Systems Rev 2 Ears-nose-throat, Orthopedics, obstetrics

Question 1

ENT equipment needed?

Answer 1

Tracheostomy equipment need immediately available. kid in closet example dan with oxygen tank

Question 2

Which paralytic may be used?

Answer 2

SCh if not contra by surgeon or procedure

Question 3

How to minimize blood loss?

Answer 3

head up position and mild hypotension

Question 4

What is T&A? When is surgery postponed 7-14 days?

Answer 4

tonsils and adenoids. URIs so reduce laryngospasm risk by delaying

Question 5

Head and neck surgery what do we want to do in preop?

Answer 5

GREAT airway exam. Consider awake intubation

Question 6

When is tracheotomy made? Dan’s trick

Answer 6

Comfortable for patients and easier for a pulmonary toilet. do not take the tube out totally until completely confirmed

Question 7

Airway fire occur, three steps

Answer 7

disconnect circuit, remove ETT, fire continues use saline

Question 8

Nitrous oxide with ear surgery?

Answer 8

NO

Question 9

Ear surgery why consider TIVA

Answer 9

PONV

Question 10

Bone Cement Implantation Syndrome

Answer 10

BCIS is now considered to be caused by the hemodynamic effects of medullary fat embolism, rather than the toxic effects of the cement itself

This embolic load produces acute pulmonary hypertension that can lead to right ventricular dysfunction, ischemia, hypotension, and even sudden death

Question 11

Dan’s knee surgery what did they use?

Answer 11

pneumatic tourniquet.

The tourniquet system consists of a pressure regulated control unit, hose assembly and an inflatable tourniquet cuff. The cuff inflates with air to a preset pressure to compress the patient’s blood vessels during surgical procedures, thus ensuring a bloodless operative field.

need to be 100mmHg over highest anticipated systolic pressure.

Question 12

When do tourniquet pain and HTN begin?

Answer 12

over 60 minutes

Question 13

Cuff deflation immediately does what to CVP and MAP

Answer 13

lowers

Question 14

Sickle cell disease + tourniquet

Answer 14

usually not. if you do though.. keep well hydrated and normothermic.

Question 15

How much Heparin for Venous Thromboembolism?

Answer 15

8000 SQ

Question 16

Fat embolism

Answer 16

when you are putting a broken femur together with your cemet and then the fat is forced into the vascular space,

Question 17

Hip fracture blood status

Answer 17

hypovolemic typically. use colloids to draw fluid in

Question 18

Shoulder Surgeryposition? BP?

Answer 18

Usually performed in the “beach chair” position but can also be done in lateral decubitus position

controlled hypotension. ( keep in mind head BP is lower than shoulder)

If block is placed, light general anesthesia with secure airway is appropriate

Question 19

Cervical spine… consider what intubation technique?

Answer 19

Awake Fiberoptic. use armored tube bc kink risk.

Question 20

Somatocensory evoked potential SSEP. ( nerve monitoring therapy) Alter plan?

Answer 20

used in cervical spinal surgery. use TIVA. DONT GIVE PARALYTICS

Question 21

Wake up test?

Answer 21

Toes moved with thoracic surgery. I have lidocaine on tube since they will squirm.

Question 22

Pregnant what about her blood volume?

Answer 22

increased

Question 23

Vena caval compression

Answer 23

after first trimester DONT GO ON BACK bc decreased venous return

Question 24

left uterine displacement avoids what

Answer 24

vena caval compression

Question 25

Leading anesthesia mortality cause for pregnant?

Answer 25

aspiration. so you need clear liquid to move on the gastric production as well as Metaclopramide &H2 blockers

Question 26

Smaller or bigger ETT for pregnant woman?

Answer 26

smaller since airway edema

Question 27

FRC in pregnancy

Answer 27

decrease by 20% FRC so CPAP

Question 28

WAM BAM THANK YOU MAM

Answer 28

fun saying

Question 29

Regional anesthesia contraindications

Answer 29

hypovolemia, patient doesnt want it, sepsis, and site infection

Question 30

Pitocin running in a room?

Answer 30

NO TOUCHY.

Question 31

Momma pledge of allegiance in

Answer 31

BABY not okay.