Section 2 - analgesia, anesthesia and sedation

Question 1

pain medication avoided in children? reasoning?

Answer 1

aspirin, reye syndrome

Question 2

equipment needed for procedural sedation?

Answer 2

continuous cardiac monitor, pulse ox, oxygen, suction, resuscitation equpment

Question 3

opiate of choice for brief procedural mediation procedures? why?

Answer 3

fentanyl, no hypotension and quick on quick off, can be reversed with naloxone

Question 4

side effects of midazolam?

Answer 4

hypotension, respiratory depression, can be reversed with flumazenil

Question 5

side effects of methohexital?

Answer 5

seizure in patients with seizure disorder, respiratory depression

Question 6

side effect of ketamine?

Answer 6

intracranial intraocular pressure, hypersalivation, bronchorrhea, laryngospasm, hallucinations

Question 7

ketamine contraindications?

Answer 7

children 3 months or younger, pt with airway abnl, CHF, head or eye injury, AMS, psychosis, seizures, URI, glaucoma

Question 8

side effects of etomidate?

Answer 8

nausea, vomiting, myoclonus, temporary adrenal insufficiency

Question 9

side effects of propofol?

Answer 9

respiratory depression and apnea, patient needs to be euvolemic

Question 10

addition of epi to local/regional anesthetics?

Answer 10

increases duration of anesthesia, wound hemostasis, slows systemic absorption, local vasoconstriction

Question 11

max dosage of lido without epi? max dosage of lido with epi?

Answer 11

4.5 mg/kg without, 7 mg/kg with epi

Question 12

lido onset of effect?

Answer 12

2-5 min, 1-2 hour duration

Question 13

do you use epi in digital blocks?

Answer 13

no

Question 14

what age do you not use EMLA (lido/prilocaine) cream? and why?

Answer 14

prilocaine may cause methemoglobinemia

- don’t use under 3 months