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Barry OR & def '12
Barry Intro to OR and definitions and classifications
| Question | Answer |
|---|---|
| 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
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