Safe administration of Anesthesia

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Last updated 9:21 PM on 6/17/26
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23 Terms

1
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What level of sedation can nurses do

  • ASA 1,2,3

  • No beards, dentures, or sleep apnea

  • No difficult mask ventilations

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Local that is metabolized in liver

  • Bupivacaine

  • Lidocaine

  • Mepivacine

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Pts at risk for LAST

  • Heart disease

  • Liver disease

  • Low albumin levels

  • Medications that prevent seizures

  • Metabolic or respiratory acidosis

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Treatment for LAST

  • O2, monitors, and IV fluids

  • 20% lipid emulsion → 1-1.5 mL/kg bolus per min

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Who can’t be treated for LAST?

Soybean allergy

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Lidocaine dosage

5 mg/kg per day is max dose

  • If epi is present than 7mg/kg

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Brachial plexus block

  1. Interscalene is the most important

  2. Supraclavicular

  3. Infraclavicular

  4. Axillary

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Interscalene complications

  • Horner’s syndrome (constricted pupil, drooping eyelid, and decreased sweating)

  • Phrenic nerve paresis (paralyzes a portion of diaphragm) common

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Supraclavicular complications

  • Penumothorax

  • Phrenic nerve paresis less common

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Infraclavicular facts

  • Short duration

  • Good pain control

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Axillary

  • Hematoma

  • Accidental vascular injection

  • use ultrasound

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Bier block

  • Max dose of lidocaine

  • 1. proximal up 2. distal up 3. proximal down 4. distal down

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Femoral block

Used for quad tendon repair

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Neuraxial anesthesia

Epidural and spinals

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Spinals

Into spinal fluid “pop”

Injects into spinal fluid

Lasts about two hours

Not for post-op pain

Position slowly

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Epidurals

Tissue outside spinal space, in epidural space

Feels resistance on entrance and then back up

Always aspirate first

Position slowly to prevent hypotension

Longer duration and larger dose

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CI for neuraxial anesthesia

  • Hx of spinal malformation

  • Previous spinal surgery

  • Psych status

  • High skill needed in children

  • Increased ICP

  • MS

  • Skin infection at site

  • Anticoagulated pt

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Neuraxial complications

  • Respiratory depression

    • Bladder distention

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Tx for Post dural h/a

  • HOB flat, fluids, pain meds, caffeine, and sumatriptan

  • Epidural blood patch

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Laryngospasm

  • Is drowning reflex

  • Encourage coughing

  • 100% O2 → sedate → paralyze if severe

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Trauma/swelling

  • 100% O2

  • Vaporized epi (racemic or vaponefrin)

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Bronchospasm

  • 100% O2 → bronchdilators → positive pressure

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Aldrete score

Assessment of readiness for d/c