Other Randoms on the Guide Flashcards by Kyle & Marlea

List some symptoms of LAST.

Local Anesthetic Systemic Toxicity

Analgesia, lightheadedness, tinnitis, tongue/circumoral numbness, tingling of mouth, funny/metallic taste, SZ, LOC, respiratory arrest, cardiovascular arrest.

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Explain the lipid rescue for LAST.

In addition to CPR -
1. bolus 20% intralipids 1.5ml/kg
2. start infusion at 0.25mg/kg/min
2. circulate lipids w/ CPR
3. repeat bolus q3-5 mins UP TO 3ml/kg total dose until ROSC.
4. ⬆ infusion to 0.5ml/kg/min if BP declines - continue infusion until hemodynamically stable.

*MAX DOSE: 8ml/kg

If you dont have 20% lipids immediately handy - give what you have until you obtain the 20%.

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List the formula for Farenheit from Celcius.

°F = [(9/5) x °C) + 32]

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If my patient’s temp is 96.8°F, what is it in °C?
94°F?

36°C
34.5°C

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What is the formula for Celcius from Farenheit?

°C = [(5/9) x (°F - 32)]

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If my patients temp is 38°C, what is it in °F?
40°C?

100.4 °F
104 °F

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A nice pattern to help do quick temp conversions.

If you start at 95°F - celcius is 35.
As you increase in 0.9°F, each °C goes up by 0.5°
:)

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AIRWAY CLASSIFICATION

Describe a Mallampati 1.

Soft palate, fauces, uvula, anterior & posterior tonsilar pillars

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AIRWAY CLASSIFICATION

Describe a Mallampati 2.

Soft palate, fauces, & uvula only.

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AIRWAY CLASSIFICATION

Describe a Mallampati 3.

Soft palate & base of uvula.

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AIRWAY CLASSIFICATION

Describe a Mallampati 4.

Soft palate only.

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AIRWAY CLASSIFICATION

Describe a Mallampati 5.

Lolz, gotcha.

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AIRWAY CLASSIFICATION

List the Cormack-Lehane view grade: Full view of entire glottic opening.

Grade 1

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AIRWAY CLASSIFICATION

List the Cormack-Lehane view grade:
Neither glottis nor epiglottis seen.

Grade 4.

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AIRWAY CLASSIFICATION

List the Cormack-Lehane view grade:
Only epiglottis seen.

Grade 3.

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AIRWAY CLASSIFICATION

List the Cormack-Lehane view grade:
Only posterior portion of glottic opening.

Grade 2.

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List the normal blood gas values:
pH
PaO2
PaCO2

pH: 7.35-7.45
PaO2: 90-100
PaCO2: 35-45

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List the normal blood gas values:
HCO3-
BE
SaO2

HCO3-: 22-26
BE: -2 to 2
SaO2: 95-98%

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Formula for VO2

10 x kg(3/4) = VO2

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Formula for VCO2

8 x kg(3/4) = VCO2

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What does this formula describe?

[FiO2 x (Pb - PH2O)] - PaCO2 / 0.8

Alveoar Gas/Air Equation

https://youtu.be/vrjK4gxa-48

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Formula for arterial O2 content/dL

(hgb x 1.34 x SaO2) + (PaO2 x 0.003)

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PBW (predicted body weight) equation for a male.

AKA IBW

50 + 0.91(cm height - 152.4)kg = male PBW

This is Dr. T’s equation:
- 50 + (2.3 x each inch above 5ft)

PBW is used to determine your tidal volume (5 - 8cc/kg).

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PBW (predicted body weight) equation for a female

AKA IBW

45.5 + 0.91 (cm height -152.4)kg = female PBW.

This is Dr. T’s equation:
- 50 + (2.3 x each inch above 5ft)

PBW is used to determine your tidal volume (5 - 8cc/kg).

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Formula for MAP. What is the normal adult range?

1/3(SBP) + 2/3(DBP) Normal range: 70-105mmHg

Normal CO

4-8 L/min

Formula for CI Normal range for CI?

(CO / BSA) 2.5 - 4 L/min

Normal CVP range?

2-6 mmHg

Normal PCWP? What does PCWP measure?

8-12 mmHg Helps measures LA pressure, along with L heart function (mitral valves & LV filling pressure).

Normal PVR? (pulmonary vascular resistance)

50 - 350 dynes/cm/sec^-5

Normal SVR?

700 - 1400 dynes/cm/sec^-5

Normal EF?

55-70%

Normal mPAP? sPAP? dPAP?

mPAP: ~15mmHg sPAP: 15-30 mmHg dPAP: 5-15 mmHg

Formula for Shock Index

(HR / SBP) ## Footnote >1 = increased M&M & chance of Mass Transfusion protocol (MTP)

EBV of preemie

95ml/kg

EBV of term infant

85ml/kg

EBV of infant - 12mo

80kg/ml

EBV of male adult/child

75ml/kg

EBV of female adult/child

65ml/kg

EBV of morbid obese (BMI >40)

60ml/kg

Allowable blood loss (ABL) formula

[(initial Hct - final Hct) x EBV / initial Hct]

# Fluid Replacement Equivalent Crystalloids

3ml / 1ml EBL

# Fluid Replacement Equivalent Colloids

1ml / 1ml EBL

# Fluid Replacement Equivalent Whole Blood

1ml / 1ml EBL ## Footnote *same as colloids

# Fluid Replacement Equivalent PRBC

0.5ml / 1ml EBL ## Footnote PRBC Hct = 70%

# Fluid Replacement Equivalent How much EBL is in a fully soaked 4x4 guaze?

10 ml

# Fluid Replacement Equivalent How much EBL is in a fully soaked 'lap' pad?

100-150cc

What is the 4-2-1 rule for maintenance fluids?

