The Anesthesia Technologist’s Manual

 

Description:

 

This unique manual is an ideal resource for anesthesia technicians and technologists and those studying for certification (CerATT) in the field. It offers well-illustrated, comprehensive coverage of every aspect of day-to-day practice and workflow, with sections on Anatomy, Physiology, and Pharmacology; Anesthesia Practice; Anesthesia Equipment and Technology; Emergencies, and more. From explanations of who’s who in the operating room to detailed, step-by-step instructions on equipment maintenance, this practical manual ensures that readers will have current, complete information on the core knowledge they need to know in anesthesia technology.

 

 

Table of Contents:

 

Introduction

SECTION I. Careers in Anesthesia Technology

1 Certification for Anesthesia Technicians and Technologists

Introduction

Background

Certification Process

Certified Technician Exam

National Certified Technologist Exam

Provisional Certification

Refresher Program

Educational Programs

Certification Benefits

Summary

Suggested Readings

2 The Surgical Experience

Introduction

Overview of the Patient’s Experience

The Operating Room

The Perioperative Team

Anesthesia Provider

Surgical Attending

Circulating Registered Nurse

Scrub RN or Surgical Technologist

Allied Support Staff

The Role of the Anesthesia Technician

Assisting the Anesthesia Provider

Partnering with the Perioperative Team

Anesthesia Machine Checkout

Room Turnover

Resource and Supply Management

Equipment Sterilization

Covering Multiple Areas

Summary

Suggested Reading

SECTION II. Anatomy, Physiology, and Pharmacology

3 Pharmacology

Introduction

Safety

Pharmacokinetics

Absorption

Bioavailability

Distribution/Redistribution

Volume of Distribution

Drug Elimination

Metabolism

Clearance

Half-life

Steady State

Pharmacodynamics

Mechanism of Action

Receptors and Ligands

Agonists, Partial Agonists, and Antagonists

Potency and Efficacy

Therapeutic Index

Drug-Drug Interactions

Summary

Suggested Readings

4 Cardiovascular Anatomy and Physiology

Introduction

Surface Anatomy of the Heart

Fetal Development

Pericardium

Myocardium

Cardiac Chambers and the Circulation of Blood

Right Atrium

Right Ventricle

Left Atrium

Left Ventricle

Cardiac Skeleton

Cardiac Conduction System

Coronary Arterial Supply

Coronary Venous Circulation

Innervation

Cardiac Physiology

Cardiac Action Potential

Cardiac Electrophysiology

Abnormal Heart Rhythms

Cardiac Cycle

Ventricular Systole

Ventricular Diastole

Cardiac Volumes and Cardiac Output

Factors Affecting Cardiac Output

Preload

Afterload

Contractility

Cardiac Reflexes

Myocardial Oxygen Supply and Demand

Blood Oxygen Content

Myocardial Blood Flow

Myocardial Oxygen Demand

Myocardial Infarction

Valvular Heart Disease

Aortic Stenosis

Aortic Regurgitation

Mitral Stenosis

Mitral Regurgitation

Summary

Suggested Readings

5 Cardiovascular Monitoring

Introduction

Pulse Oximeter

Peripheral Capillary Oxygen Saturation Percentage (SpO2)

Electrocardiogram

Basic ECG Waveform

Noninvasive Blood Pressure Monitor

Perfusion Pressure

Technology

Invasive Arterial Blood Pressure Monitoring

Technology

Equipment

Central Venous Pressure Monitor

Physiologic Significance

Technology

Equipment

Sources of Error

Pulmonary Artery Catheter

Pulmonary Artery Pressure

Pulmonary Capillary Wedge Pressure

Cardiac Output

Systemic Vascular Resistance

Technology

Sources for Error

Transesophageal Echocardiography

Summary

Suggested Readings

6 Cardiovascular Pharmacology

Introduction

Positive Inotropic Agents

Catecholamines

Epinephrine

Norepinephrine

Dopamine

Synthetic Catecholamines and Phosphodiesterase Inhibitors

Dobutamine

Isoproterenol

Milrinone

Myofilament Calcium Sensitizers

Levosimendan

Vasopressors

Vasopressin

Phenylephrine

Ephedrine

Antihypertensive Medications

Vasodilator Agents

Nitroprusside

Nitroglycerin

Hydralazine

Fenoldopam

Calcium Channel Blockers

Nicardipine

Beta-Adrenergic Antagonists (Beta-Blockers)

Metoprolol

Labetalol

Esmolol

Antiarrhythmic Drugs

Adenosine

Verapamil

Amiodarone

Lidocaine

Atropine and Glycopyrrolate

Summary

Suggested Readings

7 Respiratory Anatomy and Physiology

Introduction

Anatomy

Upper Airway

Lower Airway

Anatomy of the Thorax

Lung Volumes

Blood Supply to the Lungs

Physiology

Nose, Mouth, Pharynx, and Larynx

Diffusion

Resistance to Airflow in the Airways

Gas Exchange in the Alveolar-Capillary Unit

Control of Breathing

Mechanics of Breathing

Patient Position, Anesthesia, and Respiratory Mechanics

Summary

Suggested Readings

8 Respiratory Monitoring

Operating Room Monitoring of Respiratory Function

The Respiratory System and Acid-base Balance

Ventilation

Capnometry

Oxygenation

Anesthesia Machine Monitors of Ventilation

Summary

Suggested Readings

9 Respiratory Pharmacology

Pharmacology

Bronchodilators and Bronchoconstrictors

Medications and Pulmonary Blood Flow

Metabolism and Uptake of Medications by the Respiratory System

The Respiratory System as a Route of Administration

Anesthetic Agents and Pulmonary Function

Neuromuscular Blockers

Vasoactive Medications

Suggested Readings

10 Acid and Base Physiology

Introduction

Physiologic Consequences of Acid-Base Disturbances

Respiratory Acid-Base Disturbances

Arterial Blood Gases

ABG Interpretation

Metabolic Acid-Base Disturbances

Compensation

Summary

Acknowledgment

Suggested Readings

11 Central Nervous System

Introduction

Anatomy of the Brain

Anesthetic Implications of Brain Anatomy

Anatomy of the Spinal Cord

Anesthetic Implications of Spinal Cord Anatomy

Physiology

Pharmacology

Inherent Toxicity of Anesthetic Agents in the CNS

Anatomy, Physiology, and Pharmacology of Nausea and Vomiting

Summary

Acknowledgment

Suggested Readings

12 Peripheral Nervous System

The Sensory-Somatic Nervous System

Spinal Cord Organization

Afferent and Efferent Nerves

Anatomy: Peripheral Nerves

Neurons: The Nerve Cell

Peripheral Nerve Physiology

Depolarization

Conduction Velocity

Repolarization

Peripheral Nerve Pathophysiology

Local Anesthetics and Peripheral Nerve Blockade

Basic Local Anesthetic Pharmacology

Chemistry

Structural Influences

Pharmacokinetics

Summary

Suggested Readings

13 Autonomic Nervous System

Anatomy of the Autonomic Nervous System

Physiology of the Autonomic Nervous System

Effects of Autonomic Nervous System Stimulation

Anesthetics and the Autonomic Nervous System

General Anesthesia

Benzodiazepines

Opiates

Hypnotics/Barbiturates/Sedatives

Inhalation Agents

Neuromuscular Junction Blocking Agents (Muscle Relaxants)

Muscle-Relaxant Reversals

Regional Anesthesia

Suggested Readings

14 Neuromuscular Anatomy and Physiology

Introduction

Anatomy of the Neuromuscular System

The Neuromuscular Junction

Diseases That Alter Neuromuscular Function

Pharmacologic NMJ Blockade

Monitoring Neuromuscular Blockade

Summary

Suggested Readings

SECTION III. Anesthesia Practice

15 Sedation

Introduction

Definition of Terms

ASA Recommendations

Medication Selection

Common Cases

Summary

Suggested Readings

16 Regional Anesthesia

Introduction

Indications and Contraindications

Bleeding Disorders

Pulmonary Function

Preexisting Nerve Injury

Local Anesthetic Reaction

Patient Refusal

Infection

Patient Education

Block Rooms, Monitoring and Positioning, and Common Equipment

Premedication and Sedation

Introduction to Neuraxial Regional Anesthesia

Introduction to Upper Extremity Blocks

Interscalene Block

Supraclavicular Block

Infraclavicular Block

Axillary Block

Introduction to Lower Extremity Blocks

Lumbar Plexus Block

Femoral Nerve Block

Adductor Canal Block

Subgluteal Sciatic Block

Popliteal Sciatic Block

Rescue Blocks

Follow-Up

Summary

Suggested Readings

17 Overview of a General Anesthetic

Early History of Anesthesia Agents

Four Goals of an Anesthetic

Lack of Awareness

Pain Relief (Analgesia)

Immobility

Patient Safety

Stages of Anesthesia

Time Frames of a General Anesthetic

Preoperative Phase

Intraoperative Phase

Postoperative Phase

Summary

Suggested Readings

18 Principles of Airway Management

Introduction

Airway Anatomy

Indications for Tracheal Intubation

Complications Associated with Intubation

Predicting Difficulty with Ventilation

Induction Sequence

Rapid Sequence Induction

Bag-Mask Ventilation

Supraglottic Airways

Direct Laryngoscopy

Video Laryngoscopy

Blind Intubation Techniques

Flexible Scope Intubation

Surgical Airway

Pediatric Considerations

Extubation

Summary

Suggested Readings

19 Perioperative Medications

Introduction

Sedative Hypnotics

Propofol

Etomidate

Benzodiazepines

Barbiturates

Dexmedetomidine

Ketamine

Analgesics

Opioids

Nonopioid Analgesics

Neuromuscular Blocking Agents and Reversal Agents

Neuromuscular Blocking Reversal Agents

Sugammadex

Antinausea Medications

Suggested Readings

20 Patient Positioning

Introduction

General Mechanisms of Injury

Neuropathies

Ulnar Neuropathy

Brachial Plexopathies

Median Neuropathies

Radial Neuropathies

Lower Extremity Neuropathies

Practical Considerations for Perioperative Peripheral Neuropathies

Unique Positioning Problems with Catastrophic Results

Anesthesia Technicians and Patient Positioning

Summary

Suggested Readings

21 Fluid Therapy

Introduction

Why Do Surgical Patients Require Intravenous Access?

What Are the Complications of Fluid Therapy?

What Fluids Are Available for Use during Anesthesia?

Crystalloid Solutions

Colloid Solutions

How Much Fluid Should be Given during Anesthesia and Surgery?

How Do Anesthesiologists Monitor Fluid Therapy?

