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Barry OR & def '12

Barry Intro to OR and definitions and classifications

QuestionAnswer
What temp range should the OR be? 20-23 c. or (68-73f)
Room temp for peds, trauma, burns, or exposed areas warmer at least 24 c.
Ideal OR humidity level 30 - 60%
What is the min. # of air exchanges/hr in the OR? 15 exchanges per hour with a min. of 3 from outside air.
Is the air pressure in the OR positive or negative Positive
Micro shock dose/ risk factors 100 microAmps may cause VF, central line or pacer wires
Macro Shock dose 100-300 miliAmperes
What is Ohm's law V= I x R V= volts, I = current in amps, R= resistance (ohms)
What clinical formula utilizes Ohms law? Blood pressure. BP= CO X SVR
What does the isolation transformer do? Takes power to the OR and makes it not grounded.
Is the O.R. grounded? NO!
What is a LIM (line isolation monitor?) Monitors the potential for energy to flow from the isolated power supply to the ground
Does the LIM provide saftey from electrocution. NO. Predicts amount of current that could flow if there were a second fault
When does the LIM alarm? alarms if a high current flow to the ground is possible (2ma-5ma) or faulty equiptment is plugged in.
What is the #1 occupational hazzard in Anesthesia? Substance Abuse
What are the components of the fire triad? 1. Ignition source 2. fuel 3. oxidizers
Do Nitrous and Oxygen function equally as oxidizers Yes!
How big is the margin of "contamination" on a sterile field? 1 inch
What parts of the Gown are sterile? From the front of the chest to the level of the sterile field. On the sleeves from 2 inches ubove the elbows to the cuff.
What is the purpose of denitrogenation? replace aveolar nitrogen with O2 to achieve an intrapulmonary O2 reserve that will allow apnea to be as prolonged as possible with least amount of desaturation. Fills FRC with 100% O2.
What are the 2 ways to preoxygenate? 100% Oxygen at tidal volumen for 3 min. using a well sealed facemask or 8 vital capacity maneuvers in 1 min.
If you preoxygenate well how long can a healthy adult go apenic? 6-10 minutes
What are the reasons for RSI? Full stomach, Trauma, Obese, pregnant, acute abdomen, Hiatal hernia, Gerd, PUD, Diabetes, n/v
For RSI do you manually ventilate after you give the muscle relaxer? NO!
How long do you hold chricoid pressure for RSI Until the airway is secured and the balloon is inflated and confirmation with positive End tidal CO2.
What is teh Only absolute contraindication to regional anesthesia? Patient refusal.
What is stage I? "Amnesia" Occurs during induction with loss of consciousness.Reflexes still intatct. From administration to LOC.
Can the patient still feel pain in stage I? Yes!
Stage II Delerium or excitement phase. From LOC to onset of surgical anesthsia. ***Move through this phase quickly***Disconjugate pupils, Increased HR, BP, RR. Heightened laryngeal irritability and larygospasms
What do you not do durng Phase II? and Why? Extubate. It can cause laryngospasm
What is Stage III "Surgical Plane" Fixed gaze pupils constricted eyes straigh forward, no response to stimuli. Deep regular breathing
What is Stage IV Too DEEP! Eventual Death. Profound CV and resp depressio. Profound decr in BP. Abesent or shallow resp
What is regional anesthesia? The production of insensibility of a part by interrupting the sensory nerve conductivity from that region of the body.
What are the 3 classes of Anesthesia? MAC, General and Regional
What is the difference between Sedation and MAC? Provider Capacity
What is the distinguishing feature of conscious sedation? The ability of the patient to independantly maintain their airway.
Describe pt responsiveness during minimal sedation? appropriate
Describe pts ability to maintain airway in minimal sedation? no intervention needed
In minimal sedation will the patient spontaneously ventilate Yes
In minmal sedation is the CV function of the pt affected? No
During moderate sedation describe the pts responsiveness pt responds to purposefully to tactile stimulation.
Should you require airway intervention during moderate sedation? No
How should the pt ventilate during moderate sedation adequatly
Should CV function be maintained during moderate sedation? yes, should be maintained
During Deep Sedation/MAC how should the patient respond? The pt should respond purposfully to painful or repeated stimuli
During Deep Sedation/MAC should the pt maintain their own airway? Intervention may be necessary
During Deep Sedation/MAC describe how the patient should spontaneously ventilate The ventilation may be inadequate
Is the cardiovascular function usually maintained during Deep Sedation/MAC Usually Maintained
Describe patient responsiveness during General Anesthesia Unresponsive
Describe pts airway during General Anesthesia Intervention required
Is spontaneous ventilation adequate for a pt under general anesthesia? Usually Inadequate
Is the cardiovascular function always stable under general anesthesia. It may be impaired.
Does the pt monitoring standard of Care change with MAC, Regional, and General anesthesia? No
If they are not a good canidate for general anesthesia are they a good canidate for MAC? NO
What is the best Monitor? YOU!!!
What must be monitored during all anesthetics? Oxygenation, ventilation, circulation and temp.
What is a contraindication for a MAC Full Stomach
If you are doing a MAC what do you get consent for? General Anesthesia
What is General Anesthesia? A reversable state of unconsciousness, amnesia, analgesia and lack of movement.
What types of methods and airways fall under the category of "General" Mask LMA, ETT, TIVA, Inhaled, Mixed
People with MH will always get what? TIVA
What is induction? Loss of consciousness and securing the airway.
Why do you not use inhaled inductions for difficult airways, neck tumors or lesions? Because the trachea can collapse
What are the phases of general Anesthesia? Induction, maintenance, and emergence.
How do you want the room when the pt is in Stage II? Quiet, no stimulation, no foley caths...
Created by: shamus22 on 2010-04-07



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