Clinical Procedures and Protocols Flashcards
7 cards from real ABA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Clinical Procedures and Protocols flashcards as text
When performing an ultrasound-guided transversus abdominis plane (TAP) block, between which muscle layers should the local anesthetic be deposited?
Answer: Internal oblique and transversus abdominis
The TAP block targets the neurovascular plane between the internal oblique and transversus abdominis muscles where the T10–L1 nerves travel.
A patient undergoing carotid endarterectomy under cervical plexus block suddenly becomes confused and develops contralateral weakness. What is the most likely cause?
Answer: Cerebral ischemia from carotid cross-clamping
Neurological deficits during carotid cross-clamping indicate cerebral ischemia from inadequate collateral flow, which may necessitate shunt placement.
Which parameter is MOST useful for assessing depth of neuromuscular blockade during a cisatracurium infusion?
Answer: Post-tetanic count
The post-tetanic count is the most sensitive indicator at deep levels of neuromuscular block when TOF count is zero, guiding dosing during profound blockade.
During a retrobulbar block for ophthalmic surgery, the patient develops sudden loss of consciousness and contralateral eye signs. What complication has occurred?
Answer: Brainstem anesthesia via spread along the optic sheath
Injection too deep into the muscle cone can deposit local anesthetic into the subarachnoid space surrounding the optic nerve, spreading to the brainstem.
A patient with a full stomach requires emergency surgery. Which modification of rapid sequence induction is acceptable when succinylcholine is contraindicated?
Answer: Rocuronium 1.2 mg/kg with immediate availability of sugammadex
Rocuronium 1.2 mg/kg provides intubating conditions within 60 seconds comparable to succinylcholine, and its effects are fully reversible with sugammadex 16 mg/kg.
During an interscalene brachial plexus block, which complication is virtually universal and should be discussed with every patient preoperatively?
Answer: Ipsilateral phrenic nerve palsy with 25% diaphragm hemidiaphragm paresis
Phrenic nerve block causing ipsilateral hemidiaphragm paresis occurs in nearly 100% of interscalene blocks and is clinically significant in patients with compromised pulmonary reserve.
What is the maximum safe dose of plain lidocaine for peripheral nerve block in a 70 kg adult?
Answer: 4.5 mg/kg (315 mg)
The maximum recommended dose of plain lidocaine for peripheral nerve blocks is 4.5 mg/kg (approximately 300–315 mg in a 70 kg adult).