General Set Up

General Case Set up
This is a standard setup used for a general case. Provider preference may vary. Use caution during medication dilution. Always recheck the initial and final concentration. If unsure, discard and restart dilution.

1. Perform an anesthesia machine. Turn on Etco2 machine and BIS (if used). Emergency equipment.
2. Set up.
   1. Laryngoscopes (2), Mac and Miller blade (1 each). Make sure laryngoscope light is functional
   2. Eye tape
   3. Tongue blade
   4. Oral airway (appropriate size)
   5. Endotracheal tube (appropriate size) Standard size – 7.0 Female, 7.5 Male
   6. ETT Stylet. (Keep proximal to murphy's eye)
   7. Endotracheal tape
   8. 10ml syringe for Endotracheal tube. Check tube cuff for leaks
   9. Skin/Esophageal temperature probe.
3. Additional equipment: Ensure availability.
   1. Laryngeal Mask Airway
   2. Nasogastric/Orogastric tube
   3. Surgical lube
   4. BIS monitor
   5. Esophageal Temperature probe
   6. Bair hugger (lower and upper)
   7. Head rest
   8. V lead EKG cord
   9. Arm straps, padding
   10. IV start kits
4. Set up syringes for the day. Include 30ml, 10ml, 5ml and 3ml
5. Draw and dilute emergency drugs (check vial concentration)
   1. Succinylcholine 20mg/ml = 5ml = 100mg
   2. Ephedrine 50mg/ml- Dilute in 9ml of Normal Saline- Final Concentration 5mg/mlALWAYS DOUBLE CHECK INITIAL AND FINAL CONCENTRATION
   3. Phenylephrine 10mg/ml – Need to be double diluted- Final concentration: 100mcg/ml. Dilution can be performed by using following methods.
      
      1. Draw the 1ml vial in 10ml syringe. Inject and mix in 100ml Normal saline bag. Concentration in bag is 100mcg/ml. Draw 10ml from the 100ml bag.  
      2. Draw the 1ml vial in 1ml TB Syringe. Inject 0.1 ml into 10ml syringe. Dilute with Normal Saline to a total of 10ml in syringe. Final Concentration- 100mcg/ml. ALWAYS DOUBLE CHECK INITIAL AND FINAL CONCENTRATION
6. Standard induction Medication:  Check preceptor preference.
   1. Versed
   2. Fentanyl
   3. