CANPC flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

ASA Physical Status I

A normal, healthy patient without systemic disease who tolerates surgery well. Examples include a healthy nonsmoker with no medical conditions undergoing elective procedures.

Revised Cardiac Risk Index

A six-predictor tool estimating major perioperative cardiac events: ischemic heart disease, heart failure, cerebrovascular disease, insulin-treated diabetes, creatinine above 2.0, and high-risk surgery. Each predictor adds one point.

Informed consent elements

Valid consent requires patient capacity, disclosure of diagnosis, procedure, risks, benefits, and alternatives, plus comprehension and voluntary authorization. Emergency situations may invoke implied consent.

MAC definition

Minimum alveolar concentration at end-expiration that prevents movement in 50 percent of patients exposed to a standard surgical stimulus. Values are additive when agents are combined.

MAC-awake

The alveolar anesthetic concentration at which roughly half of patients respond to command, approximately 0.34 MAC. It is useful for guiding sedation and wake-up timing.

Succinylcholine contraindications

Avoid in hyperkalemia risk states such as burns, crush injury, prolonged immobility, denervation, and malignant hyperthermia susceptibility, where it can cause dangerous potassium release or trigger reactions.

Sugammadex dosing

Reversal of rocuronium or vecuronium: 2 mg/kg for moderate blockade, 4 mg/kg for deep blockade, and 16 mg/kg for immediate rescue after a failed airway.

Malignant hyperthermia treatment

Give dantrolene 2.5 mg/kg IV and repeat until symptoms resolve, with hyperventilation, active cooling, and treatment of hyperkalemia and acidosis. Stop triggering agents immediately.

Mallampati classification

Class I shows soft palate, uvula, and fauces; II shows uvula masked by tongue base; III shows only soft and hard palate; IV shows only hard palate. Higher classes predict difficult laryngoscopy.

LEMON airway assessment

Look externally, Evaluate the 3-3-2 rule, Mallampati score, Obstruction, and Neck mobility. It is a bedside screen for difficult intubation.

3-3-2 rule

Three fingerbreadths of mouth opening, three fingerbreadths of hyoid-mental distance, and two fingerbreadths of thyromental distance. Values below these suggest a potentially difficult airway.

Cormack-Lehane grades

Laryngoscopy view grading: I full glottic opening, II partial vocal cords, III epiglottis only, IV no glottic structures. Higher grades indicate a more difficult view.

Cannot intubate cannot oxygenate

A life-threatening failure of both intubation and oxygenation. In adults, emergency invasive airway such as surgical cricothyrotomy is indicated without delay.

Capnography confirmation

Presence of a sustained end-tidal CO2 waveform confirms tracheal tube placement. Absence requires immediate evaluation for esophageal placement, disconnection, or obstruction.

Mean arterial pressure formula

MAP equals (systolic plus twice diastolic) divided by three. A MAP of at least 65 mmHg is a common target for adequate organ perfusion.

Pulse oximetry limitations

Readings become unreliable with poor perfusion, motion, ambient light, and dyshemoglobinemias such as carboxyhemoglobin and methemoglobinemia. It does not directly measure ventilation.

End-tidal CO2 drop

A sudden fall in end-tidal CO2 may indicate hypovolemia, pulmonary embolism, decreased cardiac output, or circuit disconnection. A sudden rise may signal return of circulation.

Fluid responsiveness assessment

Static measures such as central venous pressure poorly predict fluid responsiveness. Dynamic measures including pulse pressure variation and passive leg raise are more reliable in appropriate patients.

Multimodal analgesia

Combining agents with different mechanisms, such as opioids, NSAIDs, acetaminophen, local anesthetics, and adjuncts, improves pain control and reduces opioid requirements and side effects.

Acetaminophen daily limit

Maximum 4 grams per day in healthy adults. Lower limits apply with hepatic impairment or chronic alcohol use. Overdose risks hepatotoxicity and requires prompt evaluation.

Lipid emulsion rescue

Treatment for local anesthetic systemic toxicity, given as 20 percent lipid emulsion alongside airway support and seizure control. Toxicity presents with perioral numbness, tinnitus, seizures, and cardiovascular collapse.

Neuraxial opioid differences

Lipophilic opioids such as fentanyl have rapid onset and shorter duration. Hydrophilic morphine has delayed onset and longer duration, with risk of delayed respiratory depression requiring monitoring.

Apfel PONV score

Four predictors: female sex, nonsmoker, history of PONV or motion sickness, and postoperative opioids. Risk rises roughly from 10 percent at zero predictors to 80 percent at four.

Ondansetron PONV

A 5-HT3 antagonist commonly dosed 4 mg IV for prophylaxis or treatment of postoperative nausea and vomiting. QT prolongation is a consideration in at-risk patients.

Dexamethasone antiemetic

Given as 4-8 mg IV after induction for PONV prophylaxis. It provides delayed benefit and is useful as part of multimodal antiemetic prophylaxis in higher-risk patients.

PONV combination therapy

Combining antiemetics from different classes, such as a 5-HT3 antagonist plus dexamethasone, is more effective than escalating a single agent for rescue.

Laryngospasm management

Presents with stridor, hypoxemia, and absent capnography. Treat with 100 percent oxygen, CPAP, deepening anesthesia, and low-dose succinylcholine if it persists.

Anaphylaxis treatment

Epinephrine 0.1-0.5 mg intramuscularly or titrated intravenously in severe cases, with fluids, oxygen, and airway support. Antihistamines and steroids are adjuncts, not first-line.

Atelectasis prevention

Atelectasis is the most common early postoperative pulmonary complication. Incentive spirometry, early ambulation, and adequate analgesia reduce its incidence and severity.

WHO Surgical Safety Checklist

Three phases: sign in before induction, time out before incision, and sign out before the patient leaves the operating room. It reduces surgical morbidity and mortality.

Universal Protocol

Requires preprocedure verification, site marking before entering the operating room, and a time-out immediately before the procedure to prevent wrong-site, wrong-procedure, and wrong-patient errors.

Decision-making capacity

Requires understanding, appreciation, reasoning, and ability to express a choice. Capacity is decision-specific and may fluctuate, unlike the broader legal concept of competence.