What is used to add rigidity and prevent coring of the skin when placing a spinal?
What type of needle is commonly used for spinal placement?
Pencil point needle
Is a spinal a single shot or continuous infusion method?
If a spinal is performed above the level of L2 - L3 what might happen?
What is the major determinant of the level of spinal block?
What direction will a hyperbaric solution go?
It will drop
What is the benefit of a spinal?
Rapid onset with intense block
How should the dose of LA be adjusted for use in spinal?
Decrease the dose
Does a spinal dose of LA have a faster or slower absorption systemically?
What does DOSE determine with a spinal?
Duration of block
What dose POSITION determine with a spinal?
Level of block
What roots will always be blocked with a spinal but bot always with an epidural?
What direction is an epidural more likely to spread?
What is bupivacaine mixed with to make it hyperbaric?
How many ml of hyperbaric bupivacaine is needed to achieve an S1 to S5 saddle block?
How many ml of hyperbaric bupivacaine is needed to achieve a Lumbar block?
How many ml of hyperbaric bupivacaine is needed to achieve a mid-thoracic block?
How long must a Pt be positioned to achieve proper spread p a spinal dose of LA? How long p the dose will the medication cont to spread?
a) 7-12 min
b) 20 min
Laying a Pt flat p a spinal dose of LA will achieve a _____ level block? What is this location known as?
2. Thoracic Kyphosis
How is the epidural space identified when placing a combined spinal/epidural?
Same as an epidural, loss of resistance
What happens if you leave a Pt seated too long p a spinal dose of LA while threading your epidural cath for a combined spinal/epidural?
The spinal will become a saddle block
How long should you wait to does an epidural p a dose of spinal LA is given in the combined spinal/epidural? Why?
a) 20 to 30 min
b) Dosing the epidural too soon will cause the spinal dose to migrate higher?
What happens if a spinal reaches the level of C3 to C5? What is the treatment?
1. Resp arrest
What is an accidental epiarachnoid block? What will be seen?
1. When you inject between the Dura and arachnoid mater
2. High, patchy, unilateral or bilateral block
What causes a high epidural? How long will it take for this to resolve? What is the treatment?
1. Too much volume
2. 30 min
What can a Dural puncture HA result in? What are three treatments?
1. Subdural Hematoma
4. Blood Patch
How much blood is injected via epidural technique for a blood patch? How does it work?
1. 20 ml
2. Increases ICP and clots at the site
What are the signs of spinal artery thrombosis? 3
(Motor Fx lost, not sensation)
What causes adhesive arachnoiditis? What can it result in?
1. Injecting the wrong drug
What is the treatment for an epidural hematoma?