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Flashcards in Laser Airway Surgery Deck (19)
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0
Q

Characteristic of CO2 laser

A

CO2 - invisible beam

Helium-neon – marker

beam Actions - cuts and cauterizes

Beam reflection can cause secondary injuries

Beam power = kills nerves instantly so withdrawal response is delayed

1
Q

What does laser stand for

A

Light Amplification by Stimulated Emission of Radiation

2
Q

Characteristics of CO2 laser wavelength

A

10,600 nm

risk of Fire and heat injury

blocked by cornea, protects the retina but produces Heat injury to anterior eye

3
Q

What is the YAG laser

A

Yttrium-Aluminum-Garnet Invisible beam with helium-neon marker beam

Absorbed by dark pigments (Hemoglobin)

4
Q

What are the risk of a YAG laser wavelength

A

Risk are from 3 elements in the laser

355 nm – blocked by cornea, Can cause: Cataracts, skin cancer

266 nm – blocked by cornea, Can cause: Cataracts, skin cancer

1064 nm – transmitted by cornea: can cause severe retinal damage

5
Q

Name some endotracheal tubes and tracheostomies that are used with laser airway surgery

A

Red rubber ETT with Merocel wrap

Xomed ETT

laserflex ETT

Jackson tracheostomy tube (uncuffed) (All metal tracheostomy)

6
Q

What are 2 adjunct materials used for laser airway ETT

A

Merocel wrap

aluminum audio tape

7
Q

Which laser proof ETT is this?

A

LaserFlex (notice: the metal body & double cuff)

8
Q

According to Dr. Hall we would not fill the cuff of laser ETT’s with die, So what Would we use?

A

Saline

9
Q

What is the ID and the OD of the laserflex ETT

A

IV 6.0 mm

OD 8.5 mm

10
Q

Which ETT is this?

A

Rusch Merocel ETT

NOTE: it has a red rubber body and the lighter colored portion is the Merocel wrap

11
Q

What is special about the Xomed Merocel ETT

A

A double cuff that is a cuff in a cuff.

12
Q

What precautions should you take regarding the circuit during an Laser airway surgery

A

Cover circuit near patient with wet towel Wrap circuit with aluminum foil keep a backup circuit in the room

13
Q

What risk is associated with laser smoke Plume

A

Viral disease transmission (I.E. Papillomatosis with HPV DNA)

14
Q

Anesthetic agent selection for laser surgery

A

Potent short-acting drugs, such as:

Desflurane

Propofol + remifentanil

Heliox (helps Prevents heat injury sufficient)

FiO2 <0.30

succinylcholine infusion or rocuronium

15
Q

How do you protect the eyes doing laser Airway surgery

A

saline eye pads + nonflammable adhesive tape

16
Q

Standard surgical mask filtration is ____ microns

A

5

(Note: HIV, HPV, hepatitis B, hepatitis C, & TB are less than 5 microns)

17
Q

When an airway fire is detected, your first action should be… How can you get rid of O2 and the fuel source at the same time?

A

Remove the endotracheal tube

18
Q

In the event of an airway fire, if the anesthesia circuit has melted into several parts how do you provide positive pressure ventilation to the patient question?

A

Re-intubate patient (probably with a smaller diameter OETT)