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Sp: Sim Lab 1 > Session 9: Drawing Meds, Dilutions, Anesthesia Machine and Setup > Flashcards

Session 9: Drawing Meds, Dilutions, Anesthesia Machine and Setup Flashcards

1
Q

ampule

A

glass vial
requires filter needle to remove glass shards

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2
Q

vial

A

plastic topper w/rubber stopper
multi-dose to SAME pt
not sterile under cap (alc swab)

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3
Q

where do you swab the ampule

A

around the neck

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4
Q

where do you swab the vial

A

rubber stopper after removing cap

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5
Q

equipment for medication

A

syringe
needle
filter needle
blunt tip needle
syringe cap
label / marker
alcohol swab

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6
Q

syringes

A

regular (slip tip)
luer lock
insulin

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7
Q

Every label must have these 5 items

A

Name (trade or generic)
Concentration
Date drawn up
Time drawn up
Initials of who drew it up

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8
Q

JCAHO fine for improper med label

A

15,000

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9
Q

how long are meds good for after being drawn up?

A

12 hrs

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10
Q

Yellow

A

Induction Agents

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11
Q

Red

A

Paralytics

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12
Q

Blue

A

Narcotics

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13
Q

Orange

A

Sedatives

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14
Q

Purple

A

Sympathomimetics

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15
Q

Green

A

Anti-muscarinic

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16
Q

Gray

A

Local Anesthetics

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17
Q

Med label colors can

A

change at each hospital

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18
Q

swiss cheese model

A

decreases risk of using incorrect med

  • multiple levels of checks = less likely that the holes will line up resulting in an error
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19
Q

Process to Drawing up Meds

A
  1. Retrieve med from drawer
  2. Look/Read/Confirm name/conc
    (one vial at a time)
  3. Draw up med
  4. Reconfirm med and concentration
  5. Replace need w/syringe cap
  6. Label appropriately (5 items)
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20
Q

Drawing up vials

A

flip plastic top off
wipe top w/alcohol
let dry (sterility)
insert needle
invert vial
inject air
draw up med

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21
Q

Drawing up ampule

A

alcohol swap neck
use 4x4 gauze and break neck
use filter needle to draw up
*do not inject air or invert

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22
Q

phenylephrine vial

A

10mg/mL

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23
Q

phenylephrine bolus

A

100mcg/mL

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24
Q

phenylephrin infusion

A

40 mcg/mL

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25
Q

Sufenta vial

A

50mcg/mL

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26
Q

sufenta dilution

A

5 mcg/mL

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27
Q

precedex vial

A

200mcg/2mL

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28
Q

precedex bolus

A

4mcg/mL
or
10mcg/mL

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29
Q

precedex infusion

A

4mcg/mL

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30
Q

levophed vial

A

16mg/4mL

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31
Q

levophed bolus

A

Do not bolus levophed

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32
Q

levophed infusion

A

64mcg/mL

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33
Q

regular insulin

A

use insulin syringe to dose
do not dilute (keep high conc)

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34
Q

epinephrine ampule

A

1:1000 (1mg/mL)

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35
Q

epinephrine bolus little Epi

A

10 mcg/mL

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36
Q

epinephrine infusion

A

4mcg/mL

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37
Q

nicardipine vial

A

25mg/10mL

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38
Q

nicardipine dilutions

A

0.25mg/mL
or 0.1mg/mL

39
Q

ephedrine vial/ampule

A

50mg/mL

40
Q

ephedrine bolus

A

5 mg/mL
or
10 mg/mL

41
Q

ephedrine infusion

A

No infusion dose

42
Q

double dilution

A

used to go from 1mg/mL to 10mcg/mL

syringe method
IV bag method

43
Q

big epi

A

100mcg/mL

44
Q

little epi

A

10mcg/mL

45
Q

syringe method

A

9mL saline in 10mL syringe
add 1mL of conc. med
** 1/10 of original conc.

9mL saline in NEW 10mL syringe
add 1mL of 1st dilution
**1/100 of original conc.

46
Q

IV bag method

A

take 1 mL of conc med and put it into 100mL bag of saline
**1/100 of original conc.

