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Intro AS > Systems 3 > Flashcards

Systems 3 Flashcards

1
Q

Key differences between adult and kids airway

A
  1. tongue larger
  2. long floppy epiglottis use miller
  3. shorter trachea and neck
  4. narrowest part in subglottic region at cricoid (typically)
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2
Q

Child laying flat on back will… so you will need a…

A

obstruct, roll under neck

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3
Q 
For Pediatrics, 
higher or lower FRC for child?
 less or more compliant lungs? 
more or less oxygen? 
High or low CO?
Sensitive or nonexistent baroreceptor?
A

lower. less. more 2x O2. High CO. no baroreceptor

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4
Q

Main pediatric cardiac output up to age 2 is…

A

Heart Rate. CANNOT let kid get brady (need atropine to give kick)

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5
Q

Peds have increase or decrease in GERD.

A

Increased GERD

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6
Q

Renal and hepatic maturity

A

renal will mature at 6 months but not reach adult func until 2 years. Hepatic need 42 weeks

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7
Q

Kids will become anemic after birth but will increase to normal by when

A

6 months. 3 months

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8
Q

Peds, preop versed dose and mixer

A

Drink fast you are thristy!…. 0.5 mg/kg P.O. (up to 10mg) and mix with Tylenol

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9
Q

Teenager considerations

A

modesty, fear of death, fear of pain

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10
Q

Peds NPO guidelines

  • clears ?
  • breast milk ?
  • nonhuman ?
  • no solids ?
A

clears 2 hours (apple juice counts
breast milk 4 hours
nonhuman 6 hours
no solids after midnight

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11
Q

Peds IV sites

A

saphaneous and love vein near ring finger aim towards middle of wrist.

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12
Q

4-2-1 rule

do one or 12kg kid 24 kg kid

A 
look it up for kiddos to be sure and add matenance 
mL/hr =
(4 x first 10kg) +
(2 x second 10kg) +
(1 x every 1kg after)
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13
Q

Peds anestesthesia setup

A 
SUX, atropine, epi
airway= weight and age based 
(use little pinky finger nail size for ETT)
baby BP monitor
pulse ox bandaid like peds
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14
Q

LMA flippy technique used with adults or pediatrics

A

pediatrics really up to 5 years old for this flippy tech

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15
Q

What age do we think about a cuff?

A

8 years old. heart conditions as well?

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16
Q

Poiselles law with peds. why do we care

A

Resistance increases greatly! bc radius is raised to the fourth power.

17
Q 
ETT tube sizing for kiddos...
Preterm ?
1000g ?
1000-2500g ?
neo to 6 mon ?
6mon to 1 ?
1-2 years ?
over 2 years ?
A 
Preterm 2
1000g 2.5
1000-2500g 3
neo to 6 mon 3-3.5
6mon to 1 3.5-4
1-2 years 4-4.5
over 2 years (age in years + 16)/4
18
Q

Peds induction for DAN

A

normal 70/30 NO2 then sevo 8 %
rapid- prime w/ 8% Sevo, 100% O2
hide under here method- N2O/O2 place mask under blanket with kid

19
Q

Increased or decreased MAC for kids?

A

Decreased! YOUNG HOT SALTY ALCOHOLICS

20
Q

How do we know if too much anesthesetic is too much?

A

Listen to HR then turn down if heart rate is going down

21
Q

Crying child induction

A
  • use the normal or hide under method
  • excitement stage ready
  • once pulse slows cut to 3%
  • Do NOT overextend the neck
  • Gentle CPAP helps open airway
  • Let them breathe
22
Q

Eldery Cardiac output

A

1% per year after age 30. mickey 2% haha

23
Q

Eldery FRC increased or decreased

A

increased

24
Q

What is the most perioperative mortality in eldery surgical patients? Urine output minimum? (hint has to do with urine)

A

Acute renal failure. so we wantUrine output = >0.5 ml/kg/hr

25
Q

Neo nate vital signs

A

FILL IN side 24

26
Q

Elderly Increased or decrease amount of epi/nore given?

A

increased 2-4x dose

27
Q

Eldery BMR decrease after age 30

A

1% BMR decrease

28
Q

Eldery less, more, or same muscle relaxant?

A

no diff generally

29
Q

Eldery why do we have to wait for prop to set in?

A

LOW CO

30
Q

Organ donation expiration time

  • LIver
  • heart and lungs
  • pancreas
  • kidneys
A

Liver 8-10 hours
hearts and lungs 4-6 hours
pancreas 15 hours
-kidneys 24-36

31
Q

LIver transplant setup

A

CVP, PA cath, A-line after induction, no VA if acute (Go TIVA) but if chronic its okay

32
Q

Hepatic disease why do we not want to mess with esophagus?

A

varices can rupture

33
Q

What diuretic used in renal transplant

A

Mannitol. used to force urine production in people with acute (sudden) kidney failure.

34
Q

Mannitol dose for renal protection

A

12.5 to 25 grams

35
Q

Where does anesthesia occur outside the OR?

A 
radiology (C, MRI), 
radiation therapy, cardiology (Cardioversion, PPM insertion, catheterization),
psych (ECT), 
gastroenterology (EGD, Colonoscopy), 
Urology (ESWL)
36
Q

JCAHO standards for outside OR (just read them)

A

SAME FOR OR ESSENTIALLY
-oxygen, suction, machine with battery backup, scavenging, Emergency cart with defib, Emergency drugs, two way communication need assistant,

  • presed assessment
  • continuous physiologic monitoring
  • credentialing of individuals providing different levels of sedation
  • postsedation recovery and discharge
  • maintenance of instituion wide standards of care and quality assurance for all levels of care

Intro AS (9 decks)

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