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Anesthesiology James Lamberg Patient Care Plan

Date: Age/Gender: Teeth/Dentures: Ht/Wt:


MD/DO/CRNA: Surgeon: MR#:
Dx: Procedure: NPO Since:
Allergies: ASA 1 2 3 4 Mallampati 1 2 3 4
Home Meds: Pre-Med:
Med/Surg Hx:
Social Hx: EtOH Tobacco Illicit Drugs
PLAN: MONITORS:
 GA  Standard
 RSI  A-Line  CVP
 MAC  Pulm Artery (PA) Cath
 LMA  Bispectral (BIS) Monitor
 TIVA  Stetho Precordial/Esoph
 Spinal  Nerve/Twitch Stimulator
POSITION:  Epidural  Warming Blanket (Bair)
 Supine  Lithotomy  Regional  Fluid Warmer (Hot Line)
 Lateral L / R  Sitting   Esoph Temp
 Prone  Jackknife   Rapid Infuser
INDUCTION: INHALATION AGENT:
 Propofol Induction (2-2.5mg/kg)  O2  N20
 Propofol Gtt (0.1-0.2 mg/kg/min)  Sevo 2%  Hal 0.75%
 Midazolam/Versed (0.1-0.2mg/kg)  Des 6-7%  Eth 1.68%
 Fentanyl Induction (3-5mcg/kg)  Iso 1.15%
 Fentanyl Intra-op (2-50mcg/kg)
 Lidocaine (1-1.5mg/kg) PONV PROPHYLAXIS:
 Sodium Pentothal (3-5mg/kg)  Ondansetron (Zofran) 4mg
 Etomidate (0.2-0.5mg/kg)  Metoclopramide (Reglan) 10mg
 Ketamine (1-2mg/kg)  Dexamethasone (Decadron) 8mg
 Other  Droperidol (Inapsine) 0.625mg

MUSCLE RELAXANT:
 Succ (1-1.5mg/kg):  Atracurium (0.5-0.8mg/kg):
 Rocuronium (0.6-1.2mg/kg):  Cisatracurium (0.1-0.2mg/kg):
 Pancuronium (0.08-0.12mg/kg):  Mivacurium (0.15-0.2mg/kg):
 Vecuronium (0.08-0.12mg/kg):  Metocurine (0.3mg/kg):
 Pipecuronium (0.06-0.1mg/kg):

REVERSAL:
 Neostigmine (0.035-0.08mg/kg) + glycopyrrolate (0.2mg per mg Neo)
 Pyridostigmine (0.1-0.4mg/kg) + glycopyrrolate (0.2mg per 5mg Pyrido)
 Edrophonium (0.5-1.0mg/kg) + atropine (0.014mg per mg Edro)

LOCAL INFILTRATION:
 Lidocaine 5mg/kg (300mg max)  Bupivacaine 2mg/ kg (175mg max)
 Lido + Epi 7mg/kg (500mg max)  Bupiv + Epi 3mg/ kg (225mg max)

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Anesthesiology James Lamberg Patient Care Plan

Maintenance Fluid: cc/hr Fluid Deficit: cc


For the first 10kg: 4cc/kg/hr Deficit = preoperative NPO hours * maintenance
For the second 10kg: 2cc/kg/hr Preop bowel preparation adds 1 to 1.5L
For anything > 20kg: 1cc/kg/hr Replace half of deficit in first hour, half in second

Insensible Loss: cc/hr Blood Loss: cc


Losses: 2-10 cc/kg/hr 3cc crystalloid per 1cc blood loss
Minimum: 4cc/kg/hr, Extreme: 8cc/kg/hr 1cc colloid or blood products per 1cc blood loss

EBV: cc EBV = ABV * kg (ABV = 75cc/kg Male, 65cc/kg Female, 55cc/kg Obese)
ABL: cc ABL = EBV * (Initial Hgb – Hgb allowable) / Initial Hgb

Deficit Maintenance Insensible Blood Loss Hour Total


1st Hour
2nd Hour
3rd Hour N/A
4th Hour N/A

Anesthesia Notes/Concerns/Issues:

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