Integrate knowledge of airway management, perioperative physiology, patient safety, communication, ethics, and human factors in anaesthetic practice. (157 cards) Integrate knowledge of airway management, perioperative physiology, patient safety, c

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Integrate knowledge of airway management, perioperative physiology, patient
safety, communication, ethics, and human factors in anaesthetic practice. (157
cards)


1
Q
What is the earliest time point at which you would consider replacing a
tracheostomy after a new one has been inserted?

ANSWERS:


7 days
This allows enough time for the tract to mature (reduces risk of subsequent
misplacement).
2
Q
What are the cardiovascular consequences of a high spinal injury?

ANSWERS:


 Decreased SVR (loss of sympathetic tone)
 Decreased preload
 Bradycardia (loss of sympathetic fibres to heart)
 Autonomic dysreflexia
3

,Q
At what point after a spinal cord injury is there a risk of hyperkalaemia with
suxamethonium?

ANSWERS:


48 hours onwards
4
Q
What are the indications for doing a CT head scan within 1 hour of injury?

ANSWERS:


 GCS < 13 on initial assessment in ED
 GCS < 15 two hours after injury
 Suspected open or depressed skull fracture
 Any sign of basal skull fracture
 Post-traumatic seizure
 Focal neurological deficit
 More than one episode of vomiting
5
Q
What are the targets for neuroprotective ventilation?

ANSWERS:


 Normoxia: > 8 kPa
 Normocapnia: 4.5-5.0 kPa
 PEEP > 5 cm H2O
 Normotension: MAP > 90 mm Hg (normal CPP is 60-80 mm Hg)
6

,Q
How many times more radiation exposure do you get with a CT chest compared
to a chest X-ray?

ANSWERS:


70 times
7
Q
How far above the carina should the bevel of the endotracheal tube be
positioned in an adult with the head in a neutral position?

ANSWERS:


3-7 cm
8
Q
How would the presence of an ICD affect your anaesthetic management?

ANSWERS:


 Switch off ICD (cardiac physiologist or magnet)
 Place external defibrillator pads
 Avoid monopolar diathermy
 Avoid suxamethonium (fibrilliations can be misinterpreted as VF)
 Intraoperative warming (shivering can be misinterpreted as VF)
 Post-op ICD check by cardiac physiologist
9
Q
What is a never event?

ANSWERS:

, Serious incident that is wholly preventable because guidance or safety
recommendations are available at a national level.
10
Q
Give examples of perioperative never events.

ANSWERS:


SURGICAL
 Wrong site surgery
 Retained foreign object (e.g. swabs)
MEDICATION
 Wrong route (e.g. IV local anaesthetic)
 Insulin overdose
GENERAL
 ABO incompatible transfusion
 Enteral feeding via misplaced NG tube
11
Q
Outline the Le Fort classification for midface fractures.

ANSWERS:


 Le Fort 1: transverse fracture through maxillary sinuses
 Le Fort 2: oblique across zygomaticomaxillary suture, inferior orbital ridge
and nasal bridge
 Le Fort 3: horizontal above the zygomatic arch and through the lateral and
medial walls of the orbit
12