Shared Flashcard Set

Details

IV Regional Lecture- Slides 7-11
Supernumery Penis
6
Nursing
Graduate
09/21/2009

Additional Nursing Flashcards

 


 

Cards

Term
What is in the Sacral Canal?  What are its contents?
Definition

-Terminal Portion of dural sac

-filum terminale

-epidural fat

-5 sacral nerves and coccygeal nerves making up the Cauda Equina

-Sacral epidural veins

Term
What makes caudal blocks predictable in children but unpredictable in adults? 
Definition

Epidural Fat. 

 

It changes from a loose texture in children to a more fibrous close-meshed texture in adults.

Term

True or False:

 

The sacral epidural veins generally end at S4 and are therefore safe from needle puncture during the establishment of a Caudal local anesthetic.

Definition
False.  They are at risk for puncture from catheter or needle puncture. 
Term

What is the preferred position for a caudal block?

 

What does this allow for?

 

What do I need to do to make this happen?

Definition

1) Preferred position: Lateral SIMS

 

2) Allows for:

-Landmark indentification

-pt. comfort

-access to airway if needed.

 

3) Pt in lateral position

-Lower leg slightly flexed at hip

-children may be placed in "cooked shrimp" position

-If prone, toes shourl point inward or medially

Term
How do I identify the landmarks for a Caudal Block?
Definition

1) ID the tip of the Coccyx

2) Move cephalad until your finger is over sacral hiatus

3) Prominent sacral cornu should be palpable on each side of your fingertip as you move from side to side. (this is the sacrococcygeal ligament) 

4) Draw an equilateral triangle (imaginary I believe)

upside down with the point towards coccyx.

Term
How do you give the Caudal Block?
Definition

1) insert the needle at sacral hiatus (between Sacral Cornu) at 120 degrees until you feel a "pop"

You are now through the sacrococcygeal ligament.

 

2) Once through, drop needle and align with long access of canal and insert the needle an additional 1 cm.

 

3) Inject 2 cc of air.  You should feel the space bulge. 

-If you feel crepitus you are in the wrong place

 

4) Aspirate

-If you aspirate CSF or blood, you are in the wrong place. 

 

5) Give Dose for Caudal Block.

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