Anesthesia_Review

Anesthesia_Review - Anesthesia Review Vic V. Vernenkar,...

Info iconThis preview shows pages 1–10. Sign up to view the full content.

View Full Document Right Arrow Icon
Anesthesia Review Vic V. Vernenkar, D.O. St. Barnabas Hospital Dept. of Surgery
Background image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
The Anesthesiologist
Background image of page 2
Initial Assessment ASA classification is part of the physical examination of the patient. Is graded classes 1-6 in order of increasing risk of mortality.
Background image of page 3

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
ASA Classification Class 1 Healthy Class 2 Mild systemic disease, no func limitations Class 3 Moderate to severe systemic disease, functional limitations Class 4 Severe systemic disease, constantly life threatening, functionally incapacitating Class 5 Not expected to survive with or without surgery 24h Class 6 Organ Donor Class E Emergency
Background image of page 4
Monitoring Noninvasive BP monitoring with appropriate cuff size. Invasive BP monitoring (A-line) for elective hypotension, anticipation of wide variations in BP, need for frequent blood sampling. Common sites are femoral and radial sites. Don’t use Brachial artery.
Background image of page 5

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Monitoring EKG for detection of dysrhythmias, myocardial ischemia, electrolyte abnormalities. Leads V2 and V5 together detect 95% of intraoperative ischemia, allowing for early intervention. Pulse oximetry estimates level of oxygen binding by hemoglobin SaO2 of 70%, 80%, and 90% correlates to PaO2 of 40, 50, 60.
Background image of page 6
Monitoring Temperature- Axilla, esophagus, pharynx, bladder. Urine output- a measure of end-organ perfusion; Foley for all cases over 2 hrs,to decompress bladder (lap procedures). Swan-Ganz- for LVEDP, CO, SVR. Capnography- confirms adequacy of ventilation, ETT placement, estimates PaCO2. Unexpected rise in CO2: Malignant hyperthermia.
Background image of page 7

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Induction of Anesthesia IV or mask induction of general anesthesia. Combination of agents based on patient characteristics, and procedure. Includes an amnestic, analgesic, hypnotic, muscle relaxant, and a volatile agent. Rapid sequence induction.
Background image of page 8
Pre-oxygenate with 100% allows de- nitrogenation of patient’s FRV, extra time. Indications include recent oral intake, GERD, delayed emptying, pregnancy, bowel obstruction. Lidocaine, Atropine, Etomidate,
Background image of page 9

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Image of page 10
This is the end of the preview. Sign up to access the rest of the document.

This note was uploaded on 12/27/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

Page1 / 42

Anesthesia_Review - Anesthesia Review Vic V. Vernenkar,...

This preview shows document pages 1 - 10. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online