Prepare a Patient for
General Anesthesia
081-833-4522
INSTRUCTOR
SFC HILL
Joint Special Operations Medical Training Center
OBJECTIVE
As a Special Forces Medic,
prepare a patient for general
parenteral anesthesia, in
accordance with JSOMTC student
manual of anesthesia.
Joint Special Operations Medical Training Center
REASON
• As a Special Forces Medic preparation
of the patient and yourself will be a
critical task in the successful
performance of general parenteral
anesthesia
Joint Special Operations Medical Training Center
PROCEDURES
• The Preanesthetic Visit
• Prep for general parenteral anesthesia
• Emergency prep for general parenteral
anesthesia
Joint Special Operations Medical Training Center
The Preanesthetic Visit
• The preanesthetic visit is conducted
so the anesthetist can meet with the
patient for the purpose of identifying
any possible complications prior to
the anesthetic procedure and
alleviating the patients possible
anxiety or fear of anesthesia/surgery
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Preanesthetic Visit
• Should take place at least 24
hours prior to the scheduled
procedure
• If possible, it should be
conducted prior to emergency
administration of anesthesia
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Preanesthetic Visit
• What are some possible
problems or complication that
can be identified prior to the
administration of anesthesia?
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Preanesthetic Visit
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Tracheal Intubation Problems
Allergies
Drug interactions
Previous Exposure to Anesthesia
Concurrent Illnesses
Classification of Physical Status
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Tracheal Intubation
Problems
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Short Thick Neck
Disease of Pharynx or Larynx
Tracheal Deviation
Small Mouth
Stiff Temporomandibular Joint
Prominent Upper Incisors
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Tracheal Intubation
Problems
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Chipped or Cracked Enamel
Caries
Loose Teeth
Dentures, Crowns
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Allergies
• All Pharmacological Agents are
potential allergens
• Emergency drugs for anaphylactic
shock must be on hand prior to
administration of any drug
• Take detailed History to differentiate
between side effects and allergic
reaction
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DRUG INTERACTIONS
• Note present drug therapy
• Research any present drug therapies
verses the anesthetic therapy plan for
this procedure
• Many drugs will not interact well with
anesthetic agents
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Previous Exposure to
Anesthesia
• Repeat use of certain anesthetic agents may
cause hepatic damage or stress
• Take a detailed History of previous use of
anesthesia
• Agents that caused problems in the past should
not be repeated
• Take a detailed History of any previous
difficulties
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Concurrent Illnesses
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•
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Common Cold
Liver Disease
Diabetes Mellitus
Anemia
COPD
Heart Disease
Essential Hypertension
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Classification of Physical
Illnesses
• Class I- fit and healthy
• Class II- Mild systemic illness
• Class III- Severe systemic illness that is not
incapacitating
• Class IV- Incapacitating, systemic, life
threatening illness
• Class V- Expectant, with or without surgery
• “E”- Emergency
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Record information
• Record all the information from the
preanesthetic visit into the preanesthetic
summary of the patient’s SF 517
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Patient Instructions
• Review the upcoming
procedure with the patient
• Ensure the patient
understands his/her
responsibilities prior to the
planned procedure
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Prep for general parenteral
anesthesia
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Review and Prep
• Review the patients SF517
• Prepare the anesthetist cart and
all equipment to be utilized
during the procedure to include
back-up and emergency
equipment
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Receive the patient
• Identify patient and reconfirm type and
location of procedure
• Converse with the patient to establish his or
her mental status
• Establish the patients compliance with his or
her preanesthetic orders
• Review the procedure once again with the
patient
• Calm and reassure the patient
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Prepare the patient
• Establish baseline set of vitals for the
patient
• Establish the patient on 2 liters a
minute, humidified oxygen
• Establish patient on monitors
• Establish IV access, Normal Saline,
TKO
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Administer Premedication
• Administer antisialagogue (Atropine, .4.6mg deep IM 45 minutes prior to
induction)
• Administer sedative (Promethazine, 2550mg PO 30 minutes prior to induction)
• Continue to monitor the patients vitals
every 15 minutes until induction
• Move the patient to the OR
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Emergency prep for general
parenteral anesthesia
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Receive the patient
• Identify the patient and attempt to obtain a
brief but thorough history
• Work with the surgical team to establish the
patients condition (A-B-C) and level of
consciousness
• Perform life saving measures
• If the patient is conscious and orientated X 3,
converse with the patient to establish his or
her mental status
• If the patient is conscious and orientated X 3,
attempt to calm and reassure the patient
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Prepare the patient
• Obtain vitals of the patient
• Establish and maintain the patients
airway
• Establish the patient on 6 - 15 liters a
minute, humidified oxygen
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Prepare the patient
• Draw blood for grouping and crossmatching
• Establish large bore IV access and
prepare for fluid resuscitation and
possible transfusion
• Establish patient on monitors
• Establish nasogastric tube
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Administer Premedication
• Administer antisialagogue (Atropine, .4.6mg deep IM)
• Administer sedative (Promethazine, 2550mg slow IV)
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Prepare for induction
• Prepare for induction of anesthesia
• Emergency patients should be stabilized prior
to induction of anesthesia whenever possible.
• With the unstable patient, induction should
proceed when only the immediate surgical
intervention will save the patients life
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SUMMARY OF
PROCEDURES
• The Preanesthetic Visit
• Prep for general parenteral anesthesia
• Emergency prep for general parenteral
anesthesia
Joint Special Operations Medical Training Center
RESTATED
OBJECTIVE
As a Special Forces Medic,
prepare a patient for general
parenteral anesthesia, in
accordance with JSOMTC student
manual of anesthesia.
Joint Special Operations Medical Training Center