Flashcards in Anesthesia & Surgical Complications* Deck (40):
What are some conditions that would require prolonged intubation?
___________ problems, which occur in ___% of PACU patients, are the most frequently encountered serious complication in PACU
what are the 3 most common respiratory problems in PACU?
what are some common causes of airway obstruction?
Posterior displacement tongue*
Blood in airway
External pressure on trachea
in a Partial vs. complete obstruction you will see what?
Paradoxical chest movement
what are some corrective measures for airway obstruction?
Jaw thrust, head tilt
NAW (preferred) or OAW
what are some corrective measure for laryngospasm?
PPV and jaw thrust
0.1 mg/kg or 10-20 mg of succinylcholine
how is hypoventilation defined?
Generally defined PaCO2 > 45 mmHg
Common after anesthesia
Significant > 60 mmHg or pH < 7.25
what are some indicators of hypoventilation?
Tachypnea w/shallow breathing
what are some potential complications resulting from hypoventilation?
Respiratory acidosis = HTN, tachypnea, and cardiac irritability = cardiac depression
Most common respiratory problem that occurred in PACU
what are some causes of hypoventilation?
Depressant effects of anesthetic agent(s)*
splinting due to pain
how is hypoxia defined?
Hypoxia PaO2 < 60 mmHg
What are some signs of hypoxia?
Early signs: Restlessness, tachycardia, cardiac irritability
Late signs: Obtunded, bradycardia, hypotension, and cardiac arrest.
what are some causes of hypoxia
Prolonged intraoperative hypoventilation
Lobar collapse from obstruction
What are some treatment options for hypoxia?
Diuretics = fluid overload
Bronchodilators = bronchospams
PEEP/CPAP = atelectasis
Most common GI complication in PACU is ________
what are the three most common circulatory problems in PACU?
what are the primary and secondary causes of post-op HTN
Vascular volume overload
4 Abnormal ECG Requiring Tx
ST w/hemodynamic instability
ST segment depression or elevation is measured relative to what?
what are some treatment options for ventricular tachycardia?
-Electrical (DC) 200,300,360 J (EXTERNAL)
what is the most common dysrhythmia associated with cardiac arrest?
hyperkalemia is treated with what?
which rhythm can you not shock?
ventricular asystole.......ok, you can, but it won't do any good.
how does hyperkalemia effect the EKG?
increases the T wave then begins to widen the QRS complex. Finally, the EKG begins to morph into a "sine" wave
what are the neuromuscular signs of hyperkalemia in an awake patient?
Weakness, respiratory insufficiency
Flaccid paralysis (doesn't sound fun)
disturbance of which ion is responsible for malignant hyperthermia?
Ineffective uptake of calcium by SR or
Inappropriate release of intracellular Ca+2
what are the triggering agents for malignant hyperthermia?
Inhalational anesthetics (except N2O)
Malignant Hyperthermia Signs
Hypermetabolic state muscles
Hyperthermia (40-43 C)
HYPERCARBIA (Increased EtCO2)*
Increased Cardiac Output
Masseter muscle spasm
treatment for malignant hyperthermia
Halt administration triggering agent
Dantrolene 2mg/kg q 5 min (max 10 mg/kg)
Pack groin, axilla, neck ice
Irrigate stomach bladder iced solution
Insert arterial line for ABG and enzyme monitoring (CPK, myoglobin, glucose, etc)
what are some other common places for injury?
Peripheral Nerve Injury
Cardiopulmonary arrest after spinal
ischemic optic neuropathy is associated with what position?
venus air embolism is most often associated with which position?
What is alopecia?
bald spot from having too much pressure on one area for too long
which drugs are most likely to ellicit and allergic reation?
most errors are the result of what?
what is a critical incident?
A human error or equipment failure that could have led (if not discovered or corrected in time) or did lead to an undesirable outcome, ranging from increased length of hospital stay to death.
human error accounts for what percentage of all critical incidents?