Failed intubation: Causes

"INTUBATION"

• Infections of larynx
• Neck mobility abnormalites
• Teeth abnormalties(loose tooth,protuberant tooth)
• Upper airway abnormalties (strictures or swellings)
• Bull neck deformities
• Ankylosing spondylitis
• Trauma/tumour
• Inexperience
• Oedema of upper airway
• Narrowing of lower airway

Spinal anesthesia: Agents

"Little Boys Prefer Toys"

• Lidocaine
• Bupivacaine
• Procaine
• Tetracaine

PREANAESTHETIC MEDICATION

OH! SANA
O Opiods
H H2 blockers
S Sedatives antianxiety drugs
A Antiemetics
N Neuroleptics
A Anticholinergics

Halothane

H- malignant Hyperthermia
A- anaesthesia without analgesia
L- decomposed by Light
O- vasOdilatOr, brOnchOdilatOr, uterine relaxtant
TH- thymol as preservtive
A- amber bottle to store it
N- hepatic Necrosis
E- eraser, erodes rubber

Day care anaesthesia

PROSIDAS
P Propofol
R Remifentanil
O n2O
S Sevoflurane
I Isoflurane
D Desflurane
A Alfantanil
S Succinylcholin

Endotracheal intubation: diagnosis of poor bilateral breath sounds after intubation

 DOPE:
Displaced (usually right mainstem, pyreform fossa, etc.)
Obstruction (kinked or bitten tube, mucuous plug, etc.)
Pneumothorax (collapsed lung)
Esophagus

Respiratory complications of anaesthesia: patients at risk

 COUPLES:
COPD
Obese
Upper abdominal surgery
Prolonged bed rest
Long surgery
Elderly
Smokers

Anesthesia: quick check

 SOAP:
Suction
Oxygen
Airway
Pharmacology

Anesthesia machine/room check

MS MAID:
Monitors (EKG, SpO2, EtCO2, etc)
Suction
Machine check (according to ASA guidelines)
Airway equipment (ETT, laryngoscope, oral/nasal airway)
IV equipment
Drugs (emergency, inductions, NMBs, etc)

Xylocaine: Where not to use with Adrenaline?

"Digital PEN"

• Digits (Fingers and toes)
• Penis
• Ear
• Nose tip

Adrenaline causes vasoconstriction which helps to trap Xylocaine (anaesthetic) locally prolonging its duration of action. The two are not used together at sites supplied by end arteries as the vasoconstriction produced by adrenaline can cause ischemic necrosis of the tissues.

Adrenaline is also referred to as Epinephrine.