Summary

Suggested Readings

22 Blood Transfusion

Introduction

Blood Types

Compatibility Testing

Indications for Transfusion

Complications and Adverse Reactions

Handling, Verification, and Storage

Administration

Different Blood Products

Summary

Suggested Readings

23 Infectious Diseases

Introduction

Pathogens

Bacteria

Fungi and Parasites

Viruses and Prions

Prevention of Health Care–Associated Infections

Infection Control Precautions

Exposure to Infectious Body Fluid

Postexposure Prophylaxis

Summary

Suggested Readings

SECTION IV. Anesthesia Equipment and Technology

24 The Anesthesia Machine

Introduction

Pipeline and Cylinder Gas Supply

Oxygen Supply Failure Safety Devices

Flowmeters

Vaporizers

Carbon Dioxide Absorber

Common Gas Outlet

Oxygen Flush Valve

Breathing Circuit

Ventilator

Scavenging

Monitors

Summary

Suggested Readings

25 Anesthesia Machine Checkout

Introduction

History of Machine Checkout Recommendations

Anesthesia Machine Checkout Procedure

Automated Checkouts

Summary

Suggested Readings

26 Vaporizers

Introduction

Physical Chemistry

Vapor and Vapor Pressure

Gas Concentration: Partial Pressure and Volume Percent

Principles of Modern Vaporizers

Variable Bypass Vaporizers

Vaporization Method

Temperature Compensation

Operation of Vaporizers

Installation of a Vaporizer

Filling the Vaporizer

Delivery of Anesthetic

Removal of Anesthetic

Troubleshooting

Higher than Expected Vapor Output

Lower than Expected Vapor Output

Low-Pressure Circuit Leak

Other Problems

Summary

Suggested Readings

27 The Breathing Circuit

Introduction

Fundamental Requirements

Anesthesia Breathing Circuits

To-Fro System

Circle Systems

Carbon dioxide Absorption Systems

Summary

Suggested Readings

28 Ventilators

Introduction

Ventilator Modes

Clinical Scenarios

Ventilator Operation

Gas Delivery Mechanisms

Ventilator Maintenance

Ventilator Failure

Summary

Suggested Readings

29 Preventing and Solving Anesthesia Machine Problems

Introduction

Brief Overview of the Anesthesia Machine

General and Daily Maintenance

Troubleshooting Common Problems

Low Pressure

Hypoxic Gas Mixture

Flowmeter Problems

Ventilators

Ventilator Maintenance

Troubleshooting Common Ventilator Problems

Gas Analyzer

Maintenance of Gas Analyzers

Troubleshooting Common Problems with Gas Analyzers

Agent Concentration

CO2 Absorber

Maintenance of CO2 Absorbers

Troubleshooting Common Problems with CO2

Scavenging System

Scavenging System Maintenance

Troubleshooting Common Problems with Scavenging Systems

Summary

Suggested Readings

30 Gas Analyzers

Gas Analyzers

Types

Mainstream

Sidestream

Technology

Electrochemical

Paramagnetic

Infrared

Raman Spectroscopy

Calibrations and Troubleshooting

Troubleshooting

Commonly Monitored Gases

Oxygen

CO2

Anesthetic Agents

Summary

Suggested Readings

31 ASA Standard Monitoring

ASA Standard I

Pulse Oximetry (ASA Standards II and IV)

Technology

Sources of Error

Capnography (ASA Standard III)

Electrocardiogram (ASA Standard IV—Circulation)

Noninvasive Blood Pressure (ASA Standard IV)

Temperature (ASA Standard V)

Summary

Suggested Readings

32 Intraoperative Neurophysiologic Monitoring

Introduction

Evoked Potentials: Stimulus and Response

Types of Evoked Potential Monitoring

Somatosensory Evoked Potentials

Motor Evoked Potentials

Brainstem Auditory Evoked Potentials

Visual Evoked Potentials

Electromyography

Evoked Potential Monitoring and Anesthesia

Other Monitors

Electroencephalography

Processed EEG

Intracranial Pressure Monitoring

External Ventricular Drains

Intraparenchymal Fiberoptic Catheters and Bolts

Other Monitors

Summary

Suggested Readings

33 Temperature Management

Introduction

Thermoregulation

Mechanisms to Protect the Body against Cold are Blunted by General Anesthesia

Adverse Effects of Hypothermia in Anesthetized Patients

Increased Blood Loss

Increased Risk of Surgical Site Infection

Increased Cardiac Morbidity

Increased Anesthetic Potency and Prolonged Metabolism

Increased Recovery Time—PACU and Hospital

Treatment Options

Prewarming Before an Operation

Forced Air

Warming Fluids

Heating Lights

Maintenance

Hyperthermia

Neuroleptic Malignant Syndrome

Malignant Hyperthermia

Temperature Monitoring

Summary

Suggested ReadingS

34 Medication Handling

Introduction

Controlled Substances Accountability

Reducing Medication Errors during Anesthesia

Standardization of the Anesthesia Drug Tray System

Standardized Pharmacy-Prefilled Syringes

Standardized Pharmacy Premixed Infusion Bags

High-Risk Medications

Safe Medication Administration

Aseptic Technique

Automated Medication Dispensing Machines

Medication Waste

Summary

Suggested Readings

35 Blood Gas Analyzers and Point-of-Care Testing

Introduction

Blood Gas Machine

Activated Clotting Time

Hepcon

Thromboelastography

International Normalized Ratio

Blood Glucose Machine (Glucometer)

Future POCT

New Equipment

Device Selection

Arrival of New Equipment

Personnel

Quality Management

Manufacturer’s Procedure Manual (User Manual)

Specimen Handling

Results Reporting

Quality Control

Calibration

Summary

Suggested Readings

36 Vascular Access

Introduction

Peripheral Intravenous Catheter

Definition and Indications

PIV Catheter Equipment

Technique for Placing PIV Catheters

PIV Catheter Procedure

Removing PIV Catheters

Complications of PIV Catheters

Troubleshooting PIV Catheters

Central Venous Catheter

Definition and Indications

Central Venous Anatomy

CVC Types

CVC Indications

CVC Equipment

Technique for CVC Insertion

Provider Technique for Placing a CVC

Complications

Troubleshooting

Intraosseous Venous Access

Definition and Indications

Intraosseous Access Equipment

Technique

Intraosseous Complications

Associated Equipment

Basic IV Sets

Fluid Warmer

Rapid Infusion Systems

Autotransfusion

Summary

Suggested Readings

37 Intravascular Monitoring Equipment

Introduction

Arterial Line (A-Line or Art Line)

Definition and Indications

Indications for Arterial Line Placement

Contraindications to Arterial Line Placement

Arterial Line Equipment (Fig. 37.1)

