AND CORRECT ANSWERS
Sudden spasm of the vocal cords that completely occludes the laryngeal opening. ✅✅ANSW-
Laryngospasm
When does laryngospasm typically occur? ✅✅ANSW-Occur in the transitional period when the
extubated patient is emerging from general anesthesia.
Although laryngospasm is most likely to occur in the OR at the time of extubation, patients who
arrive in the PACU asleep after general anesthesia are also at risk for laryngospasm on awakening.
What should you try first if the patient is having a laryngospasm? ✅✅ANSW-Jaw thrust maneuver
with CPAP (40cm water)
What should you do if jaw thrust/CPAP method of breaking laryngospasm fails? ✅✅ANSW-If jaw
thrust/CPAP fails go immediately to skeletal muscle relaxation which can be achieved with:
SUCCINYLCHOLINE (0.1-1.0mg/kg IV or 4mg/kg IM).
Should you try to put an ETT through a glottis that is closed because of laryngospasm? ✅✅ANSW-
No. That's unacceptable.
Post op shivering often occurs after: ✅✅ANSW--General Anesthesia
-Epidural Anesthesia
How much does oxygen usage increase with shivering? ✅✅ANSW-300-400%
What is the incidence of shivering after GA and Epidural Anesthesia? ✅✅ANSW-General
Anesthesia: 65%
Epidural Anesthesia: 33%
, What are risk factors for post op shivering? ✅✅ANSW--Male
-Choice of induction agent (Propofol is more commonly associated with shivering than Pentothal)
What drug is used to stop shivering? What's the dose? ✅✅ANSW-Demerol (Meperidine) 12.5mg
stops shivering
Post-op shivering is usually, but not always, associated with what? ✅✅ANSW-Hypothermia
Although thermoregulatory mechanisms can explain shivering in a hypothermic patient, there are
other mechanisms involved involved in patients who are normo-thermic.
Accurate core body temperatures can MOST EASILY be obtained by the ____. ✅✅ANSW-
tympanic membrane
Which temperature methods are less accurate and underestimate core temperature? ✅✅ANSW-
-Nasopharyngeal
-Axillary
-Rectal
What other medications have been shown to stop shivering? ✅✅ANSW--A number of opioids
-Zofran
-Clonidine
In adults, what is the most commonly used drug to treat hypothermia? ✅✅ANSW-Demerol
(Meperidine) 12.5mg
Pre-warming is important: You see a temp drop in the ____hour.
Keep patients warm if surgery delayed because of line placement--- if unable to use hair hugger, use
trash bags. ✅✅ANSW-1st hour
What are clinical effects of post-op shivering? ✅✅ANSW-Clinical Effects of post op shivering: