Anesthesia 2.0 BTR

Anesthesia
INSTRUMENTS
SIZE OF LMA
Child: 3
Female: 4
Male: 5 HAND:
INSERT:
PRESSURE:
MC injury:
Low-pressure, high-volume cuff
DIFFICULT INTUBATION
Plan A: Facemask ventilation and tracheal intubation
Direct/ video Laryngoscopy (max 3+1 attempts)
Plan B: 2nd generation SAD insertion

Max-3 attempts
Plan C: Facemask ventilation
Plan D: Front-of-neck-access
Scalpel Cricothyrodotomy
Obese
Bearded
Edentulous Fibreoptic
Snorer intubation
Elderly
Neck circumference >40cm
Finger breadth:TMJ
Thyromental distance N
Sternomental distance N
MC vein for central line: TPN
MC vein for TPN: 20:30:50
Max risk of pneumothorax: >1kg/day weight gain:
Max risk of infection: Weight gain after:
Max risk of thrombosis: Refeeding syndrome:
Zn, B12 deficiency
MC metabolic complication:
Mc nerve:
2nd mc nerve:
Extubation TOF:
MC stimulus:
Tetanic stimulation:
MC circuit in spontaneous:
MC circuit in controlled:
Max flow rate: 5l/min
Max saturation: 40%
Max flow rate: 10l/min Max flow rate: 15l/min
Max saturation: 60% Max saturation: 60%
Max flow rate: 15l/min Max flow rate: 60l/min Humidification, PEEP+
Max saturation: 85-90% Max saturation: 100% May delay intubation
Length of NG tube:
NEX
NEMU
Colour Code
Orange Green 14fr
Gray Orange 16Fr
White
Red 18Fr
Green
Pink Yellow 20Fr
Blue
Purple 22Fr
Yellow
Violet Blue 24Fr
PHARMACOLOGY
MAC BLOOD GAS
SOLUBILITY
Methoxyflura 0.2 12
ne
Halothane 0.75 2.5
Isoflurane 1 1
Sevoflurane 2 0.65 Compound A Coronary steal? Min MAC Tec-6 vaporizer
Desflurane 6 0.45 Fruity odour AI hepatitis Maintenance agent
(Xenon min) of choice
N20 104 0.47 Best for Renal
Surgery, Obese
Concentration effect CO with dessicated
Second gas effect soda lime
Diffusion hypoxia
ALL Inhalational agents: ALL IV agents:
-Cerebral metabolic O2 -Cerebral metabolic O2

-CBF/ ICP -CBF/ ICP
-CVS, HR -CVS,HR
-Respiratory drive -Respiratory drive
IV anesthetic agents:
DOC (Induction) for day care/ liver/ kidney/ neuroSx/TIVA/malignant hyperthermia/porphyria
Infusion syndrome, Painful injection-soyabean oil, egg lecithin
NMDA antagonist, Dissociative anesthesia, DOC in asthma/COPD, Cyanotic HD, Shock
CI in hypertension / epilepsy/ glaucoma
DOC in cardiac surgery, S/E Adrenal suppressant (11B-hydroxylase)
DOC in hyperthyroidism, seizures, narcoanalysis, cause Intra-arterial vasospasm
LA: MOA-
Causing Hypertension:
Most cardiotoxic: Dose:
Max dose of lignocaine:
Proparacaine duration:
DOC for LAST:
MethHb:
MR
Depolarising, Hyperkalemia, Bradycardia, Best for RSI-
Most cardiostable-
Hoffman elimination(safe in RF/LF/pediatrics)- Byproduct-
Shortest acting:
Reversal-
Sugammadex-
OPIOIDS
Full agonist: Morphine, Pethidine, Heroin, Meperidine, Methadone, Codeine, Fentanyl
Partial agonist: Buprenorphine
Mixed agonist/antagonist: Nalbuphine, Pentazocine, Butorphanol
Antagonist:
AVOID IN:
Mydriasis:
Pruritus:
No tolerance to:
Serotonin syndrome:
Wooden chest syndrome:
Prolonged QTc:
Shortest acting (Day care):
REGIONAL/ NERVE BLOCKS
CAPNOGRAPHY
Infrared spectroscopy
Sch, Inhalational anesthetics

Fever + tachycardia+ rigidity
Earliest-
Late-
RYR/DHPR (Chr 19)
DOC-
MISCELLANEOUS
Pre-op drug DOC to reduce anxiety:
Pre-op drug DOC to reduce secretions:
Pre-op Antibiotic time:
MC nerve injured intra-op-
MC intra-ophthalmic complication-
PONV DOC:
POVL MCC:
MCC of intra-op anaphylaxis:
Stop Clopidogrel: Warfarin: LMWH: UFH:

Lithium: ACE/ARB/OHG/Insulin:
Goldman Grading system
Aldrete score: Activity/ BP/ Consciousness /

Respiration/ o2 saturation
Mendelson syndrome
PIH, Heart disease in pregnancy: Epidural > GA
NPO solid:
Except coarctation of aorta/ Eisenmenger/ Uncorrected TOF -GA
Liquids:
Breastmilk: Dibucaine number <30:
Clear liquids:
MECHANICAL VENTILATION MODES
Volume- controlled • Controlled mechanical ventilation (CMV):Breaths all triggered by ventilator, predefined rate and volume set
• Assist-controlled ventilation (ACV): Breath triggered by patient’s effort, if no patient breath per unit time,
ventilator triggered; predefined tidal volume set
• Synchronized intermittent mandatory ventilation (SIMV): Spontaneous breathing permitted with no
ventilator assist; mandatory, timed breaths delivered in synchrony with patient’s breaths when possible;
predefined tidal volume set.
Pressure-controlled Pressure support ventilation (PSV): Triggered by patients inspiration only; assist with pressure limitation
provided.
Volume- and PS/SIMV: Ensures spontaneous breaths permitted in SIMV receive pressure assist
pressure-controlled
Not for weaning:

Best for weaning:
PEEP:
-Prevents collapse, Increase recruitment
-Reduce work of breathing
-Barotrauma, Low CO, Raised ICP
N: 3-5cm ARDS:8-12cm
MECHANICAL VENTILATION MODES
BLS /ACLS
No
breathing,
pulse felt PUSH HARD-PUSH FAST
Rate of breathing in CPR

Adults:
Children:
Neonates:
OT?
Pffanelstein?
LSCS?
• ADRENALINE DOSES
• Anaphylactic shock / status asthmaticus:
• Cardiac arrest:
• Vasoconstriction:
• With LA for VC:
• Labour epidural:
NRP
Q. BMV Q. Order of suction:
-Start within:
-Saturation term: Q. Temp of room:
-Saturation <35wks:
-RR:
-CI:
Q. CC
Q. Vascular access of -2 thumb
choice: -Lower 1/3 body sternum
-Midline
-1/3rd depth of AP
CC:PPV-
Saturation monitoring
done at:

Anesthesia 2.0 BTR

Uploaded by

Copyright:

Available Formats

Anesthesia 2.0 BTR

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Anesthesia 2.0 BTR

Uploaded by

Copyright:

Available Formats

Anesthesia

Plan B: 2nd generation SAD insertion

Plan C: Facemask ventilation

-Cerebral metabolic O2 -Cerebral metabolic O2

Sch, Inhalational anesthetics

Stop Clopidogrel: Warfarin: LMWH: UFH:

Goldman Grading system

Aldrete score: Activity/ BP/ Consciousness /

Not for weaning:

Rate of breathing in CPR

You might also like