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36 Cards in this Set

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