Under resting conditions, red blood cells move through the pulmonary capillary bed in approximately 0.75 seconds (transit time), although equilibration of oxygen and carbon dioxide takes place in about 0.25 seconds. In a diffusion limited gas exchange situation, the alveolar gas is still equilibrating with the blood cell at the…
Tag: Anesthesia
Emergency Medicine
Rapid Sequence Intubation (RSI) – Mnemonic Approach
Approach the patient with 9 Ps. 0-10 minutes (Possibility of Success): Anticipating difficult airway Mnemonic: LEMON approach 1. Look externally: Remember “BONES“ Beard Obesity No teeth Elderly Sleep apnea/Snoring 2. Evaluate 3-3-2 rule: Ideal dimensions for visualization of larynx 3 fingers in mouth: adequate mouth opening 3 fingers under the…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Hepatorenal syndrome (HRS) – Quick revision
New Criteria for HRS 1. Cirrhosis with ascites 2. Serum creatinine >1.5mg/dl 3. No sustained improvement in renal function after 2 days of diuretic withdrawl (if on diuretics) and volume expansion with albumin infusion at 1 gm/kg/day upto a maximum of 100 gm/day. 4. No evidence of shock 5. No…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Opioid Receptors Mnemonic
Opioid receptors are a group of inhibitory G protein-coupled receptors with opioids as ligands. Mu (µ) Receptor (MOP) Mnemonic: MU CARDS Miosis eUphoria Constipation Analgesia (Supraspinal + Spinal) Respiratory depression Rigidity (truncal) Dependency Sedation µ1 mediates supraspinal analgesia, and most of other effects including spinal analgesia is mediated by µ2. Kappa…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Brachial Plexus Block Made Easy
Brachial plexus is sub-divided from proximal to distal into: Roots, Trunks, Divisions, Cords, Branches. This can be easily remembered with a mnemonic: Randy Travis Drinks Cold Beer. Approaches for Brachial Plexus Block Basically, there are 4 approaches to the brachial plexus block at different levels as described in the mnemonic…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Local Anesthetics Mnemonic
All Local anesthetics contain suffix “-caine”. Local Anesthetics (LA) can be classified as: Esters and Amides. Esters vs Amides A mnemonic device is that the names of amides contain 2 “i”s compared with only 1 “i” seen in esters. Remember: One-eyed ester or Amide word has an “i” in it…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Priming, Precurarization and Self taming
Priming Administration of a small sub-paralyzing dose of non-depolarizing muscular blocking agent (usually 10% of the intubating dose) is given 2-4 minutes before administering a 2nd large dose for tracheal intubation to accelerate the onset of non-depolarizing NM blockade by 30-60 seconds. Mechanism and Concept of Priming 2 theories have…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Concentration effect, Second gas effect and Diffusion hypoxia
Concentration effect The higher the concentration of an inhaled anesthetic, the faster the alveolar concentration approaches the inhaled concentration. This is referred to as concentration effect and is clinically significant only in cases where gases are administered in high concentration: Nitrous oxide Xenon Ostwald’s blood gas solubility coefficient: ratio of…