Random Crap I Should Know Flashcards
Child-Pugh score
Each 1-3 points.
Used to predict surgical mortality
A - 5/6;
B 7-9 points
c - >10; >50% mortality; 1 year survival 45%, 2yr 33%
Bilirubin 50
Albumin (g/l) >35, 30-35, 2.3
Encephalopathy none, grade 1-2, grade 3-4
Ascites none, moderate, marked
Sarcoidosis is;
A multi system granulomatous disease that causes non caseating granulomas in involved organs
Lung disease in 50 %; restrictive or obstructive picture, skin issues, laryngeal sarcoid, may have mediastinal mass
SLE is;
A chronic autoimmune inflammatory condition
Pericarditis, libman-Sachs endocarditis, accelerated CAD
Pulm HTN, interstitial lung disease, risk of PE
Small vessel vasculitus
Renal involvement
Joint issues in 90%
High risk thromboembolic events
May be on steroids
Signs of an innocent murmur in a child
Clinically well, growing normally, feeding normally Pulses are normal No history of recurrent chest infection Murmur is; Soft EarlySystolic or continuous Often varies with posture No thrill Quality - blowing, musical
Nerves to block for scalp block
7 paired nerves; Supraorbital - V1 Supratroachlear - V1 Zygomaticotemporal - V2 Auriculotemporal - V3 Lesser occipital - cn2/3 Greater occipital - cn2 Greater auricular - cn2/3
Non technical skills
Situational awareness
Team working
Task management
Decision making
Effects of quitting smoking
1 day - HbCO levels and nicotine levels lower; better oxygen delivery
3 weeks - improved wound healing
6-8 weeks - sputum volume not > than non smokers, improved pulmonary function
>6/12 - improved immune function
Ask, advise, refer
Classification of equipment;
Critical - will penetrate skin, mucous membranes, enter vascular system. Must be sterilised.
Semi-critical - will be in contact with intact mucous membranes or be contaminated with readily transmissible organisms. Need high level disinfection or sterilisation.
Non-critical - intact skin, or no direct patient contact. Low level disinfection or cleaning.
Hand hygiene solution contains;
2-4% chlorhex and 60-95% alcohol
Classification of equipment re cleaning;
C = critical SC = semi critical NC = non critical
Face mask - SC
Laryngoscope - c
Bougie - c
Breathing systems - used for more than one patient if bacterial filter used
Sampling line - need viral filter
Surfaces/monitor - cleaned between each patient with detergent and water
Flexible bronch - C
Ultrasound - will depend on what used for; NC use, just clean; SC use - use a cover; critical use will need high level disinfectiono
Definitions asepsis, disinfection, sterilisation
Asepsis - prevention of microbial contamination of living tissues or sterile materials
Disinfection - inactivation of non-sporting organisms using thermal or chemical means
Sterilisation - compete destruction of all microorganisms including spores
Systemic sclerosis;
Immune activation, vascular damage and deposition of collagen
Classified as;
limited cutaneous - hands/face and CREST
Diffuse cutaneous - risk of renal, lung, CVS disease
Develop - Myocarditis and conduction abnormalities Pulmonary fibrosis and HTN Chronic renal failure Oesophageal hypomotility Thick skin - difficult iv access Limited mouth opening
ETT size for children;
Depth;
Size of LMA
Age/4 +4
Age/2 + 12
LMA - on packaging 1, 5kg 1.5 5-10kg 2 10-20kg 2.5 20-30 3 >30kg
Assessment before any procedure;
Simple!
Consent Iv access Monitoring Position Local anaesthetic Evaluate
Active cardiac conditions
Unstable coronary syndromes (Mi last 30 days, CCS 3 or 4)
Dulecompensated failure
Severe valve disease
Significant arrhythmias
Drugs that raise PVR
Nitrous
Ketamine
Protamine
WHO pulm HTN classification.
- Arterial - portal HTN, shunts
- Venous - MR
- Due to respiratory disease or hypoxia
- Due to thrombus
- Due to direct vasculature changes
