6。麻醉

21 flashcards · Other · by Wanying Koh

1. pt w HTN under med control, receiving op for LL fracture ASA grading

   ASA grade P2

2. uremic pts 無法 pass 麻醉評估 due to

   anemic --> possible cardiac episodic failure

3. cuff pressure 應該維持多少

   20 - 30 cmH2O

4. laryngoscope insertion 時, left-handers can use left hand to hold endotracheal tube

   不行 laryngoscope - left hand endotracheal tube- right hand

5. jaw thrust technique used in pt w head injury?

   head-tilt/chin-lift -- used in most cases unless head or neck injury is suspected in the patient jaw-thrust maneuver -- for patients with head or neck injury

6. to prevent infections when insertion of CVC use ABx-impregnanted CVC tube use U/S guided CVC insertion sterile barrier precautions use of chlorhexidine solution for skin 消毒

   all 對 except use U/S guided CVC insertion 不是 prevent infection

7. CVC complications right IJV - pneumothorax left IJV - chylothorax left subclavian v. - pneumothorax antecubital v. - brachial plexus injury

   antecubital v. - brachial plexus injury 錯誤 antecubital v. complications -pneumothorax, hemothorax, arterial puncture, intrapleural infusion, infection, and hematoma

8. venous air embolism 用什麼偵測

   transesophageal echocardiograph 最好 (> precordial doppler > capnometer > oximeter)

9. ekg placement lead I lead II lead III

10. ETCO2 during CPR can use ETCO2 to confirm CPR quality? ROSC 時 ETCO2 levels?

    yes High quality chest compressions are achieved when the ETCO2 value is at least 10-20 mmHg. When ROSC occurs, There will be a significant increase in the ETCO2. (35-45 mmHg) This increase represents a drastic improvement in blood flow (more CO2 being dumped in the lungs by the circulation) which indicates circulation

11. pulmonary capillary wedge pressure used for? 那些狀況可能會高估 LVEDP

    used to measure LA pressure indirectly but can also 推估 LV end-diastolic pressure 會使高估 LVEDP (PCWP > LVEDP) : lung 問題 COPD mitral valve stenosis 正壓呼吸 pulm v. obstruction elevated alveolar pressure

12. which med inhibits adrenal gland fnt dexmedetomidine thiopental ketamine etomidate

    etomidate inhibits adrenal gland secretion of cortisol

13. which med causes pt to eyes open, nystagmus, but pt is not conscious thiopental ketamine midazolam flumazenil

    ketamine

14. pts on long-term morphine should also be given what medication

    stool softeners morphine AE: constipation

15. which med cannot be used in brain trauma pts propofol ketamine thiopental etomidate

    ketamine - causes IICP

16. which med can be used in abdominal trauma pt w BP 75/50, HR 110 propofol ketamine thiopental midazolam

    ketamine - can use in shock or hypotension pts thiopental / propofol--> causes LOW BP

17. 對呼吸道的刺激最大 isoflurane desflurane sevoflurane halothane

    desflurane (DEATHflurane)

18. cancer pts 給予 pain meds, 最好的方式為 spinal IV oral intramuscular

    oral (By the mouth)

19. post-herpetic neuralgia pts early SNS blockade can decrease occurrences acyclovir if given during acute infection can decrease occurrences

    yes NO

20. pregnant 32wks cardiac arrest endotracheal tube size, need to choose a size smaller than average (smaller by 0.5-1.0mm) ? defibrillator dosing need to be cut? 急救藥物 dosing need to be cut? if 急救無效, within how long of cardiac arrest should C-section occur?

    yes no, all same as normal within 5 min

21. change in pressure based on bloodflow

    Bernoulli equation pressure change = 4 (velocity)^2 --pressure change through aortic stenosis