47
Q

Factor multiplier
(for IV bags)

A

multiple original conc by # of bags it takes to equal 1000mL

drop concentration UNIT by factor of 1000

48
Q

50 mL IV bag FM

A

20

49
Q

100mL IV bag FM

A

10

50
Q

250mL IV bag FM

A

4

51
Q

500mL IV bag FM

A

2

52
Q

1000mL IV bag FM

A

1

53
Q

Versed induction syringe

A

3mL syringe

54
Q

lidocaine induction syringe

A

5mL syringe

55
Q

fentanyl induction syringe

A

100mcg vial = 3mL syringe
250mcg vial = 5mL syringe

56
Q

propofol induction syringe

A

20mL syringe

57
Q

rocuronium syringe

A

5mL syringe

58
Q

succinylcholine syringe

A

10mL syringe

59
Q

ancef syringe

A

<2 g = 10mL syringe
2g+ = 20mL syringe

60
Q

anesthesia cart

A

inside is clean
- use clean hands/gloves only

61
Q

types of medication carts

A

pyxis
accudose
omnicell

62
Q

types of anethesia machines

A

draeger fabius
apollo and perseus
GE aisys

63
Q

Anesthesia machine Med Gases/Suction Basic Components (6)

A

Flowmeters
Auxillary O2 outlet
Flush
WAGD
Suction
Pipe/Cylinder pressure gauges

64
Q

WAGD

A

waste anesthesia gas disposal

65
Q

vaporizers

A

isoflurane - purple
sevo - yellow
des - blue (electrical cord)

66
Q

breathing apparatus (8 parts)

A

APL
one-way valves
bag
CO2 absorber
ventilator
ventilator interface
pressure guage
O2 analyzer

67
Q

monitors

A

EKG
pulse oximetry
Capnography/Gas analyzer
NIBP
temp
peripheral nerve stimulator (in drawer)

68
Q

Anesthesia Machine Check Procedures

A
  1. Aux O2/Ambu
  2. Suction adequate
  3. Machine On
  4. Monitors/Alarms/Cords/Pieces
  5. E Cylinder Pressure
  6. Piped gas Pressure
  7. Vaporizer Volume
  8. Low pressure
  9. WAGD (Scavenging)
69
Q

what should the regulator be set to for the aux O2 cylinder for mask breathing?

A

6-8 L/min

70
Q

what should the regulator be set to for the aux O2 cylinder for nasal cannula?

A

4 L/min

71
Q

what serves as a back up in case an issue arises w/anesthesia machine?

A

aux O2 w/ambu bag

72
Q

full aux O2 tank PSI

A

2000 PSI

73
Q

purpose of aux O2 tank

A

provide PPV at 100% FiO2

74
Q

what suction device should we not use?

A

Neptune
-300mmhg
too strong negative pressure

75
Q

what are we checking on suction?

A

no leaks
no cracks
needs blunt tipped yankeur installed

76
Q

what type of power is supplied to anesthesia machine?

A

AC

77
Q

what outlet do you plug the anesthesia machine into?

A

red outlet

78
Q

what does a red outlet mean?

A

its on the generator

79
Q

what is the anesthesia machines power backup?

A

battery

80
Q

required machine monitors(7)

A

EKG
Pulse Ox
NIBP (or A-line)
Capnography (CO2)
Temp
Gas analyzer
O2 sensor

81
Q

extra monitors

A

train of four monitor
BIS

82
Q

high pressure system check

A
  1. Disconnect wall pipeline
  2. O2 flush
  3. Open tank w/key
  4. Pressure >50PSI
  5. Close tank
  6. O2 flush
  7. Reconnect wall pipeline
83
Q

intermediate pressure check

A

piped gas gauges read >50PSI

84
Q

Vaporizer check

A

adequately filled w/fill line
filler ports tightly closed
port key is specific to agent

85
Q

Low pressure check verifies that

A

there are no leaks in gas supply line between the flowmeters and common gas outlet

86
Q

Low pressure check procedures

A
  1. flowmeter off
  2. vaporizers closed
  3. manual/spont mode
  4. bypass fipped
  5. connect bulb to CGO
  6. squeeze to evacuate bulb
  7. allow bulb to remain negative to 10+seconds
  8. remove bulb
  9. Flip bypass back
87
Q

how do you know the low p check passes?

A

bulb does not re-inflate for 10+ seconds

88
Q

squeezing the bulb causes

A

negative pressure

89
Q

scavenging system check

A

floater in between line

90
Q

low floater

A

high circuit pressure

91
Q

high floater

A

low circuit pressure

92
Q
A
93
Q
A

Sp: Sim Lab 1 (23 decks)

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