PROCEDURAL SEDATION

Question 1

SEDATION

Answer 1

CONTROLLED REDUCTION IN AWARENESS OF ENVIRONMENT

Question 2

ANXIOLYSIS

Answer 2

MILD SEDATION
STATE OF REDUCED APPREHENSION
-RESPOND NORMALLY TO VERBAL STIMULI
- CO-ORDINATION / COGNITION MAYBE IMPAIRED
-CARDIORESPIRATORY FUNCTIONS INTACT

Question 3

DISSOCIATIVE ANALGESIA

Answer 3

EG/ KETAMINE
TRANCE LIKE CATALEPTIC STATE - WITH ANALGESIA AND AMNESIA

Question 4

MODERATE SEDATION

Answer 4

• RESPONDS PURPOSEFULLY TO VERBAL + /- TACTILE STIMULI
  -CARDIORESPIRATORY FUNCTIONS INTACT
• CONSCIOUS SEDATION

Question 5

DEEP SEDATION

Answer 5

• RESPONDS PURPOSEFULLY TO PAINFUL STIMULI
• NOT EASILY AROUSABLE
• RESPIRATORY FUNCTIONS MAYBE IMPAIRED
  -CARDIAC FNS INTACT

Question 6

GENERAL ANASTHESIA

Answer 6

CARIORESPIRATORY FNS NOT INTACT
NOT AROUSABLE

Question 7

PROCEDUAL SEDATION

Answer 7

USING A SEDATIVE/DISSOCIATIVE AGENT +/_ ANALGESIA TO MAKE UNPLEASANT PROCEDURES TOLERABLE

Question 8

SOAPME

Answer 8

• SUCTION
  -OXYGEN
  -AIRWAY
  -PHARMACY/ POSITION
  -MONITOR / MEDS
  -EQUIPEMNT

Question 9

WHEN IS MAX RISK OF DETERIORATION

Answer 9

WHEN THE PAINFUL STIMULI IS REMOVED

Question 10

ASA CLASSIFICATION

Answer 10

1 - NO CO-MORB
2- MILD SYSTEMIC DISSEASE WITHOUT FUNCTIONAL LIMITATION
3- SEVERE SYSTEMIC DISEASE WITH FUNCTIONAL LIMITAION
4- DISEASE WITH CONSTANT THREAT TO LIFE
5- MORIBUND MAYNOT SURVIVE WITHOUT PROCEDURE

Question 11

PREPROCEDURAL FASTING

Answer 11

• NOT REQUIRED
• MAYNOT REDUCE EMESIS OR ASPIRATION

Question 12

OXYGEN SUPPORT

Answer 12

• MAY CAUSE DELAYED DETECTION OF HYPOVENTILLATIONOR APNEA
  -USE CAPNOGRAPHY

Question 13

BIS

Answer 13

• NOT USED IN INFANTS
• DEPTH OF SEDATION (EFFECT OF DRUG ON CORTEX RATHER THAN CONSCIOUSNESS IS ASESSED)
  -0-100
  -40-60 FOR GA

Question 14

PROPOFOL ADVANTAGE

Answer 14

-ANTIEMETIC
-SHORT ACTIMG
-RAPID ONSET

Question 15

PROPOFOL DISADVANTAGE

Answer 15

-HYPOTENSION
-RESPIRATORY DEPRESSION

Question 16

PROPOFOL DOSE

Answer 16

1-1.5 MGKG
INCREMENTS OF 0.5 MG/KG

Question 17

ADVANTAGE OF KETAMINE

Answer 17

1.SEDATION (DISOOCIATIVE)
2.AMNESIA
3. ANALGESIA
4 MANITAIN CARDIORESPIRATORY FN
-PROTECTIVE AIRWAY REFLEX
-SPONT RESPIRATION
-INCREASE BP
-INCREASE HR/CO
-MYOCARDIAL O2 CONSUMPTION INCREASED
-BRONCHODIALATION

