

0-8/10 months, no separation anxiety

25
Q

Waht are the pitfalls of induction

A
  1. Breath holding: don’t assist respirations
  2. Laryngospasm: partial vs complete
  3. Anesthetic overdose
26
Q

Partial laryngospasm

A

Stridor:

  • gentle positive pressure
  • PEEP on a bag
  • deepen pt: Propofol 1-2 mg/kg
27
Q

Complete laryngospasm

A

Rocking of chest/abd but NO air exchange
Deepen pt
If no improvement: Positive pressure & Tighten APL

Propofol IV
Sux: IV/IM if pt continues to desat or become Brady & spasm does not break

28
Q

Anesthetic Overdose

A

Bradycardia, listen to pulse Ox , dec agent

29
Q

Which age group has the easiest intubation

What blade to use

A

Toddlers

Miller 2, WIS 1, MAC 2 blade

30
Q

Infants intubation

A

Shoulder roll
Stylet available
Larynx more anterior

31
Q

Assessing for correct tube size

A

Pt should have audible leak @ 20cm H2O, but not much less than that

Lg leak at

32
Q

Which VA increases post op delirium

A

Sevo

33
Q

When would u use LTA

A

Planning for deep extubation when case is

34
Q

Rx for emergence delirium

A

Narcotics: fentanyl: .05-1 mcq/kg or morphine 0.025-0.1 mg/kg
Dexmedetomidine: .1-.3 mcq/kg

Narcotics more effective than benzo

35
Q

Stridor Rx

A

Decadron 0.25-1mg/kg

Racemic epi 0.25-0.5 ml 2.25% solution nebulizer in 2.5 ml NS

36
Q

POC for urologic procedures

A

Caudal block w/light GA, superior to local nerve block or GA alone

37
Q

Where does caudal space lie

A

Under sacrococcygeal ligament that runs through the sacral hiatus under the skin

38
Q

Where does the dural sac ends

A

Ends at S1-2, May extend to S3 in neonates

39
Q

What are some additives that can be added to caudal anesthesia

A

Morphine 50-70 mcq/kg
Clonidine 1-2 mcq/kg
Dilaudid 15 mcq/kg

40
Q

What is used in caudal

A

Marcaine 0.25% , typically 1ml/kg up to 10 ml, may dilute to 15 ml max w/PF saline

With or without epi

41
Q

What is used in TAP

A

0.5 ml/kg 0.25% bupivicane with epi

42
Q

What is programmed cell death that’s induced by anesthesia

A

Apoptosis

Advance Principles I, Exam 4 (5 decks)

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