Maintenance

Question 1

How to anticipate effects in care phase 2?

Answer 1

Look online or relay on experience or ask

Major vascular = sig blood loss and drop in bp

Question 2

What direction is autonomic?

Answer 2

Increase

Usually treat hypertension not hypo
Individualize succinylcholine so you don’t need ephedrine later

Question 3

Maintenance goals

Answer 3

Control autonomic
Fluids
Blood

…

Question 4

Cap refill test

Answer 4

Touch forehead 2sec good

5s hypovolemic

Question 5

Conjunctiva look can tell us

Answer 5

On darker patient. Pale? Then more blood!

Question 6

Anesthesia depth parameters

Answer 6

Eye position- divergent with MR
RR
Reflex muscle

Question 7

Always check before intubation

Answer 7

Suction
Ambu
Circuit
Call attend

Question 8

Who is the best monitor?

Answer 8

You!

Question 9

How much propofol does dan give and why

Answer 9

150mg so he has 50 left

Question 10

What’s that nice necklace for?

Answer 10

After intubation for breaths bilateral
Quality
Stridor= bronchospasms

Heart failure use esophageal temperature probe
Think about narc since less of a resp effect

Question 11

EtCO2 goes up means? Decrease?

Answer 11

Increase minute vent
Malignant hypothermia?
Check CO2 absorber (might be out)

Decreased
Sudden etCO2 = mechanical or CO dropped
Slow = hypervent

Question 12

How does capnograph work? When cap changes and rule out mechanically what do you do?

Answer 12

INfrared light through the cap tube so absorbed light tells us a percentage (Beer lambert)

Blood pressure

Question 13

At 45 etco2 at incision for a spontaneously breathing ???.?

Answer 13

Green for if depth is good

Give prop if patient stop breathing

Question 14

Mac

Answer 14

Theoretical value with just gas!
Minimum alveolar concentration or MAC is the concentration of a vapour in the alveoli of the lungs that is needed to prevent movement (motor response) in 50% of subjects in response to surgical (pain) stimulus

List these!

Question 15

End tidal agents and gases low and patient light

Answer 15

Increase flow rate ( note will decrease temp note heat and flow relation)
Increase vap only if low BUT keep hand on why????
Causes hypotension

Question 16

Minimum total flow and why?

Answer 16

2L/min bc sevo toxic residues

Question 17

Anatomical dead space

Answer 17

2cc per kg or about 1 per lb

Question 18

For pulse ox what are the wavelengths of lights that shine into

Answer 18

650 950 deox and ox

Question 19

Glycopyrrolate for adults or kids

Atropine for adults or kids

Answer 19

Glycopyrrolate adults

Atropine kids cuz they are SV driven

Question 20

HR up and then Blood pressure down

HR up and BP high

Answer 20

• Hypovolemia you can give phenylephrine
• more prop

Common labelalol given just when BP looked at but HR needed
Check BP with HR

Question 21

Toes to the nose?

Answer 21

When bp low and HR is fine POSITION

Question 22

Minimum acceptable BP

Answer 22

80/40 especially if zem given and intubation will cure hypotension

Question 23

Lowest MAP

Answer 23

60 mmhg

Question 24

Which heart nerve fibers slow down so ventricles can fill.
P is SA
QRS is AV

Answer 24

Internodal pathway

Question 25

Which ventricle vectors do we like besides RA LA RL LL

Answer 25

V2 for inferior left vent V4 or 5 for anterior left ventricle

Question 26

When does core temp stabilize

Answer 26

3-4 hours need temp prob if greater than half hour temp or one hour

Question 27

Ask nurse if you don’t know how long

Answer 27

Keep up with timing

Question 28

BIS monitor

Answer 28

If paralyzed Lower number deeper anesthetic Found by measuring brain waves when people waking