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Chem / Physics II > Lasers > Flashcards

Flashcards in Lasers Deck (15):
1

Laser stands for _____?

Light Amplification by Stimulated Emission of Radiation

2

What is the relationship of wavelength to power?

Shorter the wavelength, higher the frequency, higher the power.

3

Name 2 'weak' medical lasers and their uses

CO2 - Upper airway 

Nd:YAG - distal tracheobronchial tree and retina


Note: The slides do say that Nd:YAG is a “powerful” laser, but my justification here is that while it is approximately 10X more powerful than the CO2, when compared to the other lasers (KTP, Argon) on the chart 3 slides prior, the Nd:YAG is a RELATIVELY lower-power laser.

4

Name 2 'powerful' medical lasers and their uses.

KTP - Neurosurgical and otolaryngeal

Argon - Neuro, retinal, otolaryngeal

5

What is the color of a CO2 laser, Nd-YAG laser, He-Ne laser. Are they visible?

CO2: Invisible (far infrared)
Nd-YAG: Not visible (Near infrared)
He-Ne: Red (used as aiming beam)

The first 2 are not visible to the naked human eye; the 3rd is.

6

Name 3 main risks associated with laser use.

I got 4!

Fire
Burns
Eye Damage
Loss of Airway

7

Laser may be used for what type of surgeries of particular involvement with anesthesia providers?

Airway surgeries:

  • laryngeal papillomas
  • tracheal scarring
  • vascular malformations
  • neoplasms
  • idiopathic subglottic stenosis

8

What type of anesthesia is recommended for laser airway surgery?

  • VAA (Sevo) or TIVA
  • Low FiO2 (40% or less, 21% preferred)
  • Complete neuromuscular blockade
  • Avoid N2O

9

What is the preparation for a laser airway case?

  • Anti-sialagogue
  • Eye protection for OR personnel AND patient
  • Laser tube or ETT wrapped with laser tape (smaller tube size)
  • Bottle of saline/water immediately available

10

What is the maintenance technique of an above case? (this one's a little long, sorry, it's all the crap that was in the slide...)

  • Complete neuromuscular blockade
  • Routine monitoring
  • Close monitoring of breath sounds and EtCO2
  • Do not look into laser
  • Do not allow laser to lay on drapes
  • Be aware of when laser is in use and confirm in standby mode
  • Eye Protection (lube pt eyes, tape shut; saline soaked eye pads; laser goggles on pt; appropriate laser glasses on all OR personnel)
  • Continually assess cuff integrity
  • Do not breathe laser plume

11

How do you treat an airway fire?

  • Stop ALL gas flow, CUT pilot tube, EXTUBATE
  • Extinguish with H2O or NS
  • RE-INTUBATE emergently and VENTILATE with AIR ONLY until confirmation of no remaining fire
  • THEN VENTILATE with 100% O’s
  • Assess larynx, trachea, bronchiole tree for damage

12

What is the emergence, extubation technique?

  • Deep extubation
  • Airway blood may remain despite suctioning
  • Ensure all pledgets or throat packs have been removed

13

What are the postop risks?

  • Laryngospasm d/t irritation or remaining blood
  • Stridor
  • Excessive coughing
  • Bronchospasm

INTERVENE QUICKLY!!!

14

What 3 things are needed for a fire?

  • Fuel
  • Oxidizer
  • Ignition source

15

Most common laryngospasm muscle?

Cricothyroid (lengthens and tenses cords)

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