Therapeutic & Diagnostic Procedures Flashcards
Understanding that the standards of anesthesia care and patient monitoring are the same regardless of _____
location***
Realize that remote locations have different safety concerns, such as radiation and powerful magnetic fields.
Sedation practices may result in ____ or _____ which must be rapidly recognized and managed to avoid risk of aspiration, hypoxic brain damage, cardiac arrest, or death.
cardiac or respiratory depression***
It is the responsibility of the anesthesia provider to ensure that the location meets the
ASA guidelines for safety
The ASA published guidelines, standards, & definitions of general anesthesia & levels of sedation.
Understanding the procedure, ______ , the anticipated level of stimulation, and patient position during the procedure are all important considerations.
the patient’s condition***
Procedures that might be anticipated to last _____ may best be performed with GA at the onset rather than _____ after failure of sedation.
Several hours
late conversion***
- Consider performing anticipated difficult intubations in the operating room.
- Once the airway is controlled, the patient can be transported to the site of the planned procedure.
JCAHO defines anesthesia care as the administration of IV, IM, or inhalation agents that may result in the ____
loss of protective reflexes***
JCAHO introduced standards requiring anesthesia services participate with non-anesthesiology departments in setting up a ______ for patients undergoing sedation in all parts of the hospital
uniform quality of care***
JCAHO - Patients that receive anesthesia or sedation at alternative sites should expect the same ____ that they would receive in the OR.
standard of care***
Anesthesia providers undertake most of their training in the OR surrounded by familiar ______ experienced in the care of anesthetized patients.
equipment & staff***
At the conclusion of the procedure, patients should ______ supervised by personnel who are trained to take care of unconscious patients & with appropriate monitoring & resuscitation equipment immediately at hand.
recover from anesthesia or sedation in a PACU or similar setting***
Who must be present the entire case?
Qualified anesthesia personnel must be present for the entire case.
Nurses and radiology techs are often less familiar with the management of anesthesia, therefore they are often unable to provide skilled assistance in an emergency unless they receive specific training.
What monitoring is required in out of OR anesthesia
Supplemental Oxygen Pulse oximetry End-tidal carbon dioxide detection and disconnect alarm. EKG & NIBP Temperature Patient positioning
After the case, patients must be ____
medically stable before transport***
Patient must be accompanied to the recovery area with what?
Provisions for O2 delivery and monitoring on the transport cart are required.
Emergency medications***
Office based anesthesia is usually used for what type of procedures?
ENT and dental
Office based anesthesia require what?
A full pre-op workup**
Who are not good candidates for office based anesthesia?
potentially difficult airways
What type of anesthesia is used in office based settings and what agents?
Procedures often involve local anesthesia plus IV sedation or light general anesthesia with a mask or LMA.
Agents of choice include: Propofol Sevo Des N2O
Office based anesthesia ASA and JCAHO guidelines
Employment of appropriately _____
Availability of properly maintained ____
Complete documentation of the ___ as required at other surgical sites.
Use of standard ___ & availability of ___
Provision of a ____ that is staffed by trained nursing personnel.
Establishment of a written plan for ____ of the patient to a comprehensive care center if a complication occurs.
trained and credentialed anesthesia personnel.
anesthesia equipment.
care provided
ASA monitoring; emergency equipment.
PACU
emergency transport
*** this whole slide
In US, CT, MRI, RFA, and neuro-coiling, there is a unique risk for
radiation exposure***
What are the risks of radiation exposure?
Leukemia and fetal abnormalities (abnormalities caused by damage to the gonadal cells or developing fetus).
Dosimeters are required for radiation exposure, what is the annual maximum exposure? Lifetime? Monthly for pregnant women?
Annual: maximum exposure 50 mSv
Lifetime: 10 mSv x age
Pregnant: 0.5 mSv
T/F: Fluoroscopy is significantly less exposure to everyone than taking single shot x-rays.
True
What can be done to limit radiation exposure
by wearing appropriate lead aprons and thyroid shields, using movable leaded glass screens, and using innovative techniques such as video monitoring and remote mirroring