1. Administer Parenteral General Anesthesia 081-833-4548
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.
Have a student read this slide out loud to the rest of the class.

3. REASON
As a Special Forces Medic you must be prepared to anesthetize a patient requiring invasive procedures.
Have a student read this slide out loud to the rest of the class.

4. PROCEDURES Insure anesthetist preparation Insure patient preparation
Induce parenteral general anesthesia
Emergency induction of parenteral general anesthesia
Have a student read this slide out loud to the rest of the class.

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Insure the proper drugs are present in sufficient amounts and not out of date
Preparation is the key to a successful procedure.

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 in milligrams
Check all endotracheal equipment
Endotracheal equipment includes cric kit.

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
Re-inform the patient of what will take place. Attempt to alleviate the patients anxiety with words of support and reassurance.

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)
NONE

9. Induce Parenteral general anesthesia
Start induction 30 minutes after last premedication was given
The premedication at 30 minutes should be at maximum effectiveness.

10. Induce Parenteral general anesthesia
Muscle relaxation
Diazepam (induction) mg/kg Slow IV push
QUESTION: Why is it slow IV push?
ANSWER: Diazepam's has a high pH and causes respiratory depression when given to rapid.

11. REMEMBER! COMPONENTS OF GENERAL ANESTHESIA
1. Unconsciousness (Hypnosis)
2. Analgesia (Areflexia)
3. Muscle relaxation
The components of general anesthesia are a very important factor in anesthesia pharmacology.
Can any non-recycle tell me why this is so?
We do not utilize a single drug produces all the effects that we need to cover all the components of general anesthesia.
We have to utilize a combination or cocktail of drugs.

12. Induce Parenteral general anesthesia
Unconsciousness
Ketamine (induction) mg/kg slow IV push
QUESTION: Why is it slow IV push?
ANSWER: Ketamine causes respiratory depression when given to rapid.

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
Rapid means to move with haste.

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) mg/kg Slow IV push
If the trauma patient is hypotensive this step might be skipped or delayed.

17. Induce Parenteral general anesthesia
Unconsciousness
Ketamine (induction) mg/kg slow IV push
Remember Ketamine will increase the patients B/P by 20mm of mercury.

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
Rapid means to move with haste.

19. SUMMARY OF PROCEDURES Insure anesthetist preparation
Insure patient preparation
Induce parenteral general anesthesia
Emergency induction of parenteral general anesthesia
Have a student read this slide out loud to the rest of the class.

20. RESTATED 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.
Have a student read this slide out loud to the rest of the class.