Anesthesia Simulation

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Author:
emm64
ID:
310637
Filename:
Anesthesia Simulation
Updated:
2015-10-30 01:22:21
Tags:
Anesthesia Simulation
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Description:
Anesthesia Simulation
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  1. Difficult Mask
    • 1. Reposition head
    • 2. Use head strap
    • 3. Oral/nasal airway
    • 4. get help
    • 5. 2 handed ventilation
    • 6. Difficult airway cart
    • 7. LMA
    • 8. Inform surgical team, proceed with LMA or cancel case
  2. Hypotension causes
    • 1. low preload (fluid bolus)
    • 2. low SVR (fludi bolus, decrease agent)
    • 3. low HR (vagolytic)
  3. Hypotension managment
    • 1.
    • Low preload: fluid bolus
    • Low SVR: fluid bolus, decreases agent
    • Low HR: vagolytic
    • 2.
    • Administers pressor (ephedrine 5mg/phenyl 40mcg)
    • Administers vagolytic (glyco .2mg/ atropine .5mg)
    • Turns off agent, 100% O2
    • Calls for attending
    • Start second IV
    • 3.
    • Calls for help
    • Calls for cardiac ultrasound
    • Prepares for pressors (epi 10mcg /vasopressin .5-1unit/minute)
    • Cancels case
  4. Bronchospasm signs
    • Tachycardia
    • Peak airway pressure rise, triggering high pressure alarm
    • Upsloping EtCO2 waveform
    • Wheezing on exam
  5. Bronchospasm management
    • Increases O2 to 100%
    • Deepens inhalational
    • Checks tube to rule out obstruction, corrects if finds.
    • Gives albuterol
    • Notifies attending
    • Calls for help
    • Notifies surgeons
    • Gives low dose epi (10 mcg to begin).
    • Gives low dose ketamine (.2-1 mg/kg)
    • Gives hydrocortisone (100 mg)
    • Bronchospasm resolves: continues case
    • Bronchospasm does not resolve: cancels case and begins anaphylaxis ddx.

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