Arterial Line Technique

Placement of Arterial Line

Arterial Waveform Basics

Arterial Line Complications

Arterial Line Troubleshooting

Pulmonary Artery Catheter

Definition and Indications

PAC Equipment

Technique for PAC Insertion

Cardiac Output Measurement (by Thermodilution Technique) (Also See Video 37.2)

PAC Complications

PAC Troubleshooting

Pressure Transducers

Setting Up a Pressure Transducer (See Video 37.3)

Zeroing the Pressure Transducer

Blood Sampling

Summary

Suggested Readings

38 Infusion Pumps

Introduction

Medication Pump Safety

Types of Medication Pumps

Analog Pumps

Microcomputer Pumps

Patient-Controlled Pumps

Continuous Infusion Pumps

General Operating Principles for Inpatient Microcomputer Pumps

Troubleshooting

Summary

Suggested Readings

39 Airway Devices

Introduction

Nasal Prongs—Passive Oxygenation

Nasal Cannulas

Face masks—Passive Oxygenation

Standard Face Mask

Nonrebreather Face Mask

Venturi Mask

Tracheostomy Mask

Face Tent or Shovel Mask

Face masks—Positive Pressure Masks

Basic Anesthesia Masks for Positive Pressure Ventilation

BiPAP/CPAP Masks

Endoscopy Masks

Nasopharyngeal Airways

Oropharyngeal Airways

Laryngeal Mask

iGels

Intubating Laryngeal Masks

Combitube and Laryngeal Tubes

Endotracheal Tubes

ETT Adapters

Double-Lumen Endotracheal Tubes

Endobronchial Tubes

Endobronchial Blockers

Suggested Readings

40 Airway Equipment Setup, Operation, and Maintenance Tools to Access the Glottic Opening

Introduction

Direct Laryngoscopy

Handles

Blades

Disinfection

Special Circumstances

Troubleshooting the Laryngoscope

Indirect Laryngoscopy

Optical Stylets

Fiberoptic Bronchoscopes

Rigid Video Laryngoscopes

Tools for Blind Techniques

Intubating Stylets

Intubating the Airway

Preparing for Endotracheal Intubations

Intubating stylets (bougie, lighted)

Preparing for Surgical Airway Techniques

Ventilation Through Small-bore Tubing

Summary

Suggested Readings

41 Ultrasound

Introduction

Basic Ultrasound Physics/Machine Controls

Frequency of Ultrasound Waves

Gain

Depth

Doppler/Color

Focus

Multibeam

Compression

Presets

Types of Transducers

Ultrasound Terminology

Storage of Ultrasound Images

Tips for Optimizing Conditions for Ultrasound Exams and Procedures

Optimizing the Ultrasound Image

Ergonomics

Proper Use and Maintenance of Ultrasound Equipment

Preparation for Use

Following Use

Maintenance

Summary

Suggested Readings

42 Transesophageal Echo

Introduction

Basic Principles of Ultrasound and TEE

Types of TEE: Two-Dimensional and Three-Dimensional

TEE Parts

Indications and Contraindications

Complications from TEE

TEE Setup

Preinsertion Checklist

Helping the Anesthesiologist Place the Probe and Acquire Images

End of the Case

Probe Removal

Probe Processing

Probe Storage and Identification

Safety

TEE in Emergencies

Summary

Suggested Readings

43 Intraaortic Balloon Pumps and Ventricular Assist Devices

Introduction

Aortic Balloon Pumps

Cardiac Cycle and Coronary Perfusion

Diastole

Systole

How an IABP Works: Counterpulsation Hemodynamics

Setup and Placement

Operation and Management of an IABP

Troubleshooting

Ventricular Assist Devices

Ventricular Assist Devices: How do they Work?

Types of Pumps: Pulsatile Versus Continuous Flow Pumps

Pulsatile Pumps

Continuous Flow VADs

Setting Up a VAD

Monitoring and Operation

Pump Speed

Pump Power and Flow

Pulsatility Index

Complications and Troubleshooting VADs

Summary

Suggested Readings

44 Autotransfusion Devices

Introduction

Cell Salvage

Common Types of Surgery for Cell Salvage

Acute Normovolemic Hemodilution

Preoperative Autologous Blood Donation

Jehovah’s Witnesses

Blood Saving Protocols

Summary

Suggested Readings

45 Defibrillators

Introduction

Types of Defibrillators: Internal Defibrillators, External Defibrillators, and Automatic External Defibrillators

