Surgical Emergencies Flashcards
During the laser microlaryngoscopy there is an airway explosion and fire. The first thing to do is…
Remove the endotracheal tube in its entirety
ensuring the entire tub is removed, turn off the gasses and oxygen, pour water or saline into the airway reintubate and examine the airway. Next steps are decided upon examination.
During the laser microlaryngoscopy there is an airway explosion and fire. The first thing to do is…
Remove the endotracheal tube in its entirety
ensuring the entire tub is removed, turn off the gasses and oxygen, pour water or saline into the airway reintubate and examine the airway. Next steps are decided upon examination.
Action point
The moment when an individual recognizes that an employee may be on the path toward committing some type of violent act in the workplace and subsequently takes action to prevent it
-talk to person directly, supervisor, HR, security
Flash point
Moment when workplace violence occurs, & it’s too late for any type of prevention strategy & best avoided by implementing initiatives early, once an action point has been detected
Vasogenic shock
Resulting from anaphylaxis or sepsis
Moderate blood loss
750 mL to 1500 mL
15% to 30% of total blood volume
Crystalloids are the recommended fluid replacement 
Disseminated intravascular coagulation (DIC)
Inappropriate clotting, followed by hemorrhaging
Coagulation goes systemically instead of locally
Two causes of DIC
Systemic response
-Trauma
-Sepsis
-Obstetrics: amniotic fluid into mothers blood
Release of procoagulant into the bloodstream
-Boney tumor
DIC complications
-Severe bleeding
-stroke (clots cause most harm, in spine or kidney)
-Reduced blood flow to organs
-Overload of liver and kidneys
DIC treatment
-Correct the cause
-Treat with FFP and cryoprecipitate (replaces clotting factors)
-Heparin sometimes used in the beginning (draw PTTs, order for heparin once PTT is trending down)
-volume/blood replacement
Venous air embolism risk
-pressure in the right atrium is less than atmospheric pressure
-Neuro procedures where the patient is sitting
-hysteroscopy and TUR procedures
Arterial air embolism risk
-bypass
-Dialysis
Air embolism signs and symptoms
-Rapid onset pulmonary edema (fluid in air sacs in lungs)
-Drop in ET CO2
-Hypoxia
-Hypotension
-Arrhythmias
-Neurologic damage
Venous air embolism treatment
-first identify and occlude the sites of air entry
-Sloppy wet sponges, irrigation syringe
-Bone wax
-Discontinue nitrous oxide
-Place patient in left lateral position (Durant’s maneuver)*
-Aspirate RA (right atrium) catheter
Arterial air embolism treatment
-Deep Trendelenburg position
-Aspirate air from circuit
Cardiac arrest, medical reasons
-MI
-Arrhythmias
-Anaphylactic reaction
-Emboli
-Vagal stimulation
-Malignant hyperthermia
-Anesthesia overdose
-Hypoxia
-Laryngospasm
-Aspiration
-Hypothermia
-Electrolyte imbalance
Cardiac arrest surgical reasons
-hypovolemic shock related to blood loss (Nick something and bleeding out)
OMI (Oh my) for cardia emergencies
Oxygenation
Monitors
IV Fluids
Treatments for Vfib with inadequate heart rate/blood pressure
-CPR
-Defibrillator
-Epinephrine (for BP)
-Amiodarone (good for her myocardium, helps it contract)
Treatment for Vfib with adequate heart rate
-Epi (for blood pressure)
-Amiodarone (good for myocardium, helps it contract)
-dopamine
-ICU monitored bed
-Cardioversion, after meds and when controlled
Premature ventricular contraction (PVC)
Relatively common event where the heartbeat is initiated by the ventricles rather than by the Sino atrial (SA) node
Ventricular tachycardia
Tachycardia with beats initiated in the ventricles
Sawtooth rhythm
Ventricular fibrillation
Uncoordinated contractions of the ventricles
Quivering rhythm
Ventricular arrhythmias - Couplet
Pair of PVCs
