Week 5 Anesthesia Provided at Alternate Sites Flashcards
What are the three factors for anesthesia at alternative sites?
- Environment
- Procedure
- Patient
Center is the Anesthesiologist
What is JCAHO definition of anesthesia care?
Administration of IV, IM, or inhalation agents that result in the loss of the patient’s protective reflexes.
What are the four levels of sedation/analgesia and general anesthesia?
- Minimal sedation “Anxiolysis”
- Moderate Sedation/Analgesia “Conscious Sedation”
- Deep Sedation/Analgesia
- General Anesthesia
What are the four patient considerations when administering anesthesia?
- Responsiveness
- Airway
- Spontaneous ventilation
- Cardiovascular function
What stage of sedation are you at if the patient only responds to “Purposeful response following repeated or painful stimulation.”
-Deep Sedation
What may impair the elimination of contrast media?
- renal insufficiency
- hypovolemia
- Diabetic
- NSAIDS
- Metformin (lactic acid)
What would be considered a moderate reaction to contrast media?
- Edema
- bronchospasms
- Hypotension
- Seizures
How would you pretreat for contrast media?
-adequate hydration
-Sodium bicarb
(one hour before)
-Oral methylprednisone
What drugs would be used to treat contrast media reaction?
- Epinephrine (Adrenergic agonist)
- Aminophylline (Methylaxanthine)
- Atropine (Anticholinergics)
- Diphenhydramine (Antihistamines)
- Methylpredinisolone or Dxamethasone
- Normal Saline
What is the annual recommended occupational exposure of radiation?
5000 mrem
What is the usual INITIAL bolus of heparin?
3000 to 5000 units
What is the usual dose to maintain the correct ACT levels of heparin?
1000 units/hour
What is the usual reversal with protamine for heparin?
Protamine 1 mg / heparin 100 units
At what age does sedation or general anesthesia required for a MRI?
-5 to 11 years of age.
Prevent thromboembolism for patients in atrial fib. for longer than __ hours.
48
When should thromboembolism begin and end for a patient going to receive a cardioversion for atrial fib?
- 3 weeks prior
- 4 week after
What antispasmodic would be used for a endoscopic retrograde cholangiopancreatography?
-hyoscyamine IV
Dose for succinycholine?
(0.75 to 1.5 mg/kg)
Dose for labetolol?
(0.3 mg/kg)
Dose for esmolol?
1mg/kg
Dose for clonidine/dexmethomidine?
1mcg/kg/10min)
The physiologic response of a ECT for a grand mal seizure is ___ seconds tonic phase followed by ___ seconds of clonic phase.
- 10 to 15
- 30 to 60
What are some physiologic concerns for oral surgeries with Down’s Syndrome?
-Atlanto-occipital dislocation
-Airway problems
macroglossia (big tongue)
hypoplastic maxilla
palatal abnormalities
mandibular protrusion
What is the dose for midazolam for pediatrics?
???