Electrical Energy

Basic Features

Use of the Defibrillator

Attaching the Pads or Paddles

Turn the Power ON

Rhythm Analysis

Energy Selection

Charge the Defibrillator

Deliver the Shock

Complications

Troubleshooting

External or Transcutaneous Pacing

Maintenance

Defibrillator Summaries by Manufacturer

Philips Healthcare Defibrillators

Physio-Control Defibrillators

Zoll Defibrillators

AEDs

Phillips AEDs

Zoll AEDs

Physio-Control AEDs

Defibtech AEDs

Summary

Suggested Readings

46 Pacemakers and Implantable Defibrillators

History and General Overview of Pacemakers and Implantable Defibrillators

Brief Review of the Cardiac Cycle

Pacemaker and ICD Insertion and Function

Other Pacing Modalities

Transcutaneous Pacing

Temporary Pacing from an External Pulse Generator (Pacemaker)

Transvenous Pacing

Pacing Pulmonary Artery (Swan-Ganz) Catheter

Epicardial Pacing

Transesophageal Pacing

Pacemaker Code

Common Pacemaker Modes

Perioperative CIED Management

Intraoperative CIED Management

Postoperative CIED Management

Summary

Suggested Readings

47 Anesthesia Supply and Equipment: Contamination, Sanitation, and Waste Management

Introduction

Sterile Operative Terminology

Anesthesia Turnover

Anesthesia Breathing Circuits

Anesthesia Machine Cleaning

Anesthesia Equipment Cleaning

Anesthesia Work Area and Auxiliary Part Cleaning

Laryngoscope Blade and Handle Management

Reusable Laryngoscope Blade and Handle Management

Disposable Laryngoscope Blade and Handle Management

Anesthesia Drug Management

Ensuring Accountability

Returning and Wasting Controlled Substances

Properly Returning Controlled Substances

Noncontrolled Drug Management and Disposal

Anesthesia Gas Management and Disposal

Handling and Disposal of Sharps

Waste Management and Disposal (Solid Waste, Medical Waste, Recycling, and Reprocessing)

Reprocessing

Summary

Suggested Readings

SECTION V. Special Considerations

48 Pediatric Anesthesia

Introduction

Differences between Pediatric and Adult Patients

Anatomy and Physiology

Psychological Issues with Pediatric Patients

Specific Surgeries

Neonatal and Infant Surgery

Pediatric Neurosurgery

Cardiac

Urology

Orthopedics

Otolaryngology

Ophthalmology

Dental

Pediatric Sedation/Anesthesia Out of the Operating Room

Risk of Pediatric Anesthesia

Summary

Suggested Readings

49 Obstetric Anesthesia

Introduction

Design of Obstetric Units

Monitoring

The Physiologic Changes of Pregnancy

Labor Analgesia

Labor Epidurals

Cesarean Section

Spinal Anesthesia

Epidural Anesthesia for Cesarean Section

Combined Spinal Epidural

General Anesthesia

Other Obstetric Emergencies

Seizures

Hemorrhage

Embolism

Cardiac Arrest in Pregnancy

Other Emergencies

Summary

Suggested Readings

50 Anesthesia Considerations for Out-of–Operating Room (OOR) Locations

Introduction

General Principles

The OOR Environment

Diagnostic and Therapeutic Equipment

Anesthetic Equipment

Constraints Related to Diagnostic and Therapeutic Imaging Techniques

Out-of–Operating Room Staff

Environmental Hazards

Patient Concerns in the OOR Environment

Procedural Concerns

Radiologic Procedures

Gastrointestinal Endoscopic Procedures (GI Procedures)

Interventional Cardiology

Anesthesia Concerns in OOR Sites

Constraints of OOR Environments

General Anesthesia vs Sedation

Airway Assessment

Postanesthesia Care and Patient Transport

Pediatric OOR

Scope of Practice for Pediatric OORA

Radiation Oncology

Hematologic Oncology

Practical Considerations

Complications during Pediatric OORA

Recovery from General Anesthesia

Future Trends in Pediatric OOR Anesthesia

Summary

Suggested Readings

51 Patient Transport

Introduction

Monitoring during Transport

Ventilation and Oxygenation

Cardiovascular Monitoring

Additional Monitors

Patient Care during Transport

Prevention of Hypothermia

Management of Ventilation

Transfer to and from the Transport Bed

Transport Checklist

Summary

Suggested Readings

52 MRI Safety

Introduction

The MRI Scanner Magnet

The MRI Suite

Potential Hazards in the MRI Suite and Their Anesthetic Implications

Summary

Suggested Readings

53 Electrical Safety

Introduction

Electrical Shock

Loss of Electrical Power

Burns and Fire

Implanted Devices

The Role of the Anesthesia Technician

Suggested Readings

54 Radiation Safety

Introduction

Basic Principles of Radiation Physics (Fig. 54.1)

