jeopardy sedation sg 2010
TRANSCRIPT
![Page 1: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/1.jpg)
![Page 2: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/2.jpg)
DateSingleJeopardy
FinalJeopardy
PRIZE !!
![Page 3: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/3.jpg)
100
200
300
400
500
100
200
300
400
200
300
400
500
100
200
300
400
500
100
200
300
400
localanesthetics analgesics sedation more
sedation fun facts
SINGLE JEOPARDY
![Page 4: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/4.jpg)
Appropriate alternative locale anesthetic for patient with
reported allergy to procaine?
Topic I 100 Question
![Page 5: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/5.jpg)
What is any Amide local anesthetic?
![Page 6: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/6.jpg)
![Page 7: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/7.jpg)
Amides Esters
• Lidocaine• Mepivacaine• Bupivacaine• Prilocaine
• Procaine• Benzocaine• Tetracaine
Topic I 100 AnswerGo To Single
Jeopardy
![Page 8: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/8.jpg)
DOUBLE JEOPARDY
2 local anesthetics which can cause methemoglobinemia
Topic I 200 Question
![Page 9: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/9.jpg)
What are:
Topic I 200 AnswerGo To Single
Jeopardy
Benzocaine and Prilocaine
![Page 10: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/10.jpg)
A one year old boy, 10 kg, has just been bitten by a cockapoo...
Topic I 300 Question
![Page 11: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/11.jpg)
![Page 12: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/12.jpg)
No, of course not, it was a pit bull...
![Page 13: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/13.jpg)
![Page 14: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/14.jpg)
He will require extensive laceration repair. Calculate the
maximum doses of lidocaine 1 % with and without epinephrine?
PRIZE !!
![Page 15: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/15.jpg)
What are:
4.5 cc plain, 7 cc with epi?
![Page 16: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/16.jpg)
% solution = gram/dl ; 0.5% = 5 mg/ml, 1.0 % = 10 mg/ml
• Lidocaine 1%: Max dose 4.5 mg/kg plain, 7 mg/kg with epinephrine
• Mepivacaine 1 %: Max dose 5 mg/kg plain, 7 mg/kg with epinephrine
Topic I 300 AnswerGo To Single
Jeopardy
![Page 17: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/17.jpg)
Topic I 400 Question
While injecting lidocaine to anesthetize a laceration, your
patient complains of her tongue feeling numb. Instead of thinking “crazy patient”, you should prepare for the
following 2 problems:
![Page 18: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/18.jpg)
What are:
CNS Toxicity (seizures, coma)
and
Cardiovascular Toxicity (dysrhythmias, myocardial depression)
![Page 19: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/19.jpg)
Toxicity of local anesthetics• All with dose-dependent CV toxicity via
sodium channel blockade (myocardial depression and dysrhythmias)
• Bupivacaine highest CV toxicity• CNS toxicity • Early sx: lightheadedness, peri-oral
paresthesias, tongue numbness, twitching• Seizures-->anticipate VT
Topic I 400 AnswerGo To Single
Jeopardy
![Page 20: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/20.jpg)
5 ways to decrease the pain of infiltration of local
anesthetics?
Topic I 500 Question
![Page 21: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/21.jpg)
What are:1. Inject slowly2. Buffer with sodium bicarbonate3. Inject through open margins of wound4. Use warm anesthetic5. Use small needle6. Reassure patient/distraction
Topic I 500 AnswerGo To Single
Jeopardy
![Page 22: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/22.jpg)
Safe and appropriate oral analgesic choice for patient
reporting an allergic reaction of vomiting to codeine
Topic II 100 Question
![Page 23: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/23.jpg)
What is:
Anything except codeine
![Page 24: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/24.jpg)
Analgesic Classes• Phenanthrenes: Morphine, Hydromorphone,
Codeine, Hydrocodone, Oxycodone, mixed agonists/antagonists
• Phenylpiperidines: Fentanyl, Meperidine
• Diphenylheptanes: Methadone
Topic II 100 AnswerGo To Single
Jeopardy
![Page 25: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/25.jpg)
Analgesic just removed from US market on 11/19/2010
Topic II 200 Question
PRIZE !!
