Anesthesia Care Plan

Anesthesiology Date: MD/DO/CRNA: Dx: Allergies: Home Meds: Med/Surg Hx: Social Hx: EtOH

POSITION:  Supine  Lateral L / R  Prone

James Lamberg Age/Gender:

Teeth/Dentures: Surgeon: Procedure: ASA 1 2 3 4 Pre-Med:

Tobacco

 Lithotomy  Sitting  Jackknife

INDUCTION:  Propofol Induction (2-2.5mg/kg)  Propofol Gtt (0.1-0.2 mg/kg/min)  Midazolam/Versed (0.1-0.2mg/kg)  Fentanyl Induction (3-5mcg/kg)  Fentanyl Intra-op (2-50mcg/kg)  Lidocaine (1-1.5mg/kg)  Sodium Pentothal (3-5mg/kg)  Etomidate (0.2-0.5mg/kg)  Ketamine (1-2mg/kg)  Other MUSCLE RELAXANT:  Succ (1-1.5mg/kg):  Rocuronium (0.6-1.2mg/kg):  Pancuronium (0.08-0.12mg/kg):  Vecuronium (0.08-0.12mg/kg):  Pipecuronium (0.06-0.1mg/kg): REVERSAL:  Neostigmine (0.035-0.08mg/kg)  Pyridostigmine (0.1-0.4mg/kg)  Edrophonium (0.5-1.0mg/kg) LOCAL INFILTRATION:  Lidocaine 5mg/kg (300mg max)  Lido + Epi 7mg/kg (500mg max) Version 11Nov09

Patient Care Plan Ht/Wt: MR#: NPO Since: Mallampati 1 2 3 4

Illicit Drugs PLAN:  GA  RSI  MAC  LMA  TIVA  Spinal  Epidural  Regional  

MONITORS:  Standard  A-Line  CVP  Pulm Artery (PA) Cath  Bispectral (BIS) Monitor  Stetho Precordial/Esoph  Nerve/Twitch Stimulator  Warming Blanket (Bair)  Fluid Warmer (Hot Line)  Esoph Temp  Rapid Infuser INHALATION AGENT:  O2  N20  Sevo 2%  Hal 0.75%  Des 6-7%  Eth 1.68%  Iso 1.15% PONV PROPHYLAXIS:  Ondansetron (Zofran) 4mg  Metoclopramide (Reglan) 10mg  Dexamethasone (Decadron) 8mg  Droperidol (Inapsine) 0.625mg

 Atracurium (0.5-0.8mg/kg):  Cisatracurium (0.1-0.2mg/kg):  Mivacurium (0.15-0.2mg/kg):  Metocurine (0.3mg/kg):

+ glycopyrrolate (0.2mg per mg Neo) + glycopyrrolate (0.2mg per 5mg Pyrido) + atropine (0.014mg per mg Edro)  Bupivacaine 2mg/ kg  Bupiv + Epi 3mg/ kg

(175mg max) (225mg max) -1-

Anesthesiology

James Lamberg

Maintenance Fluid: For the first 10kg: 4cc/kg/hr For the second 10kg: 2cc/kg/hr For anything > 20kg: 1cc/kg/hr

cc/hr

Insensible Loss: cc/hr Losses: 2-10 cc/kg/hr Minimum: 4cc/kg/hr, Extreme: 8cc/kg/hr EBV: ABL:

Patient Care Plan

Fluid Deficit: cc Deficit = preoperative NPO hours * maintenance Preop bowel preparation adds 1 to 1.5L Replace half of deficit in first hour, half in second Blood Loss: cc 3cc crystalloid per 1cc blood loss 1cc colloid or blood products per 1cc blood loss

cc EBV = ABV * kg (ABV = 75cc/kg Male, 65cc/kg Female, 55cc/kg Obese) cc ABL = EBV * (Initial Hgb – Hgb allowable) / Initial Hgb Deficit

Maintenance

Insensible

Blood Loss

Hour Total

1st Hour 2nd Hour 3rd Hour

N/A

4th Hour

N/A

Anesthesia Notes/Concerns/Issues:

Version 11Nov09

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