The Electromagnetic Spectrum and Ionizing Radiation

Radiation Exposure and the Inverse Square Law

Radiation Exposure and Time

Radiation Exposure and Shielding

Radiation Safety at Work in the Anesthesia Environment

Distance

Time

Shielding: Personal Protective Equipment

Summary

Suggested Readings

55 Laser Safety

Introduction

Laser Technology

Laser Interactions with Tissues

Safety Concerns

Eye Injury and Protective Eyewear

Air Contamination

Fire Hazard

Airway Management during Laser Surgery

Laser-Resistant ETTs

Summary: The Role of the Anesthesia Technologist

Suggested Readings

SECTION VI. Emergencies

56 Simulation-Based Training

Introduction

Simulation in Health Care

Anesthesia Technicians and Simulation

Simulation Environments

CRM

Summary

Suggested Readings

57 Airway Emergencies

Introduction

Preparation

Plan Execution

Awake Intubation

Asleep Intubation

Invasive Airway Techniques

Difficult Airway Cart

Special Diseases or Procedures

Airway Diseases

Airway Procedures

Team Dynamics

Summary

Suggested Readings

58 Cardiac Arrest

Introduction

Prearrest: Initial Response

Signs of Cardiac Arrest

Cardiac Arrest: Initial Response (Basic Life Support)

Cardiac Arrest: Secondary Response

Postresuscitation Care

Summary

Suggested Readings

59 Anaphylaxis

Introduction

Pathophysiology

Clinical Manifestations of Anaphylaxis

Triggers of Perioperative Anaphylaxis

Treatment of Perioperative Anaphylaxis

Prevention

Anaphylaxis and the Anesthesia Technician

Summary

Suggested Readings

60 Malignant Hyperthermia

Introduction

Epidemiology

Pathophysiology

Clinical Presentation

Laboratory Findings

Intraoperative Management

Postoperative Care

Testing

MH-Susceptible Patients

Support for MH-Susceptible Patients

Summary

Suggested Readings

61 Fire Safety

Introduction

Preventing and Responding to Fires: General Principles

The Fire Triangle

Fire Prevention

Responding to a Fire

Preventing and Responding to Fires: Specific Situations

Airway Fires

Surgical Fires

OR Fires

Fires Elsewhere in the Facility

The Role of the Anesthesia Technician

Summary

Suggested Readings

62 Massive Hemorrhage

Introduction

Preparation

Delegation of Responsibilities

Anesthetic Management

Large-Bore Intravenous Access

Intravenous Fluids, Blood Products, and Infusion Devices

Additional Considerations

Equipment for Massive Hemorrhage

Suggested Readings

63 Local Anesthetic Systemic Toxicity

Introduction

Preparation and Prevention

Detection

Monitors

Symptoms

Treatment

Lipid Emulsion Therapy

Summary

Suggested Readings

SECTION VII. Workroom Systems

64 Workroom Management and Resource Planning

Introduction

Workroom Organization Chart

Opening a New Anesthesia Workroom

Resource Planning: Equipment

Resource Planning: Physical Space

Resource Planning: Personnel

Management of an Established Anesthesia Workroom

Establishing and Maintaining a Workroom Routine

Standard Operating Procedures

Equipment Management and Planning

Personnel Management and Planning

Summary

Suggested Readings

65 Legal and Regulatory Issues

Introduction

Credentialing

Accreditation

Privacy

Informed Consent

Negligence

Product Liability

Risk Management

Summary

Suggested Readings

Acronyms and Abbreviations

Index

 

An aparitie	10 Oct. 2018
Autor	Emily Guimaraes, Matthew Davis, Jeffrey R. Kirsch MD, Glenn Woodworth MD
Dimensiuni	17.53 x 2.54 x 25.4 cm
Editura	LWW
Format	Paperback
ISBN	9781496344311
Limba	Engleza
Nr pag	728