Peds-other Flashcards by B -

Q

Tonsillectomy and Adenoidectomy:

All children undergoing T&A should be considered at increased rick for what periop complication

A

airway complication esp if diagnosed w/ sleep apnea

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Q

Tonsillectomy and Adenoidectomy:

what is the position postop

A

Left lateral head down

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Q

Myringotomy and Tympanotomy Tubes:

what is good anesthestic

A

VAA and N2O

Facemask/LMA

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Q

Malignant Hyperthermia:

what are 6 early signs/symptoms

A

Masseter muscle spasm
Tachypnea
Rapid exhaustion of soda lime
tachycardia
Irregular HR

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Q

Malignant Hyperthermia:

4 intermediate signs/symptoms

A

warm
Cyanosis
dark blood in surgical site
irregular HR

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Q

Malignant Hyperthermia: Signs and Symptoms

4 late signs/symptoms

A

Prolonged bleeding
dark urine
irregular HR
muscle rigidity

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Q

Malignant Hyperthermia: Monitor Changes

3 early changes

A

Increased MV
Increased ETCO2
Peaked T waves

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Q

Malignant Hyperthermia: Monitor Changes

what is the 1st sign of MH

A

Increased ETCO2

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Q

Malignant Hyperthermia: Monitor Changes

what is 3 intermediate changes

A

Increased body temp
decreased O2 sat
Peaked t waves

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Q

Malignant Hyperthermia: Monitor Changes

how much does the temp increase

A

1 C Q 5 min

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Q

Malignant Hyperthermia: Monitor Changes

1 late change

A

peaked T waves

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Q

Malignant Hyperthermia:

what usually causes death

A

V-fib
Renal failure
DIC

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Q

Malignant Hyperthermia: Biochemical Changes

3 early signs

A

Hyperkalemia
Increased PaCO2
Acidosis

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Q

Malignant Hyperthermia: Biochemical Changes

1 intermediate sign

A

hyperkalemia

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Q

Malignant Hyperthermia: Biochemical Changes

3 late signs

A

hyperkalemia
increased CK
Myoglobinurinia

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Q

Malignant Hyperthermia: treatment

what drug do u give

A

dantrolene

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Q

Malignant Hyperthermia: treatment

how much dantrolene and how often do you dose it

Study These Flashcards

A

2.5 mg/kg Q 5-10 min

Q

Malignant Hyperthermia: treatment

what is the max total dose of dantrolene

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A

10 mg/kg

Q

Malignant Hyperthermia: treatment

what is the treatment

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A

call for help
IV dantrolene
turn off VAA
maintain anesthetic
hyperventilate w/100% O2 (ambu bag)
Initiate cooling
correct metabolic acidosis
maintain UOP

Q

Malignant Hyperthermia:

how do you prepare the machine?

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A

vaporizers out
high O2 flow (10 LPM)
for 20-30 min

Q

Neonate: Post birth

what are they placed in

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A

radiant warmers in slight trendelenburg

Q

Neonate: Post birth

what are normal respiration

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A

30-60 bpm

Q

Neonate: Post birth

normal HR

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A

120-160 bpm

Q

Neonate: Post birth

w/ APGAR the 1 min correlates to what?

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A

survival

Neonate: Post birth | w/ APGAR the 5 min correlates to what?

neurological outcome

Neonate: Post birth | what is the most common cause of neonatal depression

intrauterine asphyxia

Neonate: what should you do? | APGAR 0-2

intubate chest compressions

Neonate: what should you do? | APGAR 3-4

temp assist w/ ventilation

Neonate: what should you do? | APGAR 5-7

stimulation and O2 across the face

Neonate: | what are indications for positive pressure ventilation

Apnea | HR

Neonate: | assisted ventilation with bag and mask should be at what rate

40/min w/ 100% O2

Neonate: | start chest comressions if HR

60 bpm

Neonate: | cardiac compression is at what rate

120 bpm

Neonate: | vascular access via cancelation of what?

umbilical vein

Neonate: | umbilical artery cannulation allows for measurement of what 2 things

blood pressure | ABG monitoring

Neonate: | volume expansion may be with what 2 things?

O-neg blood or 10mL/kg of 5% albumin or LR

Pediatric laryngospasm can usually be avoided by extubating the pt with certain techniques. identify these tech

awake deep (anything in-between is hazardous)

which inhalation agent has become the preferred induction agent for peds anesthesia

Sevoflurane

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 ```

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

A child unexpectedly has cardiac arrest after SCh administration. how would you immediately treat this situation?

treat for hyperkalemia | also long and heroic resuscitation efforts may be required