-Other conditions that have similar reaction to MH - -Allergy to bone cement
PE
Allergy to anesthesia
-Blood Transfusion reaction steps - -1st- STOP transfusion
Replace tubing with 0.9% NACL
Report to surgeon and blood bank
Anticipate orders for emergency drugs
-Signs of reaction to blood transfusion - -Blood in urine
Urine output decrease
Hypotension
Hyperthermia
Excessive or unusual bleeding
-IVS ready for discharge - -stay awake for 20 minutes without stimulation
-MH crisis patient observed - -36 hours post op
-Local Anesthesia toxicity
initial and increased - -initial- hypertension
increased-hypotension
-Local Anesthesia hypersensitivity - -tachycardia
-Laser Safety- OR fire - -Communicate
Pour saline slowly on patient
Remove drapes
Consult with anesthesia
Remove airway circuit
Turn off O2
Remove ET tube
Pour saline in airway
Re establish airway
, -Prevent Laser OR fire - -Gel coat facial hair
ET tube filled with Saline and Dye
Non reflective instruments
ESU rubber coated
Do not TENT drapes
-OR room Temperatures Pediatric - -Infants 80-85
Older children 75-80
-Pediatric intubation - -straight laryngoscopes
Uncuffed to 8 years
Suction lumens 5-10 french
ET tube 5.0mm
-Blocks 4 of them - -Retrograde-extremity
Pudendal-gynecology
Intercostal- thoracic
Field- hernia
-Insufflation initial flow and pressure - -9L at 14-16 mm Hg
-Fast Acting anesthetic - -Brevital (methohexital), nitrous and halothane
-Injectable agent faster spread and resolve local edema - -Wydase
-MH medications doses - -Bicarbonate 1-2 mg/kg
Dantrolene 2.5mg/kg q 5 minutes max of 10mg/kg
-ASA classifications - -PS-1 normal
PS-2 mild
PS-3- severe
PS-4- threat to life
PS-5 Die without surgery
PS-6- Brain Dead
-MH last manifestation - -increase in body temperature
-MH Crisis 1 st thing to do - -discontinue triggering agents
hyperventilate
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