![Page 26: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/26.jpg)
What is propoxyphene?
Topic II 200 AnswerGo To Single
Jeopardy
(darvon, darvocet)
![Page 27: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/27.jpg)
The correct increasing order of potency for the following ORAL
analgesics
• oxycodone• hydromorphone• codeine• morphine• hydrocodone
Topic II 300 Question
![Page 28: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/28.jpg)
What are:
• codeine 200 mg• hydrocodone 30 mg• morphine 30 mg• oxycodone 20 mg• hydromorphone 7.5 mg
Topic II 300 AnswerGo To Single
Jeopardy
![Page 29: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/29.jpg)
This relative of clonidine has sedative and analgesic properties
and reportedly very little respiratory depression
Topic II 400 Question
PRIZE !!
![Page 30: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/30.jpg)
What is dexmedetomidine?
Topic II 400 AnswerGo To Single
Jeopardy
![Page 31: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/31.jpg)
Leave blank
Topic III 100 Question
![Page 32: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/32.jpg)
Leave blank
Topic III 100 AnswerGo To Single
Jeopardy
![Page 33: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/33.jpg)
ASA physical status classification for patient with
well controlled asthma requiring procedural sedation
Topic III 200 Question
![Page 34: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/34.jpg)
What is II?
![Page 35: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/35.jpg)
Topic III 200 AnswerGo To Single
Jeopardy
![Page 36: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/36.jpg)
Amount of time recommended by ASA to wait before sedation after
patient has drank clear liquids
Topic III 300 Question
![Page 37: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/37.jpg)
What is 2 hours?
![Page 38: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/38.jpg)
ASA guidelines
• 2 hrs for clear liquids• 4 hrs for breast milk• 6 hrs for other milk or a light meal
Topic III 300 AnswerGo To Single
Jeopardy
![Page 39: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/39.jpg)
Medication used for procedural sedation which is associated with
adrenal insufficiency and myoclonus
Topic III 400 Question
![Page 40: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/40.jpg)
What is Etomidate?
![Page 41: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/41.jpg)
Buzz words for:PROPOFOL• No analgesia• Decrease ICP• Hypotension• Anti-emetic• Anti-epileptic• Infection• “propofol syndrome”• ?more resp. depression
ETOMIDATE• No analgesia• Decrease ICP• Hemodynamic
stability• Vomiting• Adrenal insufficiency• Myoclonus
Topic III 400 AnswerGo To Single
Jeopardy
![Page 42: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/42.jpg)
An increasingly popular mixture of two procedural medications has this name and contains this
common ratio of the medications
Topic III 500 Question
![Page 43: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/43.jpg)
What is Ketofol?
• Single-syringe 1:1 mixture of 10 mg/mL ketamine and 10 mg/mL propofol
• Usually requires approximately 1 mg/kg (0.5 mg/kg of each)
• Academic Emergency Medicine 2010; 17:194–201
Topic III 500 AnswerGo To Single
Jeopardy
![Page 44: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/44.jpg)
The reason not to use Ketamine in small children with active
URIs
Topic IV 100 Question
PRIZE !!
![Page 45: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/45.jpg)
What is Laryngospasm?
Topic IV 100 AnswerGo To Single
Jeopardy
![Page 46: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/46.jpg)
The most appropriate induction agent for an 18 yo male brought to ED after a single GSW to the
abdomen with a BP of 70/40 who is not protecting his airway
Topic IV 200 Question
![Page 47: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/47.jpg)
What is Ketamine?(would also accept Midazolam)
Topic IV 200 AnswerGo To Single
Jeopardy
![Page 48: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/48.jpg)
Contraindication to use of Nitrous Oxide
Topic IV 300 Question
PRIZE !!
