Twu Anesthesia Cheat Sheet

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>
MAliGNANT HYPERTHERMIA Trigge~: Halothane, Enflurane. lsoOurane, Sevoflurane, Oesflurane,

4 ml/kg/hr for first 10 kg 2 ml/kg/hr for next 10 kg 1 ml/kg/hr for each kg > 20 ~

' ' [\! • II

Succinylcholine Sings of Onset: Tachycardia, Tachypnea, 1'EtCO~ Skln Mottling, Arrhythmias, 1'Body Temp, Unstable BP, Cola-colored Urine, Muscle Rigidity, Masseter Spasm

IT

Main rate x hours NPO l p ~ Mmimal = Q-2 ml/kg/hr Moderate.:: 2-4 ml/kg/hr Severe = 4-8 ml/kg/hr

Tre<~tment

l. 2. 3.

BMI

Wt Ka/ht in mJ

4.

>23-25

Healthy

5. 6.

>25

Overweight

7.

28

Onset Wt related disease

>30

Obese

35·40

Morbid Obesity

8.

_,-_-~=-:_··.: ~."

>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

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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)