CNOR review with 100% Correct
Solutions
Early sign of MH - ANSWER-Tachycardia
Signs of MH - ANSWER-HR increase 120;
require increase 02;
purple splotches;
tight jaws
Other conditions that have similar reaction to MH - ANSWER-Allergy to bone cement
PE
Allergy to anesthesia
Blood Transfusion reaction steps - ANSWER-1st- STOP transfusion
Replace tubing with 0.9% NACL
Report to surgeon and blood bank
Anticipate orders for emergency drugs
Signs of reaction to blood transfusion - ANSWER-Blood in urine
Urine output decrease
Hypotension
Hyperthermia
Excessive or unusual bleeding
IVS ready for discharge - ANSWER-stay awake for 20 minutes without stimulation
MH crisis patient observed - ANSWER-36 hours post op
Local Anesthesia toxicity
initial and increased - ANSWER-initial- hypertension
increased-hypotension
Local Anesthesia hypersensitivity - ANSWER-tachycardia
Laser Safety- OR fire - ANSWER-Communicate
Pour saline slowly on patient
Remove drapes
Consult with anesthesia
Remove airway circuit
Turn off O2
, Remove ET tube
Pour saline in airway
Re establish airway
Prevent Laser OR fire - ANSWER-Gel coat facial hair
ET tube filled with Saline and Dye
Non reflective instruments
ESU rubber coated
Do not TENT drapes
OR room Temperatures Pediatric - ANSWER-Infants 80-85
Older children 75-80
Pediatric intubation - ANSWER-straight laryngoscopes
Uncuffed to 8 years
Suction lumens 5-10 french
ET tube 5.0mm
Blocks 4 of them - ANSWER-Retrograde-extremity
Pudendal-gynecology
Intercostal- thoracic
Field- hernia
Insufflation initial flow and pressure - ANSWER-9L at 14-16 mm Hg
Fast Acting anesthetic - ANSWER-Brevital (methohexital), nitrous and halothane
Injectable agent faster spread and resolve local edema - ANSWER-Wydase
MH medications doses - ANSWER-Bicarbonate 1-2 mg/kg
Dantrolene 2.5mg/kg q 5 minutes max of 10mg/kg
ASA classifications - ANSWER-PS-1 normal
PS-2 mild
PS-3- severe
PS-4- threat to life
PS-5 Die without surgery
PS-6- Brain Dead
MH reactions - ANSWER-hypercarbia
tachycardia
tachypnea
hypoxia
metabolic and respiratory acidosis
MH last manifestation - ANSWER-increase in body temperature
Solutions
Early sign of MH - ANSWER-Tachycardia
Signs of MH - ANSWER-HR increase 120;
require increase 02;
purple splotches;
tight jaws
Other conditions that have similar reaction to MH - ANSWER-Allergy to bone cement
PE
Allergy to anesthesia
Blood Transfusion reaction steps - ANSWER-1st- STOP transfusion
Replace tubing with 0.9% NACL
Report to surgeon and blood bank
Anticipate orders for emergency drugs
Signs of reaction to blood transfusion - ANSWER-Blood in urine
Urine output decrease
Hypotension
Hyperthermia
Excessive or unusual bleeding
IVS ready for discharge - ANSWER-stay awake for 20 minutes without stimulation
MH crisis patient observed - ANSWER-36 hours post op
Local Anesthesia toxicity
initial and increased - ANSWER-initial- hypertension
increased-hypotension
Local Anesthesia hypersensitivity - ANSWER-tachycardia
Laser Safety- OR fire - ANSWER-Communicate
Pour saline slowly on patient
Remove drapes
Consult with anesthesia
Remove airway circuit
Turn off O2
, Remove ET tube
Pour saline in airway
Re establish airway
Prevent Laser OR fire - ANSWER-Gel coat facial hair
ET tube filled with Saline and Dye
Non reflective instruments
ESU rubber coated
Do not TENT drapes
OR room Temperatures Pediatric - ANSWER-Infants 80-85
Older children 75-80
Pediatric intubation - ANSWER-straight laryngoscopes
Uncuffed to 8 years
Suction lumens 5-10 french
ET tube 5.0mm
Blocks 4 of them - ANSWER-Retrograde-extremity
Pudendal-gynecology
Intercostal- thoracic
Field- hernia
Insufflation initial flow and pressure - ANSWER-9L at 14-16 mm Hg
Fast Acting anesthetic - ANSWER-Brevital (methohexital), nitrous and halothane
Injectable agent faster spread and resolve local edema - ANSWER-Wydase
MH medications doses - ANSWER-Bicarbonate 1-2 mg/kg
Dantrolene 2.5mg/kg q 5 minutes max of 10mg/kg
ASA classifications - ANSWER-PS-1 normal
PS-2 mild
PS-3- severe
PS-4- threat to life
PS-5 Die without surgery
PS-6- Brain Dead
MH reactions - ANSWER-hypercarbia
tachycardia
tachypnea
hypoxia
metabolic and respiratory acidosis
MH last manifestation - ANSWER-increase in body temperature
