Term
| Do you face the bevel up or down when administering an epidural and why? |
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Definition
| Up to direct the catheter cephelad |
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Term
| There is a lower incidence of inadequate analgesia with the ...... catheter; however a higher incidence of inadvertent .......... |
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Definition
| Multiport, intravenous cannulation |
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Term
| When the epidural neddle is in the interspinous ligament and you let go it will flop over. true dat or hell no? |
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Definition
| hell no, the needle will stand erect like a teenagers pecker on prom night! If you are lateral to the interspinous ligament it will flop over. |
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Term
| average cm distance from epidermis to epidural space in 50% of adults? 80%? thin adults? fattys? |
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Definition
| 4cm, 4-6cm, less than 3cm, more than 8cm |
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Term
| What method is most prefered for locating the epidural space? Describe it |
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Definition
| loss of resistance, as the needle stands erect in the interspinous ligament, a syringe with 3-5cc of saline is attached and advanced untill a loss of resistance is achieved (i am assuming that the fluid is injected easily and that is the loss of resistance that is felt) |
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Term
| Name three ways we can tell that we are in the epidural space |
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Definition
| negative aspiration (of blood or CSF), negative test dose, and loss of resistance |
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Term
| Explain the concept of a negative test dose |
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Definition
| get a baseline BP/HR, deliver 3cc of 1.5% lido with 1:200,000 epi,and observe for signs of subarach injection (nearly immediate increase of HR by 15-20 beats for 2-3 minutes, and warmth or numbness in their legs), wait at least 3 minutes prior to ruling out a SAB |
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Term
| Do negative test doses and negative aspirate rule out a SAB? |
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Definition
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Term
| If you see CSF with your attempted spinal what should do? |
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Definition
| Throw your hands up and say screw this im out, or better yet you could just convert it to a spinal, convert it to a continuous spinal with catheter placement, or pull out and poke in another interspace |
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Term
| What is the five foot rule in dosing your epidural? |
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Definition
| give 1ml local for every segment required to block and an additional .1ml/segment for every 2 inches over 5 feet. |
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