Friday, August 30, 2013

Anesthesia 6 Induction Steps drugs equipment



Intravenous Induction

Objectives

     To induce loss of awareness rapidly at the start of anesthesia.

     Induction is achieved with intravenous agents (thiopentone 3-5 mg/kg, methohexitone 1-1.5 mg/kg, etomidate 0.3 mg/kg, propofol 1.5-2.5 mg/kg or ketamine 2 mg/kg).

Position

Supine.

Premedications

Any combination of anxiolite and antisialgogue.

Procedure

     Intravenous cannula inserted into a peripheral vein, preferably on the dorsum of the hand and infusion fluid attached

     Drugs prepared in syringes and labelled (IV induction agent, muscle relaxant, atropine)

     Patient connected to the monitor for ECG, non-invasive blood pressure (NIBP), and oxygen saturation

     100% oxygen by mask before the drugs are injected

     Small test dose of intravenous induction agent given and effects observed for any anaphylactic reaction

     Slow injection of the drug into the vein till the eye lash reflex is obtained

     Rapid sequence induction technique used in emergency situation where the stomach is full or chances of regurgitation are a potential problem

     Anesthesia maintained with inhalational agent

     Tracheal intubation done using muscle relaxant.

Instruments

     Intubation tray

     Anesthesia machine (Check list I, )

     Breathing circuits, face mask, inhalation set (Check list I, )

     IV cannula, infusion, fluid, spirit and Iodine swab, adhesive plaster

     Drug tray and labels

     Normal saline bottle for dilution of drugs

     Induction agents - Thropentone, Propofol, ketamine

     Arm boards

     Patient monitors for ECG, Spo2, NIBP, ETCO2 

     Anesthesia machine monitors (Oxygen analyser, gas monitor)

     Emergency drug tray (Check list II, see).
Any questions be sent to drmmkapur@gmail.com
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