Miscellaneous topics 7 Flashcards
Deflation of the pneumatic tourniquet during orthopedic surgery is expected to increase:
a. blood pressure
b. mixed venous oxygen saturation
c. end-tidal carbon dioxide
d. blood pH
c.
______________________ increases intramedullary pressure in the bone and this can produce microemboli that travel to the lungs.
Methyl methacrylate
Methyl methacrylate that produces microemboli that can travel to the lungs can result in
V/Q mismatch and potentiate right heart failure
Residual methyl methacrylate can enter the systemic circulation where it causes
bradycardia, dysrhythmias, systemic hypotension, pulmonary hypertension, hypoxia, and cardiac arrest
Methyl methacrylate entering the systemic circulation is known as
bone cement implantation syndrome (BCIS)
__________ is a recognized complication of long bone trauma
Fat embolism syndrome
The triad of fat embolism syndrome includes
respiratory insufficiency, neurologic changes, and a petechial rash
To reduce the risk of limb ischemia when using a pneumatic tourniquet, the maximum inflation time is
two hours
When used for a bier block, the tourniquet must remain inflated for at least
20 minutes after LA is injected
Premature release of LA after a bier block can lead to
seizures and/or cardiac arrest
Under general anesthesia, tourniquet pain manifests as
hypertension and tachycardia
Deflating the pneumatic tourniquet causes a
redistribution of circulating blood volume and exposes the body to the washout of metabolites that accumulated during limb ischemia
___________ is associated with the highest risk of bone implementation syndrome
Hip arthroplasty
In the awake patient under regional anesthesia, the first signs of BCIS are usually
dyspnea and AMS
Under GA, the first sign of BCIS is usually
a decreased EtCO2
First line treatment of BCIS is
100% FiO2
IV hydration
phenylephrine for hypotension
