Conscious and deep sedation in the ED.

/10

Which of the following is not true about Propofol?

Propofol---the milk of human kindness--- is a powerful short acting sedative agent but has no analgesic properties.

It causes rapid onset sedation.

It is an excellent analgesic.

It causes apnoea especially if given rapidly.

It can be expected to give some hypotension.

/10

According to the Emergency Care Institute (ECI) what is the minimum number of people required to perform a procedure under sedation?

ECI says a minimum of 3. One to give the drugs and watch the airway/monitoring. The second to perform the procedure. The third to assist.
In reality often 4 is prudent--the 4th to scribe and observe from the end of the bed. And of course they need to be properly trained for their role.

3

1

2

5

/10

Which briefly describes conscious rather than deep sedation?

Nitrous oxide is a good example of a drug that gives you conscious sedation.

A level of consciousness where you do not need an airway doctor.

A state where the drug means you only react to touch.

A drug induced decrease of consciousness during which a person can respond to verbal commands and maintain their own airway

A state where the drug means you only react to pain.

/10

Which of the following is incorrect about Ketamine?

Ketamine fortunately has a broad therapeutic window. Laryngospasm occurs in about 1% of patients.

It has a narrow therapeutic index.

The dose for sedation is 0.5-1mg/kg IV.

It is a dissociative anaesthetic and provides analgesia.

It often causes tachycardia and hypersalivation.

/10

From which movie is this abuse of nitrous oxide taken from?

Not great PR for dentists.

Dr Strangelove.

The Life of Brian.

Animal House.

Little Shop of Horrors.

/10

What is the mnemonic for predicting that a patient may be difficult to Bag Valve Mask ventilate?

Beard Obese Old Toothless Snoring

SHIRT

UNDIES

BOOTS

BEENIE

/10

Which of the following statements about preoxygenation is incorrect?

Preoxygenation is vital in or to perform a safe procedure that requires a decrease in the level of consciousness.

It's main goal is to increase the "safe apnoea" time.

A reasonable option is nasal prongs at 10-15l/min then a non rebreather mask over the top during the procedure at 15l/min.

The additional oxygen helps to wash out the nitrogen in the lungs giving the patient an oxygen reservoir.

Preoxygenation refers to organising your equipment before (or pre) doing the oxygenation.

/10

A 60yr old man presents with Ventricular Tachycardia with a systolic BP of 90 and a normal GCS. What would be a reasonable fasting state before cardioversion with procedural sedation.

There is no evidence to support any specific time for fasting before procedural sedation in the ED. Certainly in this case there is a clinical imperative to cardiovert which is more important than any fasting time (but I would not actually feed him!!).

The fasting state is not relevant just get on with the cardioversion.

1hr for food and fluids.

2hrs for fluids, 4 hours for food.

Give them a sandwich then cardiovert.

/10

How do you correctly measure a "Guedel" (Oropharyngeal) airway in an adult?

Keep it simple and have it, along with a nasopharyngeal airway, handy when doing deep sedation.

From the centre of the nose to the ear lobe.

From the centre of the mouth to the angle of the jaw.

From the angle of the mouth to the centre of the ear.

From the canines to the tragus.

/10

What is "Dwale".

Modern anaesthesia goes back to 1847 when Dr William Morton gave a public demonstration of ether anaesthesia in Boston, USA.

A traditional ale first used as a sedative in Delaware (USA) --hence Dw Ale.

An ancient Indian sedative based on opium, onions, tumeric and cloves.

An English Middle ages sedative made up of bile, opium, henbane, hemlock, lettuce, vinegar and alcohol.

An early 19 century German sedative drink first used successfully by Dr Lye Schtill.

You got {number correct}/{number of questions} correct answers

Powered by