Local Anesthesia, Field block, Digital Nerve Block; Procedural Sedation

You use a 20 gauge to insert the local anesthetic

LET- Lidocaine, Epinephrine, Tetracaine

EMLA should not be used in

What are some recommendations to reduce discomfort

Procedural sedation is used in

when are toxicities observed in plasma levels

What are the benefits of using epinephrine

Initial administration is into a intradermal location and then push into for a subdermal administration

For anesthesia in the nose lidocaine w/o epinephrine is injected to the tip of the nose

Propofol causes respiratory depression and loss of upper airway reflexes

What medications result in reducing dosing due to medication can increase depressant effect of local anesthetics

This type of injection of local anesthetic produces less discomfort

What type of injection is this?

When do you not use epinephrine when doing a field block anesthesia

Lidocaine runs the greatest potential for systemic toxicity especially for the CVS

Local Anesthesia is not safe and it's costly

Diphenydramine (Benadryl) is use subdermally

Delayed awakening and bradycardia are some complications of procedural sedation

Field Block Anesthesia

For digital block 2% lidocaine w/ epinephrine is used

You have a patient who has significant hepatic dysfunction. What type of local anesthetic do you not administer

Ester medications should be reduced in dosage when used on patients treated regularly w/ H2 blockers

You use Benzocaine for mucous membranes

You have a patient who has diabetes;they came in with a laceration to the finger. Should you be cautious using epinphrin

Esters are given when there's a Hx of allergy to amides

Open wounds you insert needle through the wound margin instead of through intact skin

When should you not use epinephrine with LA infiltration

Max dosage for children older than 6 years old is based on adult dosages

What are some causes of systemic toxicity?

What are some goals of injecting a local anesthetic

A patient is going through a tonic-clonic seizure due to CNS toxicity to a LA. This is mild, moderate, or severe?

Normal plasma levels are usually 3-5 mcg/ml

Shave excision you administer the local anesthetic above the center of the lesion

Amides

When is digital anesthesia used?

Increasing rates of vascular compromise can be seen when more than 5 ml are administered

What can occur if large volumes of local anesthetic is injected into a vein

Fentanyl is 100 times more potent than morphine

You should not use more than 7 ml of anesthesia when doing a digital block to an individual with PVD

Insert anesthesia near volar and lateral surface when digit does not develop good anesthesia

Children should not receive any form of topical analgesia for uncomplicated facial or scalp lacerations

A patient has a seizure after being administered a local anesthetic. What might be the reason(s) for this

This is a subdermal injection

What are some ways you can avoid systemic toxicity?

Prilocaine is associated w/ development of

When doing a digital nerve block anesthesia it's ok to inject into the web spaces

What are some area that LET should not be used

Administration w/ bupivacaine has the longest prolonged effect

Amides have a slower onset of action & a higher rate of allergic reaction

Local anesthetics provides irreversible loss of sensation

Subdermal is useful for a shave excisions

Field block anesthesia is used in

The anesthetic is administered as the needle is withdrawn with exiting the skin

For procedural sedation what are physiologic parameters to look out for

Use a 45 degree angle to place needle through the skin

Sedative/Hypnotic (Propofol (Diprivan))

LET is used for simple lacerations that are more than 5 cm in length, especially in the head area

Ketamine

What are some medical procedures that local anesthesia is used for

EMLA-Eutectic mixture of local anesthetics

When there's a heavily contaminated area you should still clean the site with povidone-iodine

This type of injecting of local anesthetics produces a small wheal in the skin; onset of action is immediate.

When doing a field block anesthetic you perform it in a square or diamond shape

For ear anesthesia its performed only in front of the pinna and needle needs to pass in a deep plane