Basic mnemonics in anaesthesia/ anaesthesiology

Basic mnemonics in anaesthesia/ anaesthesiology

Introduction

Anaesthesiology is the  medical specialty concerned with the perioperative care of patients before, during and after surgery.  It encompasses anaesthesia, intensive care medicine, critical emergency medicine, and pain medicine. This specialty ensures patients comfort before, during and after surgical procedure.

 

Anaesthesia is derived from Greek word meaning “without sensation”. It is a state of controlled, temporary loss of sensation that is induced for medical purpose. 

 

Anaesthesia could be general or regional/local. 

 

General anaesthetics are drugs which cause reversible loss of all sensation and consciousness. Features of general anaesthesia are unconsciousness or sleep, muscle relaxation or immobility, abolition of somatic and autonomic reflexes, and analgesia or pain relief while those of local anaesthesia doesn’t not include loss of consciousness.

 

Read also: Basic mnemonics in paediatrics

 

These anaesthesia mnemonics will be discussed under three major subheadings, this may be different in few cases. The subheadings are:

  1. Condition/item
  2. Brief description
  3. Mnemonic and meaning  

 

1. Anaesthesia equipment check

Anaesthesia equipment consists of instruments used by anaesthesiologist to ensure surgical operation goes uneventful. Proper check of these instruments, particular before surgery has numerous benefits.

 

What to check are: 

MISMADE:

  • Machine check
  • IV supplies
  • Suction
  • Monitors
  • Airways
  • Drugs
  • Equipment

 

2. Anaesthesia machine/room check

Anaesthesia machine consists of source of gas supply- pipeline system, gas cylinders, pressure regulators and gauges, flowmeters and vaporizers, breathing systems & soda lime, and oxygen analyzer.

 

It is important to check anaesthesia machine so as to ensure correct functioning of the anesthetic machine, patient safety, detect faulty equipment, and for medico-legal reasons: quality assurance, monitoring standards,  guide against equipment misuse and future litigations.

 

What to check:

MS MAID:

  • Monitors (EKG, SpO2, EtCO2, etc)
  • Suction
  • Machine check (according to ASA guidelines)
  • Airway equipment (ETT, laryngoscope, oral/nasal airway)
  • IV equipment
  • Drugs (emergency, inductions, NMBs, etc)

 

3. Anaesthesia: quick check

Check the introduction for description of anaesthesia.

 

Quick check involves:

SOAP:

  • Suction
  • Oxygen
  • Airway
  • Pharmacology

 

4. Anaesthesia: 4 stages

Check the introduction for description of anaesthesia.

"Anaesthesiologists Enjoy & M":

  • Analgesia
  • Excitement
  • Surgical anesthesia
  • Medullary paralysis

 

5. Endotracheal intubation: diagnosis of poor bilateral breath sounds after intubation

Endotracheal intubation is a medical procedure in which a tube is placed into the trachea also known as windpipe through the mouth or nose in order to maintain patent airway.

 

Diagnosis of poor bilateral breath sounds after intubation include:

DOPE:

  • Displaced (usually right mainstem, pyreform fossa, etc.)
  • Obstruction (kinked or bitten tube, mucuous plug, etc.)
  • Pneumothorax (collapsed lung)
  • Esophagus

 

Read also: Basic mnemonics in obstetrics and gynaecology

 

6. General anaesthesia: equipment check prior to inducing

Check the introduction for description of general anaesthesia.

 

Check the following prior to induction:

MALES:

  • Masks
  • Airways
  • Laryngoscopes
  • Endotracheal tubes
  • Suction/ Stylette, bougie

 

7. Inhalation anaesthetics

Inhalation anaesthetics are volatile(liquid) and gaseous anaesthetic agents administered through the inhalational route to produce and/or maintain anaesthesia. Examples are N2O and Cycloproane which are gases and chloroform, ether, ethyl chloride, methoxyflurane, enflurane and halothane which are volatile liquid.

 

Inhalation anesthetics are:

SHINE:

  • Sevoflurane
  • Halothane
  • Isoflurane
  • Nitrous oxide
  • Enflurane

 

If you want the defunct Methoxyflurane too, make it Moon SHINE.

 

8. Local anaesthesia: identify the two classes

Local anaesthetic are agents that produce loss of sensation to pain in specific areas of the body without the loss of consciousness. It may be divided into two classes which are amide and ester. All local anaesthetic agents end with caine.

 

  • AmIde: additional I, examples are lidocaine, bupivacaine, ropivacaine, etc
  • Ester: no extra I, examples are cocaine, procaine, benzocaine, etc

 

9. Spinal anaesthesia agents

Local anaesthetic are agents that produce loss of sensation to pain in specific areas of the body without the loss of consciousness. It may be divided into two classes which are amide and ester.

 

Spinal anaesthesia agents are local anaesthesia injected into the sub arachnoid space to produce spinal anaesthesia.

 

Agents used are: 

"Little Boys Prefer Toys":

  • Lidocaine
  • Bupivicaine
  • Procaine
  • Tetracaine

 

10. Xylocaine: where not to use with epinephrine

Xylocaine also known as lidocaine is a local anesthetic agent of the amide group.

 

Vasoconstrictive effects of xylocaine with epinephrine are helpful in providing hemostasis while suturing. However, may cause local ischemic necrosis in distal structures with end arteries such as the digits, tip of nose, penis, ears.

 

So do not use lidocaine with epinephrine in:

"Nose, Hose, Fingers and Toes"

 

Read also: Basic mnemonics in surgery


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