Kuwait MOH Anesthesia Technician flashcards

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

Alveolar gas equation

PAO2 = FiO2 × (Patm − 47) − PaCO2 / 0.8. It estimates alveolar oxygen tension and explains why hypoventilation lowers PaO2 even with normal FiO2.

MAC

Minimum alveolar concentration at which 50% of patients do not move to a surgical stimulus. Desflurane 6%, sevoflurane 2%, isoflurane 1.15%, nitrous oxide 104%.

Oxygen content formula

CaO2 = (1.34 × Hb × SaO2) + (0.003 × PaO2). The hemoglobin-bound fraction dominates; dissolved oxygen contributes little at normal barometric pressure.

Functional residual capacity

Volume of gas remaining in lungs after normal expiration; equals expiratory reserve volume plus residual volume. It is reduced by obesity, supine position, and general anesthesia.

ASA physical status

Classification I–V: I healthy, II mild systemic disease, III severe systemic disease, IV constant threat to life, V moribund; suffix E denotes emergency surgery.

Mallampati classification

Grades I–IV based on oropharyngeal structures visible with mouth open and tongue protruded. Grade III–IV indicates possible difficult laryngoscopy and requires airway backup.

Preoperative fasting intervals

Clear fluids 2 hours, breast milk 4 hours, infant formula and light meal 6 hours before elective anesthesia. These reduce aspiration risk while avoiding unnecessary dehydration.

Informed consent elements

Patient must understand diagnosis, proposed anesthesia, risks, benefits, alternatives, and consequences of refusal. Consent is documented and obtained in a language the patient understands.

Machine checkout sequence

Verify backup ventilation, high-pressure leak test, scavenging, O2 sensor calibration, low-pressure leak test, vaporizer check, breathing circuit and valves, suction, then manual and mechanical ventilation trial.

Mapleson A system

Magill circuit with reservoir bag and adjustable pressure-limiting valve near the patient. Efficient for spontaneous ventilation but inefficient for controlled ventilation because fresh gas escapes.

Soda lime exhaustion

Absorbent is exhausted when color changes, inspired CO2 rises, or granules crumble. Replace to prevent hypercapnia during low-flow anesthesia.

Oxygen cylinder duration

Duration (min) = cylinder factor × pressure (bar) / flow (L/min). An E-cylinder factor is about 0.3 L/bar, so 138 bar yields about 660 L.

Difficult airway algorithm

Structured plan A–D: mask ventilation, supraglottic airway, intubation, and surgical airway. Call for help early, limit attempts, and prioritize oxygenation over intubation.

Cormack–Lehane grading

Laryngoscopic view: I full vocal cords, II partial cords, III epiglottis only, IV epiglottis not visible. Grades III–IV predict difficult intubation and require alternative devices.

Capnography confirmation

Continuous waveform capnography is the standard for confirming tracheal tube placement. A sustained waveform plus auscultation and chest rise confirms correct position.

Rapid sequence induction

Preoxygenate, apply cricoid pressure if indicated, induce with hypnotic, give neuromuscular blocker, and intubate without positive pressure ventilation to reduce aspiration risk.

Propofol

Intravenous hypnotic at 1.5–2.5 mg/kg for induction. Causes hypotension and apnea; contains egg lecithin and soybean oil, so use caution in egg or soy allergy.

Succinylcholine

Depolarizing neuromuscular blocker at 1–1.5 mg/kg IV; onset 30–60 seconds, duration 5–10 minutes. Contraindicated in hyperkalemia, burns, spinal cord injury, and malignant hyperthermia susceptibility.

Sugammadex

Reversal agent for rocuronium and vecuronium. Dose 2–4 mg/kg for moderate block, 16 mg/kg for deep block; encapsulates the neuromuscular blocker and restores recovery.

Local anesthetic maximum dose

Lidocaine 4.5 mg/kg plain or 7 mg/kg with epinephrine; bupivacaine 2–2.5 mg/kg. Epinephrine slows absorption and prolongs block but does not eliminate toxicity risk.

Capnography waveform phases

Phase I inspiratory baseline, phase II expiratory upstroke, phase III alveolar plateau giving end-tidal value, phase IV inspiratory downstroke. Loss of waveform suggests disconnection or esophageal tube.

Pulse oximetry principle

Measures light absorption at 660 nm (red) and 940 nm (infrared) through pulsatile tissue. Unreliable with poor perfusion, motion, nail polish, or methemoglobinemia.

Train-of-four monitoring

Peripheral nerve stimulation with four supramaximal stimuli. A train-of-four ratio above 0.9 indicates adequate neuromuscular recovery; clinical signs alone are unreliable.

Anesthesia record requirements

Contemporaneous documentation of preoperative assessment, consent, drugs and doses, fluids, vital signs, events, and post-anesthesia plan; entries must be timed, legible, and signed.

Prone positioning safety

Protect eyes and ears from pressure, keep abdomen free to reduce inferior vena cava compression, support chest and pelvis, and abduct arms less than 90 degrees.

Lateral decubitus positioning

Place axillary roll below the axilla to protect the brachial plexus, support the upper leg, and protect dependent ear and eye. Avoid excessive pressure on nerves.

Universal precautions

Hand hygiene, gloves, gown, mask, and eye protection for contact with blood or body fluids. Follow Kuwait MOH infection control and sharps disposal policies.

Malignant hyperthermia

Hypermetabolic crisis triggered by volatile agents and succinylcholine. Signs include rising end-tidal CO2, masseter spasm, hyperthermia, tachycardia, and acidosis; treat with dantrolene 2.5 mg/kg IV.

Anaphylaxis treatment

Epinephrine 0.5 mg intramuscularly (1:1000) for adults, repeat every 5 minutes; support airway, give oxygen and IV fluids, and use antihistamines as adjuncts.

Local anesthetic systemic toxicity

Stop injection, support airway and circulation, and give 20% lipid emulsion 1.5 mL/kg bolus then infusion 0.25 mL/kg/min. Avoid vasopressin and large doses of local anesthetic.

Aldrete score

Post-anesthesia discharge score assessing activity, respiration, circulation, consciousness, and oxygen saturation, each 0–2. A score of 9 or more is required for discharge.

Apfel PONV score

Predicts postoperative nausea and vomiting using female sex, nonsmoking status, history of PONV, and postoperative opioids. Higher scores warrant prophylaxis with ondansetron and dexamethasone.

Scope of anesthesia technician

Anesthesia technicians assist under anesthesiologist supervision, prepare equipment and drugs, monitor patients, and document care; they do not independently induce anesthesia or prescribe.

Kuwait MOH documentation standards

Records must be accurate, timed, signed, and contemporaneous. Errors are corrected with a single line and initials; retrospective alteration is prohibited.