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AS - N928 Basic Principles of Anesthesia > Taxonomy & MAC > Flashcards

Taxonomy & MAC Flashcards

1
Q

Anesthesia

A

Greek

Lack of sensation

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2
Q

Three A’s

A

Amnesia
Analgesia
Areflexia

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3
Q

General

A

Total unconsciousness
Inhalation or IV induction
Volatile anesthetics or TIVA

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4
Q

Regional

A

Specific to body region
Block w/ infusion
Central neuraxial blocks - spinal or epidural

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5
Q

IV Sedation

A

MAC
Comfortable & sleepy
Able to maintain breathing

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6
Q

DAMITS

A 
Drugs
Airway
Machine/Monitors/Masks
IV supplies
Tape/Tubes/Temp
SUCTION
Other
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7
Q

DAMITS Drugs

A

Induction:

  • Versed 1mg/mL
  • Fentanyl 50mcg/mL
  • Lidocaine 2% 20mg/mL
  • Propofol 10mg/mL
  • Etomidate
  • Ketamine
  • Rocuronium 10mg/mL

Volatile anesthetics
Anti-emetics

Emergency:
- Phenylephrine* 80-100mcg/mL (10/20cc)
- Ephedrine* 5mg/mL (5/10cc)
- Atropine 1mg/mL (3cc)
- Glycopyrrolate 0.2mg/mL (3cc)
- Succinylcholine 20mg/mL (10cc)
*Laryngospasm
Reversal:
- Neostigmine
- Sugammadex

*Label syringes prior to drawing up meds
Name, concentration, date, time, & initials

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8
Q

DAMITS Airway

A 
Laryngoscope handles & blades x2 each
MAC & Miller
*Check/replace lightbulbs or batteries
Water-soluble lubricant
Tongue blade
4x4s
Various size oral/nasal airways x2
Soft bite block
Appropriate patient size ETT 7.0/7.5/8.0
LMAs 3/4/5
Check cuff - 10cc syringe to inflate
Stylet
Face mask
AMBU bag
Video laryngoscope (back-up airway)
Bougie or adjuncts
Difficult airway & malignant hyperthermia carts
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9
Q

Machine/Monitors/Masks

A 
Anesthesia gas machine check
EKG, BP cuff, Pox, ETCO2
Peripheral nerve stimulator
Set appropriate alarms
Calibration
Appropriate size mask
- Simple face mask, non-rebreather, or NC
Transport tank w/ O2
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10
Q

DAMITS IV

A 
Alcohol, tourniquet, catheter, tape/tegaderm
Stopcock(s)
Lidocaine syringe
IV fluids & warmer
Arterial line
- Pressure bag
Blood tubing
Place 2nd IV after induction
Verify IV patent & easily accessible
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11
Q

Tape/Tubes/Temp

A 
Wipe machine down prior to placing tape on surface
Pre-tear tape w/ tab (easier to find edge)
- Eyes
- Secure ETT/LMA
*Ask preceptor tape preferences
OG/NG
Temp probe - esophageal (core) or skin
Bair hugger
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12
Q

SUCTION

A

ON HIGH @ HOB

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13
Q

DAMITS Other

A 
Clamps
Stethoscope- precordial
Peripheral nerve stimulator
Bair hugger & fluid warmer
Eye protection/face shield
Laryngotracheal topicalization anesthesia LTA 
BIS (bispectral index) monitor
Wire cutters
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14
Q

Induction

A 
Attach monitors
SUCTION
Pre-oxygenate/de-nitrogenate
Time out
Fentanyl & Lidocaine
Sweep monitors
Place nerve stimulator
Adjust bed height
Fit for anesthesia
Ensure everything w/in reach
Induction medications
Confirm unconscious - check lash reflex
Baseline TOF
Paralytic (standard)
Bag-mask ventilate
Tape eyes
Re-check TOF
INTUBATE
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15
Q

Adequate Ventilation S/S

A

Bilateral breath sounds
Chest rise & fall
Fogging/condensation in mask or ETT
Continuous ETCO2

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16
Q

After Intubation

A 
Verify placement
Check appropriate ventilator settings
Switch to vent mode
↓flows 
Turn on anesthetic gas
Secure the airway
Re-position
Place temp probe & OG tube
Additional IV or A-line
Admin antibiotics
17
Q

RSI

A 
Full stomach
Violated NPO guidelines
Obesity
Pregnant >14wks
Cirrhosis ↑abdominal pressure
GERD, bowel obstruction, gastroparesis
Do NOT mask-ventilate
Apply cricoid pressure as induction agent admin & maintain until ETT placement confirmed
18
Q

Failure to Emerge

A

Residual NMB
Excessive opioid or benzo (reversal agent)
Intraop CVA
Pre-existing pathophysiologic condition - CNS disorder, hepatic insufficiency, ETOH ingestion
Electrolyte abnormalities
Acidosis
Hypothermia

19
Q

MAC

A

Monitored Anesthesia Care
Patient spontaneously breathes & able to protect own airway
NO muscle relaxant
Monitoring & supplies set up for general anesthesia
Always prepare for advanced airway management
*Consider positioning - ease to manipulate, access, & control airway
Difficult airway in inaccessible position not appropriate
VIGILENCE

20
Q

MAC Drugs

A

Versed
Opioids - Fentanyl, Remifentanil, Alfentanil, Morphine → respiratory depression
Propofol (sedative-hypnotic)
Ketorolac, Ketamine, Clonidine, Dexmedetomidine

21
Q

Potential MACs

A 
Pacemaker insertion
Burr hole
Simple GYN
Cataract
Hernia
Urological
Skin & breast
Arthroscopic
22
Q

MAC Failure

A

Inadequate local anesthetic
Painful position
Uncooperative patient - pediatrics or psych
Paradoxical sedation effects

23
Q

Stages of Anesthesia

A
  1. Analgesia & amnesia
  2. Delirium & excitation
  3. Surgical anesthesia (plane 2)
  4. Overdose (medullary depression)

AS - N928 Basic Principles of Anesthesia (18 decks)

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