Flashcards in Peds-other Deck (41)
1
Tonsillectomy and Adenoidectomy:
All children undergoing T&A should be considered at increased rick for what periop complication
airway complication esp if diagnosed w/ sleep apnea
2
Tonsillectomy and Adenoidectomy:
what is the position postop
Left lateral head down
3
Myringotomy and Tympanotomy Tubes:
what is good anesthestic
VAA and N2O
Facemask/LMA
4
Malignant Hyperthermia:
what are 6 early signs/symptoms
Masseter muscle spasm
Tachypnea
Rapid exhaustion of soda lime
tachycardia
Irregular HR
5
Malignant Hyperthermia:
4 intermediate signs/symptoms
warm
Cyanosis
dark blood in surgical site
irregular HR
6
Malignant Hyperthermia: Signs and Symptoms
4 late signs/symptoms
Prolonged bleeding
dark urine
irregular HR
muscle rigidity
7
Malignant Hyperthermia: Monitor Changes
3 early changes
Increased MV
Increased ETCO2
Peaked T waves
8
Malignant Hyperthermia: Monitor Changes
what is the 1st sign of MH
Increased ETCO2
9
Malignant Hyperthermia: Monitor Changes
what is 3 intermediate changes
Increased body temp
decreased O2 sat
Peaked t waves
10
Malignant Hyperthermia: Monitor Changes
how much does the temp increase
1 C Q 5 min
11
Malignant Hyperthermia: Monitor Changes
1 late change
peaked T waves
12
Malignant Hyperthermia:
what usually causes death
V-fib
Renal failure
DIC
13
Malignant Hyperthermia: Biochemical Changes
3 early signs
Hyperkalemia
Increased PaCO2
Acidosis
14
Malignant Hyperthermia: Biochemical Changes
1 intermediate sign
hyperkalemia
15
Malignant Hyperthermia: Biochemical Changes
3 late signs
hyperkalemia
increased CK
Myoglobinurinia
16
Malignant Hyperthermia: treatment
what drug do u give
dantrolene
17
Malignant Hyperthermia: treatment
how much dantrolene and how often do you dose it
2.5 mg/kg Q 5-10 min
18
Malignant Hyperthermia: treatment
what is the max total dose of dantrolene
10 mg/kg
19
Malignant Hyperthermia: treatment
what is the treatment
call for help
IV dantrolene
turn off VAA
maintain anesthetic
hyperventilate w/100% O2 (ambu bag)
Initiate cooling
correct metabolic acidosis
maintain UOP
20
Malignant Hyperthermia:
how do you prepare the machine?
vaporizers out
high O2 flow (10 LPM)
for 20-30 min
21
Neonate: Post birth
what are they placed in
radiant warmers in slight trendelenburg
22
Neonate: Post birth
what are normal respiration
30-60 bpm
23
Neonate: Post birth
normal HR
120-160 bpm
24
Neonate: Post birth
w/ APGAR the 1 min correlates to what?
survival
25
Neonate: Post birth
w/ APGAR the 5 min correlates to what?
neurological outcome
26
Neonate: Post birth
what is the most common cause of neonatal depression
intrauterine asphyxia
27
Neonate: what should you do?
APGAR 0-2
intubate chest compressions
28
Neonate: what should you do?
APGAR 3-4
temp assist w/ ventilation
29
Neonate: what should you do?
APGAR 5-7
stimulation and O2 across the face
30
Neonate:
what are indications for positive pressure ventilation
Apnea
HR
31
Neonate:
assisted ventilation with bag and mask should be at what rate
40/min w/ 100% O2
32
Neonate:
start chest comressions if HR
60 bpm
33
Neonate:
cardiac compression is at what rate
120 bpm
34
Neonate:
vascular access via cancelation of what?
umbilical vein
35
Neonate:
umbilical artery cannulation allows for measurement of what 2 things
blood pressure
ABG monitoring
36
Neonate:
volume expansion may be with what 2 things?
O-neg blood or 10mL/kg of 5% albumin or LR
37
Pediatric laryngospasm can usually be avoided by extubating the pt with certain techniques. identify these tech
awake
deep
(anything in-between is hazardous)
38
which inhalation agent has become the preferred induction agent for peds anesthesia
Sevoflurane
39
the pediatric pt becomes hypothermic in the OR: list 5 expected anesthetic concerns
delayed awakening
cardiac irritability
resp depression
increased pulmonary vascular resistance
altered drug responses
40
why is maintenance of heart rate so crucial in neonates and infants?
stroke volume is fixed by noncompliant and poorly developed LV
CO is therefore strongly dependent of HR
41