Clinical Knowledge 1

Front 1

patient's under what age should be checked for pregnancy

Back 1

under 55 years of age, at least at Optim Orthopedics

Front 2

Pregnancy tests in the OR check for

Back 2

HCG = human chorionic gonadotropin

Front 3

procedure for airway or circuit fire

Back 3

1. remove the ETT tube

2. stop the flow of all gases

3. Pour saline or water into the airway

4. Care for the patient, establish that there is no more burning and vent with 100% oxygen

5. examine airway burns and treat

6. keep all burned equipment for investigation

Front 4

T/F Medication vials do not need to be entered with a new syringe or new needle ALWAYS

Back 4

False, medication vials must ALWAYS be accessed with both clean/brand new needles and syringes

Front 5

T/F Sometimes you can use the same syringe of drugs on multiple patients

Back 5

False, you may never use more than one syringe or needle on multiple patients

Front 6

PPE stands for

Back 6

personal protective equipment

Front 7

units of percent

Back 7

each percent is the amount in gm per dL

Front 8

atropine is what kind of drug

Back 8

anticholinergic, a competitive antagonist

Front 9

anticholinergics operate by

Back 9

blocking acetylcholine from its receptors

Front 10

competitive antagonism

Back 10

molecule binds to a receptor without activating it, it blocks the mechanism. Dose dependent.

Front 11

the effect of atropine physiologically

Back 11

Heart rate increases

Front 12

typical atropine concentration

Back 12

0.4 mg/ml

Front 13

typical dose of atropine for brady in adults

Back 13

0.5 mg

Front 14

robinul's other name

Back 14

glycopyrrolate

Front 15

robinul is what type of drug

Back 15

anticholinergic

Front 16

what are the physiological effects of robinul

Back 16

increased heart rate, decreased secretions

Front 17

typical robinul concentration

Back 17

0.2 mg/ml

Front 18

which works faster, robinul or atropine?

Back 18

the literature says atropine at times, but clinically I have observed robinul to be faster

Front 19

what drug has the most variable effect on patients, that I have observed, clinically

Back 19

rocuronium

Front 20

first sign of malignant hyperthermia is usually

Back 20

increased end-tidal CO2

Front 21

hydralazine is what type of drug

Back 21

a direct acting smooth muscle dilator that primarily acts on arteries and arterioles. It requires functional endothelium to produce Nitric oxide, so it only works in vivo, not in vitro. It binds to gated potassium channels and causes potassium to exit/efflux, which hyper polarizes the cell. This prevents calcium mediated vasoconstriction.

Front 22

hydralazine is usually used as

Back 22

a combination drug, especially with labetalol and a diuretic. Hydralazine alone is a poor primary antihypertensive because it elicits the baroreceptor reflex.

Front 23

Hydralazine's other name

Back 23

Apresoline

Front 24

what aspect of cardiac output does hydralazine effect?

Back 24

PVR/afterload. Both are decreased!

Front 25

Hydralazine's normal concentration

Back 25

20 mg

Front 26

Hydralazine increments

Back 26

5 mg

Front 27

hydralazine excretion

Back 27

renal

Front 28

parenteral means

Back 28

administered by another means outside of the alimentary canal. Usually intravenous.

Front 29

hydralazine onset

Back 29

10-20 minutes

Front 30

what is the only way to decrease the burn of propofol on injection?

Back 30

dilute it! 5 ml of 1% propofol with 5 ml of lidocaine appears to be effective

Front 31

Any time you suspect laryngospasm with an LMA, mask, or upon extubation

Back 31

apply positive pressure, if you pass the air into the patient you know they aren't spasming.

Front 32

First drug to give when patient bucks/desats on LMA

Back 32

Succ, 20 mg or so

Front 33

drug you give for carcinoid tumors

Back 33

octreotide

Front 34

narcan comes as

Back 34

0.4 mg per ml

Front 35

give narcan in this increment

Back 35

0.04 mg per ml

Front 36

which anesthetic agent can cause grand mal seizure like activity (no idea if it's a seizure)

Back 36

etomidate

Front 37

most histamine-releasing muscle relaxant

Back 37

atracurium

Front 38

what drug and what dose(s) do you give for PSVT

Back 38

adenosine, 6 then 12 mg

Front 39

max dose of lidocaine with epi

Back 39

7 mg

Front 40

any time the airway is burned

Back 40

intubate the patient

Front 41

the cuff on a ped ETT is ___ volume and ___ pressure

Back 41

hi volume, low pressure

Front 42

can tape on the face make a guy bleed a lot and cause trauma? What makes this worse

Back 42

yep, esp if they have petechiae or rosacea

Front 43

hypoxia after nitrous use...

Back 43

atelactesis could be the cause

Front 44

when evaluating patient ventilation NEVER trust

Back 44

chest rise. Chest rise is seen in obstruction and laryngospasm

Front 45

if you extubate awake with ANYTHING then always have

Back 45

a biteblock

Front 46

no toradol for patient's with

Back 46

asthma or kidney probs

Front 47

when giving toradol, wait till

Back 47

they are closed, to decrease oozing

Front 48

is nitrous safe for malignant hyperthermia?

Back 48

yes

Front 49

never say this term in front of a patient

Back 49

malignant

Front 50

when should you give DES as a gas, in your experience

Back 50

when the patient is paralyzed, other wise use it after Sevo to smooth things out. Switch to des after patient is cut

Front 51

Never give lidocaine after a

Back 51

block

Front 52

if the patient coughs on a tube, the first thing you do is

Back 52

turn the vent off

Front 53

tourniquet release causes what on SpO2

Back 53

decrease sat reading

Front 54

when you really want to get gas on quick, turn up this flow

Back 54

Nitrous. #secondgaseffect

Front 55

greater than this age, give IV

Back 55

10 yo

Front 56

tourniquet pain typically presents at

Back 56

30-45 minutes

Front 57

always check this before giving a Beta Blocker

Back 57

HR

Front 58

to fight scavenging from deflating the bag on older machines (dragers)

Back 58

close the APL valve

Front 59

if the patient is too light, pain can cause this complication

Back 59

laryngospasm

Front 60

tx for atelactesis

Back 60

Positive pressure breaths!