Anesthesia and physiological monitoring 14

anesthesia care provider

ACP: a professional who is licensed to administer anesthetic agents and manage the patient throughout the period of anesthesia

oropharyngeal airway

OPA artificial airway that is inserted over the tongue into the larynx; used in patients in whom endotracheal intubation is difficult or contraindicated

neuromuscular blocking agent

a drug that blocks nerve conduction in striated muscle tissue

anxiolytic

a drug that reduces anxiety

anesthetic

a drug that reduces pr blocks sensation or induces unconsciousness

laryngoscope

a lightened instrument used to assist endotracheal intubation

pulse aximeter

a monitoring device that measure the patents hemoglobin oxygen saturation by means of spectrometry

bispectral index system

a monitoring method used to determine the patients level of consciousness and prevent intraoperative awareness

anesthesiologist

a physician specialist in the administration of anesthetics and pain management

intraoperative awareness

a rare condition in which a patient undergoing general anesthesia is able to feel pain and other noxious stimuli by unable to respond

malignant hyperthermia

a rare state of hypermetabolism that occurs in association with inhalation anesthetic and neuromuscular blocking agents

esmarch bandages

a rolled bandage made of rubber or latex that is used to exsanguinate blood from a limb

homeostasis

a state of balance in physiological functions

delirium

a state of confusion and disorientation. in the past it was defined as a distinct stage of induction and emergence from general anesthesia. however, this stage is rarely demonstrated in associated with modern anesthetics.

hypothermia

a subnormal body temperature

apnea

absence of breathing

pneumatic tourniquet

an airfilled tourniquet used to prevent blood flow to an extremity during surgery

laryngeal mask airway

an airway consisting of a tube and small mask that is fitted internally over the patients larynx

anesthesia technologist

an allied health professional trained to assist the anesthesia care provider

sedation

an arousbale state in which an individual is unaware of sensory stimuli. depression of a central nervous system

endotracheal tube

an artificial airway that is inserted into the patients trachea to maintain patency

pulmoary embolism

an obstruction in a pulmonary vessel caused by a blood clot, air bubble, or foreign body. causes sudden pain and possible pulmonary arrest

general anesthesia

anesthesia associated with a state of unconsciousness. it is not a fixed state of unconsciousness, but rather ranges along a continuum from semi-responsiveness to profound unresponsiveness

regional block

anesthesia in a specific area of the body, achieved by injection of an anesthetic around a major nerve or group of nerves

topical anesthetic

anesthesia of superficial nerves of the skin or mucous membrane

alternative analgesia

anticholinergics, histamine receptor

nasopharyngeal airway

artificial airway between the nostril and the nasopharynx; used in semiconscious patients or when an oral airway is contraindicated

physiological monitoring

assessment of the patient vital metabolic function

maintenance

begins when the patients airway is secured and inhalation drugs can be administered

anesthesia machine

bio-technical device used to deliver anesthetic gases or volatile liquids and provide physiological monitoring

arterial blood gas

blood gas samples

halothane and enflurane

both produce deep anesthesia

perfusion

circulation of blood to specific tissue, organ system, or the whole body. perfusion is necessary to maintain life in the cells.

intermediate nondepolorizing agent

cisatracurium, vecuronium, rocuronium

balanced anesthesia

combination of drugs and gases

depolorizing agents

deffect muscles in paralysis and contraction

types of benzodiazepines

diazapam, midazolam, larazepam, alprazalam

isotonic

equal in solute concentration than plasma

capnography

exhaled gas is monitored

intravascular volume

fluid volume within the blood vessels

anesthesia alarm

goes off when ventilation is interrupted

hypertonic

greater solute concentration than plasma

narcotic reversal

halothane, halmefene

risk of spinal

high riding spinal

epidural

hollow needle and catheter placed in-between spinal column and epidural space

anterograde amnesia

in anesthesia, the patients ability to recall events that occur after the administration of specific drugs

isoflurane

inhalation anesthetic for short surgeries

induction

initiation of general anesthesia with a drug that causes unconsciousness

spinal

injection into subarachnoid space

what is the danger of an LMA

it does not protect you from aspirations

hypotonic

lower solute concentration than plasma

induced hypothermia

lowering the patients core temperature to help treat MH

fluid balance

maintains intravascular volume and pressure using drugs and solution

renal output

measurement of urine output

pulse oximeter

measures arterial O2 saturation in the hemoglobin by spectrometry

vital signs

minimum assessments of heart rate, temperature, and respiratory rate. in actual practice, a qualitative assessment of these indicators is necessary to provide a more meaningful picture of the patients cardiac, ventilatory, and perfusion status.

short acting nondepolorizing agent

mivacurium

monitored anesthesia care

monitoring of vital functions during regional anesthesia to ensure the patients safety and comfort.

reversal drugs for neuromuscular blocking agents

neostigmine, edrophonium, phridostigmine

protective reflexes

nervous system responses to harmful environmental stimuli, such as pain, obstruction of the airway, and extreme temperature. coughing, blinking, shivering, and withdrawal are protective reflexes

consciousness

neurological state in which a patient is able to sense environmental stimuli such as sight, sound, touch, pressure, heat and cold.

unconsciousness

neurological state in which the person is unabe to respond to external stimuli. can be induced with drugs or may be caused by trauma or disease

preoperative medication

one or more drugs administered before surgery t prevent complication related to the surgical procedure or anesthesia

recovery

patient is transferred to PACU

PACU

post anesthesia care unit: the critical care area in which patients recover from the sedation of general anesthesia

cryoanalgesia

post op thoracic surgery pain

narcotics

produce analgesia by altering how the patient perceives pain

sedative hypnotics

propofol, etomidate, thiopental, ketamine

sevoflorane

rapid emergence drug

nitrous oxide

rapid induction

bier block

regional anesthesia in which the anesthetic agents injected into a vein

neurological response

relaxation achieved through neuromuscular blocking agents

analgesia

the absence of pain, produced by specific drugs

anesthesia

the absence of sensory awareness or medically induces unconsciousness

airway

the anatomical passageway or artificial tube through which the patient breathes

gas scavenging

the capture and safe removal of extraneous anesthetic gases from the anesthesia machine

coma

the deepest state of unconsciousness, in which most brain activity ceases

ventilation

the exchange of CO2 and O2 between the body and the environment

amnesia

the loss of recall of events or sensations

why is maintaining homeostasis an important physiological parameter?

the medication works quicker and more effectively

induction

the patient is conscious and begin with the process of relaxing the patient

observation

the patients thorax is observed for expansion

ventilation

the physical act of taking air into the lungs by inflation and releasing carbon dioxide from the lungs by deflation

intubation

the process of inserting an invasive artificial airway

breathing bag

the reservoir breathing apparatus of the anesthesia machine. gases are titrated and shunted into this, which is connected to the patients airway

emergence

the stage in general anesthetic in which the anesthetic agent is withdrawn and the patient regains consciousness

levels of consciousness

these decrease the possibility of intraoperative awareness

central nervous system depression

this refers to a decrease i sensory awareness caused by drugs or a pathogenic condition

long duration nondepolorizing agent

tubocurararine, galimine, metocurine, pancuronium, pipecuronium

transesophageal monitoring

used to monitor the patients heart rhythm, intensity, pitch and frequency during general anesthesia via transesophageal stethoscope

benzodiazepines

used to promote loss of recall

clinical evaluation

watching the patients clinical signs

extubation

withdrawal of an artificial airway