הרדמה

anethesia

a state of narcosis, analgesia, reflex loss, and relaxation of muscles

narcosis

unconsciousness induced by narcotics or anesthesia

anesthesiologist

doctor that is in charge of ventilating the patient during surgery and monitoring the patient's vitals

surgeon

doctor in charge of the surgery and of post surgery care

surgery nurse

in charge of helping the surgeon during surgery

recovery nurse

in charge of the patient's recovery after surgery until the patient returns to the ward. Need an ICU course to do this

ward nurse

in charge of the patient's treatment in the ward before and after surgery

analgesia, to prevent patient movement, muscle relaxation

the 3 main reasons anesthesia is administered

reasons for anesthesia

to give control over the airway, reflexes, body symptoms, and to prevent trauma to the patient

situations when anesthesia is provided

large surgeries, a patient that isn't cooperating, any procedure with a risk of pain or muscle contraction

general anesthesia

a reversible state of consciousness of the patient so that the patient won't feel or react to outside stimuli. It is administered mechanically

IV or inhalation

routes of administration of general anesthesia

Induction, maintenance, waking up the patient, recovery from anasthesia

steps of anasthesia

analgesia, excitement, surgical anesthesia, medullary depression

the 4 stages of anesthesia

analgesia

Stage I of anesthesia. The patient is conscious, there is muscle tonus, but they can't feel pain

excitement

stage II of anesthesia. The patient is unconscious, in a state of hyperactivity( they may be crying, laughing, or mumbling), blood pressure and respirations are irregular, there is risk of laryngospasm

surgical anesthesia

Stage III of anesthesia. full anesthesia, there is no pain or reflexes. In this stage surgery can be performed

Medullary depression

stage IV of anesthesia. depression of the vasomotor and respiratory centers of the medulla oblongata. It can lead to coma and death. The anesthesiologist needs to monitor the patient and make sure they don't reach this level or if they do get them out of it quickly.

sedation, anesthesia, surgical anesthesia, medullary depression

4 types of general anesthesia

sedation

light anesthesia. motion and breathing are reduced but are still present

anesthesia

partial loss of equilibrium but there is still reaction to touch

respiratory issues

the most common complication of general anesthesia

early mobilization, sitting position

ways to prevent atelectasis in a post operation patient

blood clots

a complication of general anesthesia and surgery caused by long periods of immobilization and increased activity of the coagulation system after surgery

raised sitting position, mobility, respiratory physiotherapy

ways to prevent irregular ventilation and oxidation after general anesthesia

mobilization, analgesia, respiratory physiotherapy

the best 3 ways to prevent complications of general anesthesia

spinal and epidural

the two types of regional anesthesia

spinal anesthesia

injection of anesthetics directly into the CSF causing a blockage of nerve signals in areas under the injection site

advantages of spinal anesthesia

has less side effects, there are less respiratory complications, control over pain, has quick recovery time

disadvantages of spinal anesthesia

it isn't useful in every surgery, can't be given to a patient with spinal issues

epidural anesthesia

injection of anesthetics on top of the spinal layers, injection on top of the dura mater. Needs a higher dose to work but it is more superficial then spinal anesthesia. it mainly dose analgesia

sitting, lateral, or prone position

what are three positions a patient can be in for administration of regional anesthetics

absolute contraindications of regional anesthesia

the patient is opposed to it, infection in the area where the injection is supposed to be, patient is in shock, severe aortic stenosis, brain tumor or increased ICP, spinal damage

relative contraindications of regional anesthesia

coagulation problems, systemic infection, a need for intubation or general anesthesia

complications of regional anesthesia

respiratory depression, hypotension, epidural hematoma, infection

respiratory depression

can be a complication of regional anesthesia if the anesthetics travels up the spine instead of down it

hypotension

can be a complication of regional anesthesia because of vasodilation in the area under the injection site

meningitis

which specific type of infection is there a risk of when giving regional anesthetics

safety, respirations, motor and sensory functions

what three things is it important to follow up on with a patient that recieved regional anesthetics

local anesthetics

appropriate for small surgeries and procedures as well as brain surgery where the patient needs to be awake. The patient is fully conscious and aware of his surroundings

advantages of local anesthetics

no need for an anesthesiologist, no need to fast before, short and quick recovery, protected airway, less risk of respiratory issues

light sedation

the patient is awake and is able to cooperate but doesn't feel pain

deep sedation

the patient is unconscious but anatomic functions are still protected. It requires close supervision, and ready intubation equipment as well as attachment to a capnograph

peripheral nerve block

the blocking of a nerve signal to a peripheral nerve by direct injection. Used for limb surgery in addition to regional or general anesthetics. Also used to treat pain

pre surgery assessment

medical and anesthetic history, physical respiratory assessment, labs, discussion of proper medications

anesthesia, analgesia, amnesia

a good anesthetic does these three things

ASA 1

healthy patient without previous illnesses

ASA 2

a patient with a light systemic illness that is balanced

ASA 3

a patient with an unbalanced and severe systemic illness

ASA 4

a patient whose background illness are a constant threat to his life unrelated to the surgery

ASA 5

a patient who will die without surgery

ASA 6

a brain dead patient who is waiting to donate organs

oral intubation

insertion of a pipe into through the trachea by way of the mouth and larynx. It sits right above the carina junction

complications of oral intubation

broken teeth, wound in the mouth, pressure ulcer on the lips, damage to the trachea, one lung intubation, infection of the airway

one lung intubation

when the endotracheal tube goes into the right lung only

nasal intubation

used for surgery in the mouth or when there is damage to the mouth or jaw

complications of nasal intubation

bleeding from the nose, pressure ulcer on the nose

lowers risk of aspiration

why is it important to fast before administration of general anesthetics

monitoring of patient after surgery

check vitals, give anticoagulants, early mobilization, respiratory physiotherapy, make sure the drugs didn't cause side effects

delirium

a usually brief state of excitement and mental confusion often accompanied by hallucinations. can be a complication of anesthesia in the elderly

ways to prevent delirium in elderly patients

have someone the patient recognizes with them at all times, let them hold your hand or give hugs, play music they like, make sure they get enough sleep

guardian

a child must have a _____________ with them until the induction phase of anesthesia is over and while they are awakee