Peds-other Flashcards
Tonsillectomy and Adenoidectomy:
All children undergoing T&A should be considered at increased rick for what periop complication
airway complication esp if diagnosed w/ sleep apnea
Tonsillectomy and Adenoidectomy:
what is the position postop
Left lateral head down
Myringotomy and Tympanotomy Tubes:
what is good anesthestic
VAA and N2O
Facemask/LMA
Malignant Hyperthermia:
what are 6 early signs/symptoms
Masseter muscle spasm Tachypnea Rapid exhaustion of soda lime tachycardia Irregular HR
Malignant Hyperthermia:
4 intermediate signs/symptoms
warm
Cyanosis
dark blood in surgical site
irregular HR
Malignant Hyperthermia: Signs and Symptoms
4 late signs/symptoms
Prolonged bleeding
dark urine
irregular HR
muscle rigidity
Malignant Hyperthermia: Monitor Changes
3 early changes
Increased MV
Increased ETCO2
Peaked T waves
Malignant Hyperthermia: Monitor Changes
what is the 1st sign of MH
Increased ETCO2
Malignant Hyperthermia: Monitor Changes
what is 3 intermediate changes
Increased body temp
decreased O2 sat
Peaked t waves
Malignant Hyperthermia: Monitor Changes
how much does the temp increase
1 C Q 5 min
Malignant Hyperthermia: Monitor Changes
1 late change
peaked T waves
Malignant Hyperthermia:
what usually causes death
V-fib
Renal failure
DIC
Malignant Hyperthermia: Biochemical Changes
3 early signs
Hyperkalemia
Increased PaCO2
Acidosis
Malignant Hyperthermia: Biochemical Changes
1 intermediate sign
hyperkalemia
Malignant Hyperthermia: Biochemical Changes
3 late signs
hyperkalemia
increased CK
Myoglobinurinia
Malignant Hyperthermia: treatment
what drug do u give
dantrolene
Malignant Hyperthermia: treatment
how much dantrolene and how often do you dose it
2.5 mg/kg Q 5-10 min
Malignant Hyperthermia: treatment
what is the max total dose of dantrolene
10 mg/kg
Malignant Hyperthermia: treatment
what is the treatment
call for help IV dantrolene turn off VAA maintain anesthetic hyperventilate w/100% O2 (ambu bag) Initiate cooling correct metabolic acidosis maintain UOP
Malignant Hyperthermia:
how do you prepare the machine?
vaporizers out
high O2 flow (10 LPM)
for 20-30 min
Neonate: Post birth
what are they placed in
radiant warmers in slight trendelenburg
Neonate: Post birth
what are normal respiration
30-60 bpm
Neonate: Post birth
normal HR
120-160 bpm
Neonate: Post birth
w/ APGAR the 1 min correlates to what?
survival
Neonate: Post birth
w/ APGAR the 5 min correlates to what?
neurological outcome
Neonate: Post birth
what is the most common cause of neonatal depression
intrauterine asphyxia
Neonate: what should you do?
APGAR 0-2
intubate chest compressions
Neonate: what should you do?
APGAR 3-4
temp assist w/ ventilation
Neonate: what should you do?
APGAR 5-7
stimulation and O2 across the face
Neonate:
what are indications for positive pressure ventilation
Apnea
HR
Neonate:
assisted ventilation with bag and mask should be at what rate
40/min w/ 100% O2
Neonate:
start chest comressions if HR
60 bpm
Neonate:
cardiac compression is at what rate
120 bpm
Neonate:
vascular access via cancelation of what?
umbilical vein
Neonate:
umbilical artery cannulation allows for measurement of what 2 things
blood pressure
ABG monitoring
Neonate:
volume expansion may be with what 2 things?
O-neg blood or 10mL/kg of 5% albumin or LR
Pediatric laryngospasm can usually be avoided by extubating the pt with certain techniques. identify these tech
awake
deep
(anything in-between is hazardous)
which inhalation agent has become the preferred induction agent for peds anesthesia
Sevoflurane
the pediatric pt becomes hypothermic in the OR: list 5 expected anesthetic concerns
delayed awakening cardiac irritability resp depression increased pulmonary vascular resistance altered drug responses
why is maintenance of heart rate so crucial in neonates and infants?
stroke volume is fixed by noncompliant and poorly developed LV
CO is therefore strongly dependent of HR
A child unexpectedly has cardiac arrest after SCh administration. how would you immediately treat this situation?
treat for hyperkalemia
also long and heroic resuscitation efforts may be required