1st 10kg = 4cc/kg/hr 2nd 10kg = 2cc/kg/hr Every kg >20 = 1cc/kg/hr

How do you accomodate for an NPO deficit with maintenance fluids?

(maintenance rate x #hrs NPO)

What are the estimated evaporated losses? (minimal, moderate, severe)

Minimal = 0.2 mL/kg/hr Moderate = 2 - 4 mL/kg/hr Severe = 4 - 8 mL/kg/hr

BMI formula(s)

## Footnote 1in = 0.025meters

Healthy BMI range

18.5 - 25

Overweight BMI

>25

Obese BMI

>30

Morbidly obese BMI

>35-40

Super morbidly obese

>55

List the IBW formulas. (male, female)

Male: (cm Ht - 100)=kg Female (cm Ht - 105)=kg ## Footnote 1in = 2.5cm

# LABS Hct (male, female)

male: 42-52 g/dL female: 37-47 g/dL

# LABS Hgb (male, female)

male: 14-18 g/dL female: 15-16 g/dL (seems high...I use 13-16 lolz)

# LABS WBCs

4k-11k microL

# LABS Plts

150k-450k microL

# LABS K+

3.5-5 mEq/L

# LABS Mg

1.5-2.5 mEq/L

# LABS Ca++

8.5-10.5 mg/dL

# LABS iCa++

**4.8 - 5.3 mg/dL** (easy to remember bc it's 1/2 of normal Ca++ level) or **1.1 - 1.3 mmol/L** (used often)

# LABS Phos

1.8 - 2.6 mEq/L

# LABS Cl-

100-108 mEq/L

# LABS BUN & Creatinine

BUN: 10-20 mg/dL Creatinine: 0.6-1.3 mg/dL

# LABS Albumin

3.5-5.5 g/dL

# LABS PT

11-14 sec ## Footnote WEPT (warfarin, extrinsic, PT level)

# LABS INR

1 sec ## Footnote Normal INR on Warfarin: 2-3secs

# LABS PTT

21-34 sec ## Footnote On heparin = varies (~60-100 secs) depending on your coag goals!

# LABS ACT | Activating Clotting Time

80-120 secs > 160-180sec for ECMO | > 400sec for CPB ## Footnote Used for large heparin doses.

# LABS FSP | Fibrin Split Products

<10 µ/dL | Fragments from dissolved clots. Used often for DIC

# LABS Fibrinogen

160-450 mg/dL | (the netting that covers the clot)

# LABS Plasminogen

62-130% | Plasminogen makes Plasmin. Plasmin degrades fibrin (or clots)

# LABS FDP | Fibrin Degredation Products

<10 µ/mL | basically FSP but resulted in different units.

# LABS D-Dimer

<250 ng/dL | Only detectable if you are currently breaking down lots of clots.

# LABS TSH T3 T4

TSH: 0.4 µ units/mL T3: 90 -230 ng/dL T4: 13 - 15 µ/dL | Control metabolism, temp, mood, weight, neuro fxn, & muscle strength. ## Footnote T3 = MORE active, 7%, majority made in cells. T4 = main circulating thyroid hormone, 93%, can be converted to T3 using iodinase.

# LABS AST ALT

<35 IU/L ## Footnote Liver function - ALT more specfic to liver, AST involves other organs including the liver.

# LABS Fill in the blanks:

List triggers for MH.

Volatile Anesthetics & SCh

List signs of MH crisis

1. tachycardia 2. **rapidly increasing ETCO2** 3. skin mottling 4. tachypnea 5. increase in temp

List the treatment regimen for MH.

1. STOP THE TRIGGER 2. 100% O2 hyperventilation 3. Dantrolene 2.5mg/kg IV (repeat 5-10mins; MAX 10mg/kg) 4. Actively cool pt 5. correct hyperkalmia and metabolic acidosis 6. Monitor labs and maintain UO >2cc/kg/hr (hydration, mannitol, lasix) *watch for rhabdo*

# PEDI ETT How can you determine the ETT length?

(Tube size x 3)

# PEDI ETT List the ETT sizes: Preemies (≤ 1kg) Preemies (1-2.5kg) Term Neonate

2.5 3 3-3.5

# PEDI ETT List the ETT sizes: 6mo-1yr 1-2yr

3.5-4 4-4.5

# ETT SIZING How do you determine ETT for >2yrs?

[(age + 16) / 4]

# PEDI LMA SIZES List the size & max cuff air volume: 0-5kg 5-10kg 10-20kg 20-30kg >30kg Adult

1 (4cc) 1.5 (7cc) 2 (10cc) 2.5 (14cc) 3 (20cc) 4 (30cc)

Other Randoms on the Guide Flashcards

TXWES REFERENCE GUIDE (91 cards)