anesthesia note packet three

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  1. injectable
    • minimal equiptment, less costly
    • poor control once given, metabolized in liver and excreted in kidneys, oxygenation minimized
  2. inhalant
    • depth change easy/safe, metabolized by lungs, can administer large volumes of O2, mechanical ventilation possible
    • high equiptment costs, slow induction, gas anesthetic waste/pollution
  3. fill the lungs (alveoli) with gas ASAP
    inhalants goal
  4. safe and rapid
    ideal inhalant agent
  5. halogenated compounds
    liquid at room temperature
  6. halothane
  7. isoflurane
    Aerrane, most commonly used from the mid 80's
  8. sevoflurane
    SevoFlo, mid 90's
  9. mechanism of action
    inhibition of nerve function and disabling effect of nerve cells
  10. general anesthesia, muscle relaxation, poor analgesia, slows respiration and slows heart function
    physiological effects of gases
  11. gas in brain, blood, and alveoli
    anesthetic depth is dependant on the partial pressure of...
  12. vapor pressure
    measures the tendency of a molecule to escape from the liquid to the vapor/gas phase
  13. the speed of evaporation
    the vapor pressure determines...
  14. volatile (ie. vaporizes easily)
    High VP
  15. minimally volatile
    low VP
  16. solubility coefficient
    measurement of distribution of an inhalant agent between blood and gas phases of the body
  17. speed of induction and recovery
    solubility coefficient indicates...
  18. slow induction and recovery because it will hang out in the blood or tissues
    high solubility
  19. fast induction and recovery
    low solubility
  20. minimum alveolar concentration (MAC)
    lowest concentration that produces no response in 50% of the patients exposed to a painful stimulus
  21. reflects the potency of the agent
    the importance of MAC...
  22. less potent
    high MAC
  23. more potent
    low MAC
  24. 1.5 x MAC *nothing else on board*
    surgical anesthesia formula
  25. halothane (red)
    • High VP
    • Moderate Solubility Coefficient
    • 0.87% MAC
    • 1% Surgical Anesthesia Maintenance
    • 80% Alveolar Metabolism
    • 20% Liver Metabolism
  26. isoflurane (purple)
    • High VP
    • Low Solubilty Coefficient
    • 1.2% MAC
    • 2% Surgical Anesthesia Maintenance
    • 99% Alveolar Metabolism
    • <1% Liver Metabolism
  27. sevoflurane (yellow)
    • High VP
    • Low Solubility Coefficient
    • 2.1-2.3% MAC
    • 3% Surgical Anesthesia Maintenance
    • 97% Alveolar Metabolism
    • 3% Liver Metabolism
  28. ether
    1842, flammable, explosive
  29. nitrous oxide
    not a potent agent, 100% in humans, 200% MAC in dogs and 250 in cats
  30. desflurane
    chemically similar to iso, twice as fast as iso, single breath induction agent in humans
  31. mask technique
    • deliver 100% O2 for 3 min
    • gradually increase to 5% iso
    • either maintain on mask or intubate
  32. prevents cardiac arythmias
    allows for patient adjustment to the smell of iso
    struggling may occur after 2-3 min
    purpose of gradual increase with mask technique
  33. analgesia
    unpleasant sensory or emotional experience associated with actual or potential tissue damage, relief of pai without loss of consciousness
  34. mild, moderate and severe
    3 classifications of pain intensity
  35. acute
    abrupt onset, relatively short, usually treatable (type of pain)
  36. chronic
    slow onset, long duration, potentially manageable (type of pain)
  37. increased heart rate, blood pressure, respirations and dilated pupils
    physiological signs of pain
  38. endorphins
    chemicals in the brain that are released in response to pain to provide analgesia
  39. preemptive analgesia
    analgesia provided before its needed
  40. operative analgesia
    analgesia provided throughout surgery
  41. postoperative analgesia
    analgesia provided after surgery for pain relief
  42. opioids/alpha-2 agonists, NLA
