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SUM'20 - Advanced Principles > Basic principles of Peds > Flashcards

Flashcards in Basic principles of Peds Deck (81)
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61

deep tracheal extubation requires an organized plan.

in order to extubate the trachea deep, what must the depth of inhalational anesthesia be?

1.5 -2 x MAC

example: 2 yr old
-MAC of Sevo = 2%
deep extubation, MAC needs to be 3-4%

62

Emergence delerium has a peak incidence in children of what ages

2-6yrs

63

emergence delerium is more common after certain anesthetics. order of likelyhood:

sevo ~ des~ iso > halothane ~ TIVA

64

how long does emergence delerium usually last?
how can it be terminated?

last 10-15mins
-terminate spontaneously OR after an IV dose of:
propofol
midazolam
clonidine
dexmedetomidine
ketamine
opioids

65

many parents express more concern about the risk of _____ than those of the surgery.

risks of anesthesia than those of the surgery

66

each child and family must be evaluated individually. what is good for one child and family...

may not be good for the next

67

max stress for parents. minimum on infant (not old enough to fear strangers)

likely age?

0-6mos

68

Max fear of separation.
significant post-op emotional upset and behavior regression
magical thinking
cognitive development and increased temper tantrums

likely age?

6mos - 4 yrs

69

Concern about body integrity
separation anxiety
understands processes and explanations

likely age?

8yrs - adolescence

70

independent
self esteem and body image issues
developing sexual characteristics
fears loss of dignity

likely age?

adolescence

71

cyanosis is likely associated with what CV condition?

right to left shunt

72

a murmur may be related to what CV condition?

septal defect

73

hx of neuromuscular dx? what might this indicate?

NMD sensitivity
r/o MH

74

hypoglycemia and adrenal insufficiency in childs hx may indicate use of what medication?

steroid

75

vaccinations may have been recent in a child presenting to surgery. what must anesthesia provider consider?

- whether the iummunomudulatory effects of anesthesia and surgery might affect the efficacy and safety of the vaccine.

-whether the inflammatory responses to the vaccine will alter the perioperative course

76

in peds, what anesthetic agents are associated with undesirable bradycardia?

to prevent the undesirable bradycardia associated with some anesthetic agents (halothane and succinylcholine)

77

to minimize the autonomic vagal reflexes manifested during surgical manipulations (e.g., laryngoscopy, strabismus repair) what agents are used?

anticholinergics

78

what is more commonly used and blocks the vagus nerve more effectively than scopolamine?

atropine

79

factors associated with laryngospasm include:

1. age
2. URTI recently
3. hx of reactive airway disease
4. second hand smoke exposure
5. airway surgery
6. airway devices (ETT, LMA)
7. stimulation of glottis during light plane
8. secretions in oropharynx
9. inhaled anesthesia (des and iso)
10. **inexperienced anesthesia provider

80

laryngospasm risk is greater in infants than older children and adults; the risk decreases with

increasing age

81

algorithm for laryngospasm doses;

IV access
IM access

IV: 1-2mg/kg Succ; 0.02mg/kg Atropine; consider propofol

IM: 3-4mg/kg Succ; 0.02mg/kg Atropine; and call for help