Laser ppt Flashcards by Josh Newby

What does LASER stand for

Light 
Amplification
by
Stimulated
Emission 
of
Radiation

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what is a device that controls the way energized atoms release photons

Laser

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what are the 3 main properties of a laser that make if very different from other lights

monochromatic
coherent
directional

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what property of a laser is that it contains one specific wavelength of light (one specific color).

monochromatic

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the wavelength of light is determined by what?

the amount of energy released when the electron drops to a lower orbit

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what property of a laser describes how it is organized- thus each photon moves in step with the others, this means that all the photons have wave fronts that launch in univision

coherent

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which laser property is that a laser light has a very tight beam and is very strong and concentrated

directional

a flashlight in contrast releases light in many directions, the light is very weak and diffuse

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Carbon dioxide laser properties (2)

invisible

marked with a helium-neon aiming beam

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what is the Carbon dioxide laser used for

upper airway sx

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is carbon dioxide laser common

yes,

very common

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Nd-YAG laser stand for what?

neodymium-yttrium aluminum-garnet laser

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Nd-YAG laser properties (1)

short wave length allows transmission by fiberoptics

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Nd-YAG laser is used for what sx’s

distal tracheobronchial tree and retina sx

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KTP laser stand for what?

Potassium-titanylphosphate laser

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KTP laser can be transmited by what?

fiberoptics

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KTP laser is used in what sx’s

neurosurgical and

otolarygeal

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Argon Laser can be transmitted by what

fiberoptics

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Argon laser is used in what sx’s

neurological, retinal, and otolaryngological

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7 wavelengths in order of power (weakest to most powerful

radio
microwave
infrared
visible
ultraviolet
x-ray
gamma ray

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with laser wavelengths longer wavelengths= what?

lower freq and lower energy

all start with L

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with laser wavelengths shorter wavelengths= what?

higher freq and higher energy

for jake sHorter= Higher and Higher) :

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frequancy is inversly proprtional to what??

wavelength

the higher the frequency the smaller the wavelength

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what has a higher freguency?
KTP Wave length is 532
or
Nd:YAG wave length 1064

KTP
remember
freq is inversly proportional to wave length
the longer the wavelength the lower freq

which laser is for deep tissue? and why?

Nd-YAG

b/c of near infrared I guess????

what is the only laser that wet tissue can protect pt (like a wet towel)

CO2 laser

what 2 lasers are absorbed by Hgb and melanin or other similar pigments? transmitted through clear substances. tissue penetration 0.5-2 mm

Argon | KTP

which laser is more readily absorbed by dark tissue? transmitted through clear fluids tissue penetration 2-6 mm

Nd-YAG

which laser is strongly absorbed by water, and thus by all tissue, pigmented or not. tissue penetration <0.5mm

CO2

the greater the wavelength = the _______ absorption by water

greater | CO2 greatest WL 10,600

CO2 laser properties? | WL 10,600

Longer WL= Low freq= Low energy

Nd-YAG laser properties | WL 2064

sHorter WL= Higher freq= Higher energy

Lasers are freq used in airways for what sx's

``` laryngel papillomas tracheal scaring vascular malformations neoplasms idiopathic subglottic stnosis ```

Risk of lasers in sx

loss of AIRWAY FIRE burns eye damage

Preoperative preperation for laser sx

antisialagogue Eye protection for personnel and pt Laser tube or ETT wrapped with laser tape

Airway concerns with laser

``` shared airway airway obstruction (foreign body, edema, obstructive mass/lesion) ```

Induction concerns?

``` airway patency RSI vs smooth IV or mask OSA (must preoxygenate (may need oral airway)) (sevo least irritating to airway) ```

OSA is who princilple

burnelli's (spelling???) | thats why we give CPAP they lost pressure

Causes of OSA

floppy upper airway redundent fat deposits (in lateral pharyngeal walls) sleep and anesthesia- increased pharyngeal musculature relaxation and posterior tongue displacement airway narrowing (bernoulli effect)

Maintenance for laser airway sx

``` PREVENT LOSS OF AIRWAY with shared airway -communicate with surgeon -closely monitor breath sounds and EtCO2 PREVENT BURN INJURY don't look into laser confirm standby mode -know aiming beam vs power beam don't allow laser on drapes PREVENT EYE INJURY PREVENT INHALATION INJURY ```

what do you want to do to protect the pt's eyes from laser

lub eyes tape shut saline soaked pads (CO2 only) Laser goggles (not glasses)

how do you prevent inhalation injury? (to yourself and pt)

continually assess integrity of cuff | don't breath laser olume

when doing airway sx with a laser what do you want to do with FiO2?

40% or less (preferable 21%)

When doing airway sx with a laser what VAA do you want to avoid? and why?

N2O | supports combustion

when doing airway sx with a laser what must you always have immediately available?

bottle of saline or water

when doing airway sx with a laser what 2 things are important about the OETT tube

use a laser or protected ETT fill endotracheal cuff with saline or dye use smallest allowable tube for surgical exposure and ventialation usually 5.5-6.5

can you wrap a ETT in laser foil to protect from laser

yep

what 2 things do you want to be prepared for duing airway laser sx (in case of fire)

be prepared to extinguish and treat | be prepared to emergently extubate

what do you do for an airway fire?

-stop ALL gas flows -cut pilot tube -extubate pt __________________ -extinguish with water or saline _____________________ -reintubate pt -ventilate with air only until remaining no remaining fire is confirmed _______________________ - ventilate with 100% O2 ______________________ -assess (DL and FOB) larynx, trachea, bronchiole tree for damage

what 3 things are needed for a fire

oxidizer (N2O or O2) fuel (drapes or ETT) Ignition source (laser or Bovie)

what meds do you want to give post airway fire?

corticosteroids | Antibiotics

No fires back to regular sx with laser | what are poss complications/ concerns of extubation

- possible deep extubation - airway blood may remain despite sxn - laryngospasm - be sure any saline pledgets and throat packs have been removed by surgeon

Postop risk of laser sx in airway

laryngospasms (due to irritation and remaining blood) | -stridor, coughing, bronchospasm

A laryngospasm is caused by what?

vocal cord irritation

what is the primary muscle responsible to laryngospasms

cricothyroid

Treatment of laryngospasms

- CPAP by mask (attempt positive pressure ventilation <20cm H2O - jaw thrust (at angle of Ramus-accupressure point) - Succinylcholine if needed

Laser ppt Flashcards

Josh's guide to lasers