    pain relief that targets the brain and spinal cord
  43. NSAIDS
    pain relief that targets tissues and brain, inhibits chemical release fom neurons
  44. local anesthesia
    pain relief that targets regional areas
  45. ketamine
    pain relief that is somatic, dissociative
  46. neuroleptanalgesia
    opioid and tranquilizer combination
  47. balanced analgesia
    mutiple agents that will reduce the quantity of each agent, min toxicity and reduces pain via diff mechanisms
  48. cat declaw, spay and dental with extractions
    • Metacam-preanesthetic NSAID
    • dexdomitor/ketamine/buprenorphine-induction and postop analgesia
    • bupivicaine-local ring and op and postop analgesia
  49. dog spay or neuter
    • Rimadyl-analgesia
    • dexdomitor/Atropine/buprenorphine
  50. orthopedic surgery
    • fentanyl patch-analgesia
    • dexdomitor/Atropine/buprenorphine
    • morphine/ketamine/lidocaine
    • Rimadyl
  51. local anesthesia
    use of a chemical agent on sensory and motor neurons to produce a temporary loss of pain sensation and movement
  52. local anesthetics
    target organs are the PNS and Spinal Cord, they interrupt nerve pathways by loss of electrical impulses on neurons
  53. infiltration
    injectable application of agent into tissues by a major nerve
  54. regional anesthesia
    injectable application of agent near spinal cord or major nerve plexus
  55. injection into nerve-paralysis
    tissue irritation-stings
    paresthesia-abnormal sensation of tingling
    allergic reactions
    systemic toxicity
    inadvertent spinal injections
    local anesthetic risks
  56. mechanical ventilation
    physical movement of air and or anesthetic gases in and out of lungs
  57. inhalation
    active phase of mechanical ventilation
  58. exhalation
    passive phase of mechanical ventilation
  59. tidal volume
    amount of air that passes in and out of lungs in one breath
  60. assisted ventilation
    anesthetist ensures that an increased volume of air is delivered to the patient, although patient initiates each inspiration
  61. controlled ventilation
    externally initiated by anesthetist, patient does not make spontaneous repirations
  62. positive pressure ventilation (PPV)
    ensures patient receives adequate O2 and is able to exhale adequate amounts of O2
  63. hypercarbia
    rise in PaCO2 causes blood pH to fall which leads to resp. acidosis
  64. atelectasis
    partial collapse of sections of the lung due to alveoli not expanding as fully as normal due to reduced tidal volume
  65. periodic bagging
    l breath every 3-5 minutes
  66. continuous bagging
    8-12+ breaths every minute
  67. pressure manometer
    do not exceed 15-20 cm H2O
  68. neuromuscular blocks
    controlled muscle paralysis (blocks impulses of motor neurons)
  69. geriatric patients
    these patients are at greater than 75% of their life expectancy
  70. pediatric patients
    patients that are less than three months old, increased risk of hypothermia
  71. bracycephalics
    anatomical conformation impedes air exchange (elongated soft palate and small diameter ET)
  72. be a team player
    be prepared
    be active
    be responsive
    technicians role in emergencies
  73. tachypnea (hyperventilation)
    higher than normal resp rate
  74. bradypnea (hypoventilation)
    lower than normale resp. rate
  75. respiratory arrest
    perm. brain damage occurs within 4 minutes if O2 isnt delivered to it...turn off agent gas and bag every 5 minutes
  76. Cardiopulmonary Cerebral Resuscitation
  77. airway
  78. breathing
  79. circulation
  80. R lateral recumbancy
    hands at mid chest level (where flexed elbow meets chest)
    1-2 compressions/sec
    CPCR steps
  81. atropine, Respiran, Epinephrine
    drugs to be given during cardiac arrest
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anesthesia note packet three
2011-04-24 01:56:21
anesthesia note packet three

anesthesia note packet three
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