Administer Parenteral General Anesthesia 081-833-4548

1. Administer Parenteral General Anesthesia081-833-4548 INSTRUCTOR SFC HILL

2. OBJECTIVE As a Special Forces Medic given a patient requiring general parenteral anesthesia in a fixed or temporary facility, induce the patient to stage three of general anesthesia in accordance with JSOMTC student manual of anesthesia.

3. REASON • As a Special Forces Medic you must be prepared to anesthetize a patient requiring invasive procedures.

4. PROCEDURES • Insure anesthetist preparation • Insure patient preparation • Induce parenteral general anesthesia • Emergency induction of parenteral general anesthesia

5. Insure anesthetist preparation • Inspect the anesthetist cart • insure presents of anaphylaxis kit • insure presents of SPARKS kit • Insure the proper drugs are present in sufficient amounts and not out of date

6. Insure anesthetist preparation • Insure pharyngeal suction apparatus are operational and manual backup suction is present • Switch on, set up and calibrate all monitors • Clearly label all syringes with the appropriate agent and amount inmilligrams • Check all endotracheal equipment

7. Insure patient preparation • Review preanesthetic visit (SF517) • When the patient arrives, verify identity, and the nature and site of the scheduled operation • Establish rapport with the patient

8. Insure patient preparation • Insure a base line set of vitals has been established • Insure established IV is patent • Attach all monitoring devices • Insure the patient has received the proper preanesthetic medication (five rights)

9. Induce Parenteral general anesthesia • Start induction 30 minutes after last premedication was given

10. Induce Parenteral general anesthesia • Muscle relaxation • Diazepam (induction) 0.3 - 0.5 mg/kg Slow IV push

11. REMEMBER!COMPONENTS OF GENERAL ANESTHESIA • 1. Unconsciousness (Hypnosis) • 2. Analgesia (Areflexia) • 3. Muscle relaxation

12. Induce Parenteral general anesthesia • Unconsciousness • Ketamine (induction) 1 - 2 mg/kg slow IV push

13. Induce Parenteral general anesthesia • On completion of induction, a rapid sequence intubation should be preformed to protect the patients airway • The patient should then be placed on anesthesia maintenance

14. Emergency induction of parenteral general anesthesia

15. Emergency induction of parenteral general anesthesia • Emergency patients should be stabilized prior to induction of anesthesia whenever possible • With the unstable patient, induction should proceed when only the immediate surgical intervention will save the patients life

16. Induce Parenteral general anesthesia • Muscle relaxation • Diazepam (induction) 0.3 - 0.5 mg/kg Slow IV push

17. Induce Parenteral general anesthesia • Unconsciousness • Ketamine (induction) 1 - 2 mg/kg slow IV push

18. Induce Parenteral general anesthesia • On completion of induction, a rapid sequence intubation should be preformed to protect the patients airway • The patient should then be placed on anesthesia maintenance

19. SUMMARY OFPROCEDURES • Insure anesthetist preparation • Insure patient preparation • Induce parenteral general anesthesia • Emergency induction of parenteral general anesthesia

20. RESTATEDOBJECTIVE As a Special Forces Medic given a patient requiring general parenteral anesthesia in a fixed or temporary facility, induce the patient to stage three of general anesthesia in accordance with JSOMTC student manual of anesthesia.