TWU Anesthesia Cheat Sheet [PDF]

Citation preview

BLOOD LOSS MANAGEMENT



AIRWAY CLASSIFICATION Mallampatl Classification: Class 1: Visualize the soft palate, fauces, uvula, anterior and posterior Tons liar pillars Class 2: Visualize the soft palate, fauces, & uvula only Class 3: Only the soft palate and base of the uvula are visible Class 4: Only the soft palate can be seen Laryngoscopic Vlew Grades: Grade 1: Full v1ew of ent•re glottis opening Grade 2: Posterior portion of the glottis opening 1s VISible Grade 3: Only the epiglottis is visible Grade 4: Only the soft palate IS visible



ASA CLASSIFICATIONS 1-Normal healthy patient 11-Mlld systemic disease {(!I functional limitations) Ill-Severe systemic disease {some functlonallimltation) IV-Severe systemic disease w/ constant threat to hfe V-Morlbund patient who is not expected to surv~ve without surgery VI-Brain dead patient whose organs are being removed for donation



NORMAL BLOOD GAS VALUES pH::7.35 7.45 Pa0 2:90-100 PaC01:::\S-4S HCO!c22·26 BEz:· 2 to 2 Sa0f'95·98%



RESPIRATORY FORMULAS V02., 10 x ki("



VC01 = 8x kg11•



Alveolar Air Equation (F101 x (PI> - PH10)) - PaC01/0.8 Arterial 0 2 Content/100 ml bid (Hgb x1.34 x Sa0 2) + (PaO~ K 0.003)



Estimated Blood Volume (EBV); Premature mfant:95 ml/kg • Full-term lnfant=8S ml/kg • Infant to 12 mo::80 ml/kg • Adult/child male =75 ml/kg



• Adult/chlld female: 65 ml/kg • Morbid Obese=60 ml/k& {BMI > 40) Allowable Blood Loss (ABL): ([EBV x HctsrAIInJ>55



Super Morbid Obesity



Stop trlgering agent Immediately Hyperventilate with 100% O, at high flow Administer Oantrolene 2.5 mg/kg IV Repeat Q 5-10 min until symptoms controlled Max dose 10mg/kg Correct metabolic acidosis Correct hyperkalemia Actively cool patient Check labs Q l5 min until stable Maintain urine output> 2 ml/kg/hr with hydration, Mannitol, or laslx



~"~



: -·:-.:::



.~- •,"'";~·



•



~~~ .~.



~ ~--~~~



I



:.~·1 ~



1



~~~!._!_L,:



Preemies s 1 kg



2.5



Preemies 1-Z.S ka



3.0



Term neonate- 6 mo



3.0·3.5



6mo- 1yr



3.5-4.0



1-2 yrs



4.0-4.5



1



1' to 5 kg



up to 4 mL (air)



1~



5 -10 kg



up to 7 ml



2



1Q.20 kg



up to 10 ml



z~



2Q.30 kg



up to 14 ml



3



>30 kg



up to20 ml



4



Adu lt



up to 30 ml



BeyondZyrs Tube Depth



(age/2) +12



Dedicated to the Class of 2012 By: Debra Maloy · Jeff Carroll · Amanjot Dhaliwal· Yvonne Murphy· Shana Thompson



Texas Wesleyan GAADUAfl !JitOOitAHS 01' N Uitll ANIIfH IUIA



Anesthesia Cheat Sheet



1. 2. 3. 4.



Analgesia lightheadedness Tinnitus Tongue/Orcumoral numbness/ tingling/funny taste in mouth 5. Seizures 6. Unconsciousness



If un responsive to standard t herapy, in addit ion to standard CPR: • Bolus lntrallpid 20% IV 1.5 ml/kg over 1 minute • lntrallpid 20% 0.25 ml/kg/min immediately after bolus • Continue chest compressions to circulate lipids • Repeat bolus q3-5 min up to 3ml/kg total dose until circulation is restored • Increase infusion to O.Sml/kg/min if BP declines. Continue infusion until hemodynamic stability is restored. • Max total dose 8ml/kg Is recommended



Supply: 200mcg/2ml Mix in NS 48ml Result 4mcg/ml Bolus lmcg/kg x 10 min, then 0.2-0. 7 mcg/kg/hr



• www.lipidrescue.Q!& Female; Age < 40; History of PONV, Motion sickness, Vertigo; Surgeries- laparotomy, laparoscopy, major breast, strabismus, intraocular, dental, middle ear, tonsils, adenoids, neuro (intracranial), gynecolog1c, testicular, scrotum, kidney stones



Treatment



Neostigmine



Edrophonlum



0 .5-1.0 ms/kg



1-2



5-15



Atropine 7-15 Wkll



2



40%



2 drugs



3



>60%



3+ drugs



95



35



lOU



38.5



95.9



35.5



102.2



39



96.8



36



103.1



39.5



97.7



36.5



104



98.6



37



104.9



40.5



99.5



37.5



105.8



41



° F : ((9/5) X 0 C) +32



°C :(5/9) X ( 0 F- 32)