Malignant Hyperthermia
Drug of choice for a Malignant Hyperthermia crisis?
Ryanodex
(Dantrolene)
An airway assessment of:
inspiratory stridor
rapidly decreasing oxygen saturation
absence of breath sounds
complete obstruction to ventilation
are all signs of __________
Laryngospasm
What does LAST stand for?
Local anesthetic systemic toxicity
J-tip should NOT be used on babies weighing less than ______?
4 kg
Transport endoscopes to FERC within __________ minutes after use
60
What are malignant hyperthermia triggering agents?
Volatile Gases: "fluranes"
Muscle Relaxant: succinylcholine
What medication is used to break a laryngospasm?
Propofol can be used alone or with the use of succinylcholine
Early signs and symptoms of LAST?
Numbness around mouth, cheeks, chin
Ringing in ears
Dizziness
Metallic taste
What should you look for before getting labs?
Expected dates
with debridement
Who determines discharge for MH?
And what is required?
Anesthesia
An order from anesthesia
What type of trach is MRI safe?
Why?
Shiley
Bivona trach tubes have a metal coil in them to help the silicone retain its shape
Treatment for LAST?
20% Lipid Infusion
Benzodiazepines, if seizing
Prior to the beginning of any laser-based procedure, nursing will ensure that:
“Laser in Use” signs are activated
Goggles/glasses are used
Door is closed and the locked
Reflective surfaces are covered or blackened
When delivering CSF to microbiology or specimen control make sure to _________
Ring the bell and have someone physically take the sample from you
Early Signs of MH?
Muscle Rigidity
Increased Heart Rate
Increased Respiratory Rate
Temperature
What medication is used to dry up secretions?
What are two common side effects of the medication?
Glycopyrrolate (Robinul)
Flushed cheeks
Increased heart rate
Where are lipids kept on LL2?
Procedural Med Room
(cabinet above computer)
For a baby less than 3 months, LMX can be left on the skin up to ___________ minutes.
For children over 3 months old, it can be left on the skin up to _____________ minutes.
60
120
Cold spray should NOT be used under the age of _________
4, or those developmentally/ cognitively unable to understand the product
Reconstitute each 250 mg vial of Ryanodex with?
5 mL Sterile Water
(use within 6 hours)
Managing laryngospasm, what do you do first?
YELL FOR HELP!!!!
Open airway with jaw thrust
Apply positive airway pressure
What cardiac signs should you watch for?
Vitals after Walia injection?
Bradycardia, hypotension, heart block
Full set of vitals every 5 minutes x3 sets
6 months or younger who receive IV opioids in any phase of care need to be monitored for _________
Minimum of 4 hours following administration of opioid
A PAED score of _______, requires paging anesthesia, diminish stimuli, administer opiate, additional anesthesia interventions
Greater than 15 (Severe)