Syncope & Max Dose Examples Flashcards
175 pound male patient presents for removal of four teeth. You decide to use 2% lidocaine with 1:100,000 epinephrine for the surgery. In an effort to reduce any chance of overdosing the patient, you should use no more than
______________ carpules
Anesthesia max is the lesser of 3.2 mg/lb or 500 mg. At 175lbs, the max dose would be calculated at 3.2mg x 175lbs = 560 mg. Therefore, you would reach max dose at the 500 mg maximum. If there are 36 mg of anesthetic in each carpule, you would reach max dose at 13.89 carpules (500/36). HOWEVER
There is a max dose of 200 micrograms of epinephrine for all patients. With 18 micrograms of epinephrine in each carpule of 2% Lidocaine with 1:100,000 epinephrine, you would reach the 200 microgram max dose at 11.11 carpules (200/18).
Therefore, the max number of carpules to reduce any chance of overdose is 11.11
175 pound male patient presents for removal of four teeth. You decide to use 4% septocaine with 1:100,000 epinephrine for the surgery. In an effort to reduce any chance of overdosing the patient with anesthetic, you should use no more than
______________ carpules.
3.2 mg x 175 lbs = 560 mg.
Therefore, max dose of 500 mg is reached
There are 72mg of anesthetic in each carpule
500mg/72mg = 6.9 carpules
Epinephrine max is 200 micrograms.
200/18 = 11.11
THEREFORE, MAX CARPULES USED SAFELY IS 6.9
105 pound female patient presents for removal of four teeth. You decide to use 2% lidocaine with 1:100,000 epinephrine for the surgery. In an effort to reduce any chance of overdosing the patient with anesthetic, you should use no more than
______________ carpules.
The limiting factor at 3.2 mg/pound for a 105 pound patient would be 336 mg or 9 carpules. You wouldn’t reach the 200 microgram max for epinephrine until 11 carpules.
A 64 year old patient, 185 lbs., with a history of heart disease presents for multiple extractions. Due to his medications, we would like to reduce the amount of epinephrine we use. We will be using a combination of 3% Carbocaine and 2% lidocaine with 1:100,000 epinephrine. All of the extractions are completed using 5 carpules of 3% Carbocaine with no epinephrine. To suture, you would like some additional hemostasis, so you would like to use some 2% lidocaine with 1:100,000 epinephrine
How many carpules of this can you safely use?
(said something like this will be on the exam)
Max dose of Carbocaine is the lesser of 3.0 mg/lb or 400 mg. Since the patient weighs 185 lbs., you would reach the 400 mg max.
You have used 5 carpules or 270 mg (5 x 54 mg/carpule). This is 67% of the max dose of the carbocaine (270/400)
This allows you to use 33% of the max dose of 2% lidocaine with 1:100,000 epinephrine safely.
33% of the max dose of 500 mg is 165 mg. 165 mg. would be equal to 4.58 carpules (165/36mg per carp).
Therefore, you could use 4.58 carps.
what do you do for basic life support for pt?
Position patient
Airway
Breathing
Circulation
Diagnosis
what do you do if your pt is conscious but needs basic life support?
put them in comfortable position
what do you do if your pt is unconscious but needs basic life support?
place pt in supine position with legs elevated don’t leave in sitting position in dental chair (hypotension/hypoperfusion = death)
what do you do with the airway during basic life support?
head tilt/chin lift
what do you do in regards to breathing and basic life support?
check for exchange of air
feel/hear it
T/F if pt is concious and talking to you it’s a given that A(ir), B(reathing), C(irculation) is ok
true
what do you do with diagnosis part of basic life support?
can’t dx: 911
Dx, but don’t like it: 911
Dx and can Tx: treat
what is your legal obligation for someone who needs basic life support?
keep patient alive until 1) patient recovers or 2) someone arrives who is better trained than you and takes over
what emergencies are most likely to occur during or after local injection
> 60% syncope
~7% hyperventilation
what is sycope?
Sudden, transient loss of consciousness
who’s most common to have sycope?
males, ages 16-35 years
