Week 5 Flashcards
(24 cards)
Contrast onset and duration of cocaine and tetracaine
Cocaine Onset: Immediate Duration: 30-120 minutes Peak Effect: 3-5 minutes Max dose: 200 mg
Tetracaine Onset: Slow onset Duration: 30-60 minutes Peak Effect: 3-8 minutes Max dose: 50 mg or 200 mg (says 2 different things on 2 different slides)
In what instances do topical anesthesia most likely carry the risk of systemic absorption?
over large areas
What are the present day medical uses of cocaine?
Topical = vasoconstriction, used in nasal surgery, treat resistant epitaxis
What are two present day uses of tetracaine drop?
Glaucoma testing AND removal of corneal foreign bodies
What are the OTC uses for lidocaine gel/ointment?
Sunburns, insect stings, insect bites
EMLA –How deep can it penetrate? How quickly does it work?
EMLA = “Eutectic” mixture of lidocaine (2.5%) and priolocaine (2.5%)
Penetrates to 5 mm!
Needs a full hour to get to full effect
Can EMLA cream be used on mucous membranes?
YES! = won’t cause systemic toxicity
What are the precautions for use of EMLA cream?
near the eyes, broken or inflamed skin, open wounds, to 2,000 cm2 or more of skin it can result in systemic effects in susceptible individuals
What are common uses of EMLA cream?
Uses: Pain of venipuncture/injections Superficial minor surgery Pretreatment for infiltration anesthesia Skin graft harvesting
When applying EMLA, TAC, LAT & TLE what precautions does the “applier” need to observe? How do you know when if has produced an anesthetic effect? Potential complications?
Need to look for skin blanching? (For sure with EMLA) Blanching shows that there the anesthetic effect is complete- usually takes an hour.
Complications- 5% of wounds need supplemental infiltration is needed for complete anesthesia.
* applier needs to wear gloves to prevent absorption of drug into their fingertips
Name “two” types of vapocoolants. What are their medical uses?
Ethyl Chloride
Numbs skin in prep for cutting or injection- effects last 15-60 sec
Ice: low-tech skin coolant that allows needle insertion or quick incision with min to low pain
In anaphylaxis symptoms of respiratory involvement may include what sign/symptoms?
wheezing, coughing, dyspnea and sensation of chest constriction.
In anaphylaxis CV symptoms include ?
hypotension, tachycardia, syncope and cardiac arrest.
In anaphylaxis GI symptoms Include ?
nausea, vomiting, diarrhea and abdominal cramping.
What are the cutaneous symptoms that may occur in anaphylaxis?
Urticaria (hives, wheals), pruritis, warmth, redness
Contrast immediate onset and slow onset anaphylaxis.
Immediate = pt. experiences sx’s within minutes of exposure. **sooner the symptoms begin the more severe!
Slow (delayed) = sx’s occur from 15 minutes to several hours
What are the likely early warning signs of anaphylaxis?
Sensations of warmth or flushing, itching, lightheadedness, sudden fatigue, sense of “something not being right”
Know the protocol for treating early and late onset anaphylaxis.
ALWAYS START TX AND CALL 911!
T or F: To open the flow valve (green round knob) on the oxygen tank to desired flow rate you turn it in a clockwise direction.
FALSE = to open the tank you turn it COUNTER clockwise
What flow rate is generally considered to be safe for use in COPD patient? What is the risk(s) of higher flow rates?
Anything below 2L/min – should not exceed!!
Too much oxygen in and they have poor perfusion so because of the decreased rate of breathing it causes hypercapnia (excess CO2)
Name three problems that may occur with administration of greater than 60% concentration of oxygen for greater than 24 hours.
In premature infants = retrolental fibroplasia = retinal damge = irreversible blindness
Depression of ventilator drive
Oxygen toxicity
What are the “three” functions of a horizontal mattress suture?
- Helps relieve excessive pressure on the skin = reduced scarring
- Helps approximate and evert wound edges (better than vertical mattress)
- Provides hemostasis in a bleeding wound
“Retention” or “stay stitch”
Keeps stitches farther from wound edges
What are the risks of horizontal mattress suture?
If stitch is pulled too tightly, tissue hypoxia and poor healing may result
When should you remove horizontal mattress sutures?
Remove at time of surgery when other stitches are complete or a few days later when would healing has begun.
