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36 Cards in this Set
- Front
- Back
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Goals of the anesthetic plan
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provide optimal pt care, improve outcome, reduce errors, improve pt satisfaction, efficient resource utilization, anesthetic care team
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The airway algorithm is in place to
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prevent getting stuck or doing the wrong thing repeatedly -- purpose is to keep you moving!
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Human factors associated w incidents
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haste, distraction, fatigue, failed vigilance, carelessness, failure to plan, restricted access to patient, lack of skilled assistance, inadequate supervision, inexperience, poor communication, unfamiliarity w equipment
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What is the 1 question to ask
an 18 yr old pt or an 80 yr old pt? |
18- allergies?
80- comorbidities/meds? |
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People w allergies to bananas and avocados are also likely allergic to
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latex
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Weight is important for anesthesia provider for
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drug choice and dosing, fluid calculations, positioning, technical issues, airway
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Height is important for anesthesia provider for
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epidural dosing, airway
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What is ideal body weight for males and females?
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males: 50 kg + 2.3 kg for each inch over 60 inches
females: 45.5 kg + 2.3 kg for each inch over 60 inches |
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Actual body weight =
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ideal body weight + 0.4x (actual body weight - Ideal body weight)
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In a pt w HTN, the provider should maintain
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BP within 20% of baseline
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In a pt w CAD, provider should
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avoid tachycardia
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Will a R lung mass affect anesthesia?
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not really
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In a pt w COPD, provider should
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frequent pulm toileting due to incr mucous and plugging
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In a pt w chronic Afib, provider should
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provide rate control, use beta blockers or Ca channel for LVH
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For a pt w gerd, provider should
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use RSI for incr aspiration risk
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For pts undergoing chemotherapy, the provider should be aware of
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possible interactions w anesthesia drugs - modify anesthetic technique, clinically silent toxic side effects, altered reactions to common anesthetic agents, impaired stress reaction (immunosuppression), opportunistic infections
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When a pts past surgical history info is available in the record, the anesthesia provider should consider
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anesthetic issues in the past, drug doses used in the past, emergence issues in the past, family hx of anesthesia issues
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If a pt has a family hx of MH...
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give dantrolene and start w 2 mg/kg and incr if needed -- dantrolene is a muscle relaxant
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This is an anesthesia complication in which pt has a succinylcholine rxn, and any drug metabolized through hydrolysis can cause it
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pseudocholinesterase deficiency
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What are anesthesia implications of pt on HCTZ?
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diuretic, may cause hypovolemia, electrolyte imbalance, smooth muscle relaxation and exxag vascular response to induction agent
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What are the anesthesia implications of a pt on metoprolol
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its a beta 1 blocker, ask if pt has taken it today, may require more due to incr stress of OR
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What are the anesthesia implications of a pt on lovenox
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anti-coag for afib, increased bleeding and coag changes
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What are the anesthesia implications of a pt on docusate
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do not reverse
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What are the anesthesia implications of a pt on metoprolol
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its a beta 1 blocker, ask if pt has taken it today, may require more due to incr stress of OR
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What are the anesthesia implications of a pt receiving albuterol
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airway is responsive to chemicals, can cause tachycardia, DONT USE W LABETALOL
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What are the anesthesia considerations of a pt receiving protonix
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pt has gerd, RSI
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What are the anesthesia implications of a pt on lovenox
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anti-coag for afib, increased bleeding and coag changes
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What are the anesthesia implications of a pt on docusate
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do not reverse
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What are the anesthesia implications of a pt receiving albuterol
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airway is responsive to chemicals, can cause tachycardia, DONT USE W LABETALOL
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What are the anesthesia considerations of a pt receiving protonix
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pt has gerd, RSI
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What are the anesthesia implications of dolasteron?
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serotinin 5HT3 receptor antagonist, works by blocking vomiting reflex in brain
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Once you premedicate pt w anesthetic sedative....
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you cannot leave pt's side
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Vital signs goal intraoperatively
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maintain within 20% of baseline
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It is important to ____ IV status after pt is sleeping and PRN after ( after repositioning).
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reassess
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In a COPD pt, this value can help with ventilator titrations.
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ETCO2
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Never extubate a person if you're not fully prepared to
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reintubate if necessary
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