Diagnose this problem
Lightheaded, dizzy, irritability, high HR, rapid atrial tachycardia
SVT
The three types of pulmonary atresia
PA Mapcas
Pa ivs
Pa vsd
Three procedures for a hypoplastic left heart syndrome patient
Norwood, Glenn and Fontan
Intubated post op patient. Desaturated to 70s from normal 100s.
Looking at ventilator patient has no tidal volumes.
What do you do?
Suction and assess ETT! What if ETT is normally at 8cm but is now at 4cm?
Is patient irritated/ holding breath? Does patient need sedation? Bag patient.
What is the half life of Flolan?
3-6 MINUTES! Dont let it run dry!
High CVP, Muffled Heart Sounds, Low BP, High HR, Restlessness/ Agitation
Tamponade
what is avo2 difference diff
the difference between your arterial and venous oxygen content
This procedure may be done on neonates too small for a norwood procedure
Hybrid Procedure
Patient is a 5 yo post op patient in complete heart block with pacing wires set to a rate of 150. Patient's heart rate has dropped drastically and you notice patient's pacing wire broke.
What do you do?
YELL for help
Assess patient's stabiliy (BP etc)
Compressions if needed
STRIP the pacing wire-
if still not working external pacing (sedate patient!)
Why do we worry about a low potassium and administering digoxin?
Digoxin and potassium compete for receptor sites and when K is low- dig has more site to bind to and can increase risk of toxicity.
How do you diagnose a chylothorax
High CT output
Cloudy or opaque CT output
Serum and Fluid Triglycerides elevated >100 or higher than serum
Cell count
Lymphocytes elevated >80%
What are the treatments recommended during tet spells
1 knee to chest
2 02
3. morphine
4. phenylephrine
5. propranolol
A patient may be put in this medication prior to surgery to keep their PDA open, name that medication and side effects to watch for
PGE, Prostaglandin E1
Side Effects- hyperthermia, apnea, bradycardia, seizures, tremors
Patient is post op TAPVR. Patient is irritable and starts to decompensate. Vitals are bp 50/30, hr 180, spo2 80, co2 60, cvp 24.
What is happening? What will you do?
PHTN Crisis
Bag, increase fio2, sedation, INO, sildenafil
This medication can be used systemically to increase SVR during a tet spell
phenylephrine
Low SaO2, low BP, increase CVP, initlially high HR then bradycardia,
pulmonary hypertensive crisis
How do you treat pulmonary hypertension
Sedation, oxygen, INO, pulmonary vasodilators,
Types of mitral and aortic valves in hypoplast and best one to have
MS/AS, MS/AA, MA/AA and MS/AS is best
Patient is 8m fresh post op.
Vitals
HR 180 CVP 25 BP 50/45 RR 60 Muffled Heart sounds JVD on assessment
What is happening? What do you do?
Tamponade
CALL FOR HELP! Surgeon called.
STRIP that CHEST TUBE!
What medication do you use to treat VTach
NEC
What surgeries have an increase incidence of JET
Tet, VSD, ASD, AVCANAl, Arterial Switch, Truncus
This is a shunt from the RV to PA
Norwood SANO
Your intubated patient is desatting from baseline. Patient is sleeping soundly. ETCO2 is higher than usual.You look at your ventilator and your tidal volumes are only 2-3/kg.
What would you do?
Suction
ASSESS! Breath sounds! Are they equal?
If not equal notify md!
Tube is most likely right mainstem.
Hyperthermia, apnea, fever, flushing, bradycardia (dont push it), seizures, diarrhea, hypokalemia