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25 Cards in this Set
- Front
- Back
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What is the difference between CPAP and BiPAP?
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CPAP - continuous positive airway pressure is labored inhalation and exhalation
BiPAP - bilevel positive airway pressure - difficult to inhale, easy to exhale |
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Combitube, King Airway, or laryngeal mask airway (LMA) are considered what?
If all fails, try a __________ |
Back up for intubation - if you fail intubation a second time you use these
cricothyroidotomy |
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Patients that are potentially difficult intubation may have:
____ neck Prominant upper _______ Receding mandible (short) Limited ___ opening Limited ______ _____ mobility Big tongue Also Santa - why? |
short
incisors jaw cervical spine Fat and beard |
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2 types of Paralytic drugs:
Depolarizing Neuromuscular Blocker which is what drug? Nondepolarizing Neuromuscular Blocker which is what two drugs? |
Succinylcholine
Vecuronium, Rocuronium |
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Which paralytic drug is ultra short-acting, combines with cholinergic receptors to produce flaccid paralysis. Muscle fasiculations visible.
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Succinylcholine
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Which drug takes effect in 30-60 sec, optimal intubating conditions occuring at 60-90 seconds, paralysis lasts 8-12 min
Appearance: SLUD(salivation, lacrimation, urination, defecation) |
Succinylcholine
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Side effects of succinylcholine:
What happens to the following... Heart rate Intragastric pressure Intracranial pressure Intraocular pressure Serum potassium levels temperature |
bradycardia
all the rest increase |
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Which drug has optimal intubating conditions around 2.5-3 min, acts for 25-40 min. Metabolized by livera nd kidneys (affect recovery time). Not significant side effects
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Vecuronium
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Which drug - onet of muscle reaction is 15-20 seconds, duration is 25-60 min
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Rocuronium
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Which barbituate is used as a sedative, short acting, rapid onset of action, pantiepileptic properties, but risk of hypotension?
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Thiopental
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Which sedative is rapid acting, induces disassociative state where patient is in "twilight state". Disruption of conduction between the thalamocortical areas.
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Ketamine
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Which drug is used for sedation and analgesia for kids undergoing complex laceration, repairs, fracture relocations, etc... not used ina dults due to high likelihood of emergence reaction
RSI |
Ketamine
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What is the emergence reaction of ketamine?
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Psychological manifestations - treated with co-admin of benzodiazepines.
When used for RSI give a longer acting sedative to prevent emergence reaction from revealing |
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Which paralytic drug do you avoid using in someone with high K (dialysis or burn pt)?
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Succinylcholine - can produce arrhythmia
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Which sedative has some bronchodilatory preoprety useful in asthmatics?
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Ketamine - mild sympathomimetic
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Which benzodiazepine is short-acting CNS depressant to cause lack of recall.
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Midazolam
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Which drug is very commonly used, causes some HTN, lipophylic and disrputs nerve conduction. Fast onset, rapid offset (8min).
Anti-convulsant, very profound anti-emetic*, can lower intracranial pressure |
Propofol
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Which drug is rapid acting hypnotic, sedative with no analgesic or amnestic properties. Quick acting, doesn't drop BP, lower intracranial pressure, ideal for HYPOVOLEMIC pts or those in shock. Can cause vomiting and myoclonus in pts
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Etomidate
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39 year old pt suffered 30% third degree burn 16 hrs ago. Having increased resp difficult and will need to be intubated. You will need to use RSI (rapid sequence intubation)
Which of the following drugs is most likely to cause a potentially life threatening arrhythmia? 1 Succinylcholine 2 Vecuronium 3 Thiopental 4 Ketamine |
Succinylcholine
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A four year old otherwise healthy child has laceration requiring sutures on his lip. Uncontrollable fear of needles. Which is the best intervention:
1 Glue the laceration 2 Use a papoose board to immobilize 3 Use ketamine IM 4 Use midazolam nasally |
Use ketamine IM
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65 year old pt arrives to hospital in cardiogenic shock and respiratory distress. Need to use RSI and intubate him. The most useful drug to sedate him would be:
1 Midazolam 2 Ketamine 3 Thiopental 4 Propofol 5 Etomidate |
Etomidate (he is in shock)
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75 year old with a-fib at a rate of 175/min. Chest pain, BP of 120/80. You decide she is unstable and wish to cardiovert her. Which of the following drugs would be most useful in this setting?
1 Ketamine 2 Thiopental 3 Succinylcholine 4 Propofol 5 Rocuronium |
Propofol - best to cardiovert
quick onset, low cardiopulmonary depression, and rapid recovery |
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Which of the following would be the most appropriate intervention if you are unable to intubate a pt after 2 attempts:
1 Reposition the pt 2 Use a Combitube 3 Call for assistance 4 Do a crico-thyroidotomy 5 Do a tracheotomy |
Use a Combitube - at this point need a secondary airway
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In what order do you paralyze/sedate?
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Paralyze first (succinylcholine) THEN sedate
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Why give lidocaine?
Why give atropine? Why give vecuronium? What is the Sellick maneuver? Why give Etomidate? Why give Succinylcholine? |
Maybe useful in head injury case
Decreases secretions - esp in kids Prevents fasciculation Circothyroid pressure to prevent vomtiing and aspiration rapid acting hypnotic, sedative that is quick and doesn't drop BP Short acting paralytic |