Question 18

DISADVANTAGE OF KETAMINE

Answer 18

1. APNEA
2. LARYNGOSPASM (MAYBE RELIEVED BY REPOSTION, PPV, O2 , 10% NMB)
   3.EMESIS
3. EMERGENCE REACTION (MIDAZOLAM 0.03 MG/KG)
4. INCREASED SALIVATION (GLYCOPYROLATE)

Question 19

GLYCOPYROLATE OVER ATROPINE

Answer 19

1. LESS ARRYTHMIA
2. BETTER SIALAGOGUE
3. DONOT CROSS BBB
   MAY CAUSE HEADACHE

Question 20

EMERGENCE REACTION AKA

Answer 20

RECOVERY AGITATION

Question 21

EMESIS WITH KETAMINE SEEN IN

Answer 21

HIGH DOSE / IM

Question 22

KETAMINE DOSE

Answer 22

1-2 MG/KG IV (0.5- 1 MG/K ALLOQUITE)
4-5 MG/KG IM
5-7 MG/KG PO

Question 23

KETOFOL DOSE

Answer 23

0.5-0.75 MG/KG BOTH
1:1 IN SYRINGE
REPAEAT PROPOFOL 0.1-0.5 MG/KG SOS

Question 24

KETOFOL ADVANTAGE

Answer 24

• HR/BP MAINTAINED BY KETAMINE
• ANALGESIA BY KETAMINE
• ANIT EMETIC BY PROPOFOL
  -DECREASED DOSE OF DRUG

Question 25

ETOMIDATE

Answer 25

0.3 MG/KG 1 MIN (ONSET) 10 MINS (ACTION) - PAIN ON INJECTION - MYOCLONUS -ADRENAL SUPRESSION

Question 26

MIDAZOLAM

Answer 26

0.05 - 0.1 MG/KG (5YR) 0.05-0.025 MG/KG (>5YRS) 0.02 MG/KG WHEN GIVEN WITH FENTA 3 MIN (ONSET) 60 MINS (DURATION) PARADOXICAL AGITATION

Question 27

METHOHEXITAL

Answer 27

1-3 MG/KG 1 MIN (ONSET) 10 MIN (DURATION) EXTRAVASATION ACUSING NECROSIS C/I IN PORPHYRIA USE IN MALIGNANT HYPERTERMIA AND TBI

Question 28

PHENOBARBITAL

Answer 28

1-6 MG/KG 1 MIN (ONSET) 10 MIN (DURATION) EXTRAVASATION ACUSING NECROSIS C/I IN PORPHYRIA USE IN MALIGNANT HYPERTERMIA AND TBI

Question 29

NITROUS OXIDE

Answer 29

30-70% 1 MIN (ONSET) 20 MIN (DURATION) C/I TRAPPED AIR

Question 30

pain DEFNITION

Answer 30

VISCERAL OR SOMATIC UNPLESANT SENSATION A/W ACTUAL POTENTIAL OR PERCIEVED TISSUE DAMAGE

Question 31

NOCICEPTOR

Answer 31

FREE NERVE ENDINGS OF SENSORY NEURON THAT CONVERT CHEMICAL, MECHANICAL.THERMAL ENERGY TO ELECTRICAL ACTIVTY AND TRANSPORT TO DORSAL HORN

Question 32

TYPES OF PAIN

Answer 32

1.NOCICEPTIVE - VISCERAL/SOMATIC 2. NEUROPATHIC

Question 33

TYPES OF PAIN ASESSMENT

Answer 33

1. SELF REPORTING 2. BEHAVIOURAL 3. PHYSIOLOGICAL

Question 34

SELF REPORTING PAIN SCALES

Answer 34

1. NRS 2 VAS 3. FACES -WONG BAKER PAIN SCORE -FACES PAIN SCALE REVISED (3-8 YRS)

Question 35

INFANT PAIN SCORE

Answer 35

1.PIPPS 2. CRIES 3. FLACC 4. OSBD 5. CHEOPS

Question 36

NEURO IMPAIRED (PAIN SCORE)

