General Anesthesia: Induction, Maintenance, Emergence – Flashcards
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What are the 4 components of GA anesthesia
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1) Analgesia 2) Anxiolysis/Hypnosis 3) Depression of spinal motor reflexes 4) muscle relaxation
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The application of any anesthetic agent in an operative or diagnostic procedure requires: (4)
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1) preop assessment 2) NPO status 3) anesthetic hx/ rxns/ MH 4) labs/tests/ECG
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When is the use of Succinylcholine contraindicated?
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In patients post burn, paralysis, hyperkalemia, and with a history of Malignant Hyperthermia
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What patient population has the highest incidence of PONV?
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Females during child bearing years undergoing laparoscopic procedures.
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Most common anesthesia related incidents
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- breathing system disconnect/misconnect - system leal - drug overdose/underdose - incorrect drug - *undetected esophageal intubation* - failure to intubate, premature extubation - aspiration
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Normal NON-RSI Induction
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- preO2 x5 min - induction agent/eye lid reflexes - ventilate/ Forane on - muscle relaxant/ Vecuronium - intubate - confirm placement
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Goals for emergence: (4)
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1) Restoration: normal RR and airway reflexes 2) Management: coughing and bucking 3) minimizing PONV 4) Minimizing post op pain
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*Things to assess prior to extubation:*
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- VSS - O2 saturation >95% (know baseline) - NMB assessment (twitches) - airway reflexes - follows verbal commands - TV > 5ml/kg - VC > 10ml/kg - NIF > -20cm H2O - RRR - ETCO2 within near normal limits
