anesthesia

who is responsible for pre-op

anesthesia care provider

pt questionaire

pt interview

airway assesment

pre op sedatives

relive anxiety

diazepam ( valium)

lorazepam ( ativan)

midozelam ( versed)

pre op analgesics

pain relief

opioids

morphine

-astramorph

-duramorph

meperidine ( demerol)

pre op anticholinergics

block the action of acetylcholine inhibiting parasympathetic nerve impulses

atrophine

glycopyrrolate

scopolamine

pre op antacids

acid production or neutralize existing gastric acid

oral antacid -sodium citrate

h2 blockers - zantac, pepeid, tagament

pre op antiemetics

potential for nausea and vomiting

zofran

scopolamine

patient monitoring

direct observation, first line of pt monitoring

electrocardiography

record heart rate and rhythm

electrodes-leads-screen impulses

pulse oximetry

asses respiratory function on finger, toe earlobe,

calculate peripheral oxygen

blood pressure

maintains cardiovascular status

cuff- bp intervals-

temperature

detects hypo/hyper thermia, through skin, axilla, bladder, ear

pediatric/gastric pt more at risk

capnometry

assesses respiratory function, early detection of malignant hyperthermia

monitoring consciousness

used to assess patient’s level 1 of awareness

near- 100 patient is fully wake

less-60 patient appropriate death of general

neuromuscular function

assesses neuromuscular function and blockade, a surface electrode or probe

4/4 no muscle relaxion

0/4 full muscle relaxion

advanced monitoring

Arterial lines are used for potential rapid changes in blood pressure, or when bp measurement is inaccurate

central venous pressure- packed in the vena cava, assess the volume of blood returning to the heart

pulmonary artery line- measures multiple types of pressure and cardiac output

transesophageal echocardiography-used to asses cardiac function probe in esophagus sends waves emitted into tissue, used to observe cardiac wall and valve function

sedation and monitored anesthesia care ( MAC)

specific service that includes all aspects of anesthesia

minimal ( anxiolysis)

moderate ( conscious)

deep ( analgesia)

local anesthesia

the parental administration of anesthetic agent to the nerve endings in the immediate surgical site

regional anesthesia

used to accomplish sensory and motor block to an entire area of the body

injected at nerve plexus, blocks entire nerve bundle

regional: spinal block

injected into subarachnoid space

regional: epidural

injected into space surrounding the dura matter

regional caudal block

type of epidural block, used in vaginal childbirth

regional: peripheral nerve block

called the extermity block, distal arm/legs, hand/fingers, feet/toes

regional Beir block

tourniquate, to keep extremity isolated for medicine

regional retrobulbar block

injected into eye muscle cone,

general anesthesia

systemic state of anesthesia, interferes with brain’s ability to interpret impulses coming from the body

pre-induction

begins as pt admitted into the holding area continues up until the point of anesthetic

pt prep, transport to or, preoxygenation, administration of anesthetic agents

induction

begins when medications are administered to initiate general anesthesia.

mask

placed over pts nose and mouth, oxygen/inhalation agents are given

LMA

sits on tp of larynx, administers oxygen/inhalation agents

ET tube

maximum airway control

administers gasses/ inhalation agents

maintenance

starts when airway is secured/stable, until end of procedure agents given prn

emergence

begins at the end of procedure, pt begins to awaken, pt transported to pacu, highly reactive to noise be mindful

extubation

tubing is removed, anesthesia care provider gives detailed repost to PACU nurse staff

recovery

admitted into PACU, pt fully awakens vitals must be stable before discharge