![Page 49: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/49.jpg)
Topic IV 300 AnswerGo To Single
Jeopardy
What is/are: pneumothorax, SBO, middle ear effusion, balloon tip catheter use? Also
head injuries, psych, intoxication
![Page 50: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/50.jpg)
Patient responding to verbal/light touch with adequate spontaneous ventilation
after etomidate sedation is at this sedation level
Topic IV 400 Question
![Page 51: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/51.jpg)
What is Moderate Sedation?
![Page 52: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/52.jpg)
1. Anxiolysis/Minimal Sedation2. Moderate Sedation3. Deep Sedation4. General Anesthesia
Topic IV 400 AnswerGo To Single
Jeopardy
![Page 53: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/53.jpg)
Three requirements prior to the safe discharge of a patient from the ED after procedural sedation
Topic IV 500 Question
![Page 54: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/54.jpg)
What are:
1. Stable Vital Signs2. No respiratory distress3. Has ride home with responsible adult4. No significant N/V, able to take po5. Awake, at neuro baseline, ambulatory,
following instructions
Topic IV 500 AnswerGo To Single
Jeopardy
![Page 55: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/55.jpg)
Alternative method of delivery for Fentanyl besides IV and Transdermal
and Intranasal
Topic V 100 Question
![Page 56: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/56.jpg)
What is Inhaled?
• In Australian study of children with long bone fractures, 1 mic/kg inhaled Fentanyl similar analgesia to 0.2 mg/kg IM morphine
Topic V 100 AnswerGo To Single
Jeopardy
![Page 57: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/57.jpg)
These two drugs are used in the treatment of Complex Regional Pain
Type I (reflex sympathetic dystrophy)
Topic V 200 Question
![Page 58: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/58.jpg)
What are corticosteroids and calcitonin?
![Page 59: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/59.jpg)
Complex Regional Pain I/II
• Type I (RSD), is due to prolonged immobilization or disuse
• Type II (causalgia) from peripheral nerve injury
• Both types with same presentation early: burning pain, edema, warmth, local sweating
• Tx both with steroids, Type I also with calcitonin
![Page 60: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/60.jpg)
Topic V 200 AnswerGo To Single
Jeopardy
![Page 61: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/61.jpg)
What the abbreviation EMLA stands for
Topic V 300 Question
PRIZE !!
![Page 62: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/62.jpg)
What is: What is: Eutectic Mixture of Eutectic Mixture of Local AnestheticsLocal Anesthetics
(prilocaine and lidocaine)
![Page 63: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/63.jpg)
• TAC (tetracaine, adrenaline, cocaine 11.8%)• LET (Lidocaine, Epi 1:1000, Tetracaine)• EMLA (Lidocaine + Prilocaine), occlusion• ELA-Max/LMX (Liposomal Lidocaine), no
occlusion
Topic V 300 AnswerGo To Single
Jeopardy
![Page 64: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/64.jpg)
This high potency ultra-short acting opioid is on the horizon as
a sedative/analgesic
Topic V 400 Question
![Page 65: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/65.jpg)
Topic V 400 AnswerGo To Single
Jeopardy
What is remifentanil?
![Page 66: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/66.jpg)
FINAL JEOPARDY
Analgesia
![Page 67: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/67.jpg)
Ketamine can be used in this dosing regimen as a sub-dissociative drip for
pain control (recently discussed on EM-RAP for trauma patients).
![Page 68: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/68.jpg)
FINAL JEOPARDY
What is 0.3 mg/kg IV bolus then drip of 0.3 mg/kg/hour
IV?
![Page 69: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/69.jpg)
![Page 70: Jeopardy sedation sg 2010](https://reader031.vdocuments.site/reader031/viewer/2022030310/58f0ceef1a28aba82b8b4653/html5/thumbnails/70.jpg)
Credits
Software Template Design by David L. Shenson
Use of this software is free. Please maintain the credits so creditCan be given where it is due.
Comments and suggestions can be made by e-mail to [email protected]