Test 4 Flashcards
What is the objective of pre op med?(6)
Allay anxiety
Produce amnesia
Facilitate the induction of anesthesia
Block autonomic (vagal reflexes)
Reduce airway secretions
Provide prophylaxis against pulmonary aspiration of contents
What is the dose for ketamine?
5mg/kg
Is FRC high or lower in children?
FRC is lower in children
What’s is the mask airway survival position?
Dislocation of ascending ramifications anteriorly
Rotation of Tmj clockwise
Soft tissue is lifted off the hypo pharynx
What size blades to use for premie
0 miller
What size blades to use for large neonate to 4 yrs
Miller 1
What size blades to use for 4-7yr
Miller 2
Blade to use for 8 and up?
Mac 3 or miller 2
What leak should we have around the tube?
20-30 cm
What do we do if we don’t have a leak?
Replace it it can cause edema of larynx
1mm of swelling will reduce airway by what percent
75%
When do we use a cuffed ETT?
Full stomach
Non compliant lungs
Reflux
Hiatal hernia bloody oral surgery
Cleft palate
At what depth should the tube be in
Age divided by 2 plus 12
3x the ett
Kg/5 +12
In patients with epiglottis, how should we induce the patient?
(4)
Iv fluids
Atropine
Use the miller like a Mac *** don’t touch epiglottis
Have bronchoscope equipment ready
Difficult airway algorithm
- Attempt failed
- Call for help
- Mask ventilate? Yes =reattempt/No:
- LMA: yes- leave in
No: jet ventilation with percutaneous. Cricothyrotomy
Induction of a pediatric- explain
70% nitrous & .5% sevoflurane and increase the very 3-4 breaths
If child is crazy how do we induce
70% nitrous and 8% sevoflurane
Disadvantages of dextrose solutions(4)
Hyperglycemia
Osmotic diuretics
Dehydration
Neurological damage
Eye and muscle surgery: medications to administer
Zofran 0.15mk/kg, toradol 0.5mg/kg, Benadryl 0.3mg/kg
Be careful because can drop HR if infused right after other can turn crystallize
Malignant hyperthermia: what is the does for treatment?
Dantrolene 2.5 mg/kg
What levels is causal anesthesia used for?
T10-S5
What procedure is caudal anesthesia used for commonly?
Circumcisom
What is the landmark to find sacral hiatus?
5th sacral vertebral arch found by the prominences known as sacral cornu
How far does the sacral hiatus extend?
Sacral cornu to fused arch of 4th sacral vertebrae
What ligament covers the sacral hiatus
Sacrococcygeal membrane
What equipment do you need
Sterile gloves, local, prep solution and needle.
What’s is the positioning for caudal block
Lateral decubitus with knees up to abdomen
How do you inject the needle for caudal block?
45-60 degrees until you feel a pop, flatten then advance 2-4 mm , aspirate for blood and CSF, use a continuous infusion
What is the typical local used for caudal anesthesia
0.1-0.25% bupivicaine with 1:200,00 epi
Do we use a test dose?
Yes 2cc test dose and monitor for HR
How long does the caudal block last?
4-6 hrs
What is the calculation for dosing ofbupivicaine?
.75-1cc/kg of 0.1% bupivicaine
Volume = 0.05 ml/kg/dermatome to be blocked
What is the max dosing of 0.25% bupivicaine with epi?
2-3 mg/kg
Complications of epidural anesthesia 4
Intravascular
Intraosseus
Hematoma
Infection
Ct scanning can be done with placement of what device and what other anesthesia
Inhaled and LMA