Answer 36

R-FLACC

Question 37

NON PHARMACOLOGICAL TECHNIQUES OF PAIN MANAGEMENT

Answer 37

1. DISTRACT 2. PARENTAL PRESSENCE 3. HYPNOSIS 4. NON NUTRITIVE SUCKLING 5. SUCROSE 6. KANGAROO CARE

Question 38

TOPICAL ANASTHETIC ADVANTAGE

Answer 38

1. PAINLESS 2. NO NEEDLE 3. DONOT DISTORT TISSUE

Question 39

EMLA

Answer 39

1. EUTETIC MIXTURE OF LOCAL ANASTETIC 2. 1:1 LIGNOCAINE AND PRILOCAINE 3. ACTION 60 MIN 4. 5-10 GM OCCLUSIVE DRESSING 5. INTACT SKIN 6. METHHEMOGLOBINEMIA - WITH G6PD DEFICIENCY -< 1 YR / EGA<37 WKS -ON METHHEMOGLOBIN INDUCING AGENTS

Question 40

LMX

Answer 40

1. LIPOSOMAL ENCAPSULATED LIGNOCAINE 2. 4/5 % 3. INTACT SKIN 4 30-60 MINS 5 2.5 GM

Question 41

LET

Answer 41

LIGNOCAINE EPINEPHRINE TETRA CAINE -OPEN DERMIS -20-30 MINS - 5ML - DONOT APPLY AT END ARTERT/ COMPROMISED BLOOD SUPPLY

Question 42

VAPOCOOLANT

Answer 42

INSTANT -OPEN/INTACT

Question 43

LOCAL ANSTHETIC AGENT ACTION

Answer 43

REVERSIBLE SODIUM CHANNEL BLOCKER

Question 44

TYPES OF LA

Answer 44

AMIDE ESTER

Question 45

HOW TO MAKE LA LESS PAIN FUL

Answer 45

1. TOPICAL AGENTS 2. SMALL NEEDLE 3. INJECT TO S/C TISSUE 4. INJECT THROUGH WOUND 5. SODIUM BICARB 6. WARM SOLUTION 7. INJECT SLOWLY 8 MINIMIZE NUMBER OF PUNCTURE

Question 46

SIDE EFFECTS OF LA

Answer 46

1. WITH EPI : VASOCONSTRICTOR 2. ALLERGIC (ESP PROCSINE / BENZOCAINE) 3. BUPIVACAINE - CARDIAC TOX 4. BENZOCAINE / PRILOCAINE - METHHEMOGLOBINEMIA MILD- TINGLING, NUMBNESS, TINNITUS, HEARING LOSS MODERATE - SEIZURE, COMA DROWSINESS SEVERE - MYOCARDIAL DEPRESSION AND CARDIAC ARREST

Question 47

LIGNOCAINE

Answer 47

4-4.5 MG/KG

Question 48

LIGOCAINE WITH EPI

Answer 48

7 MG/KG

Question 49

BUPIVACAINE

Answer 49

3 MG/KG

Question 50

TETRA CAINE

Answer 50

1.5MG/KG

Question 51

ACETAMINOPHEN

Answer 51

PO 10-15 MG/KG ( MAX 4 GM /DAY) - Q4-6H IV 15 MG/KG Q6H

Question 52

ASPIRIN

Answer 52

10-15 MG/KG Q4-6H REYE SYNDROME (DONOT GIVE IN FLU/VARICELLA)

Question 53

IBUPROFEN

Answer 53

10 MG/KG Q6-8H

Question 54

HYDROCODONE OXYCODONE

Answer 54

0.1-0.2 MG/KG Q4-6H

Question 55

MORPHINE

Answer 55

0.3 MG/KG Q3-4H - PO 0.1 MG/KG Q4H - IV

Question 56

TRAMADOL

Answer 56

1-2 MG/KG Q4H

Question 57

FENTANYL

Answer 57

0.5-1 MCG/KG Q2H

Question 58

KETROLAC

Answer 58

0.5 MG/KG Q6H

Question 59

LOW DOSE KETAMINE

Answer 59

0.15 MG/KG OR 0.1-0.2 MG/KG/HR

Question 60

NALOXONE

Answer 60

1. 0.1 MG/KG (2 MG)

Question 61

FLUMAZENIL

Answer 61

0.01 MG/KG - UPTO 5 DOSE MAX - 1 MG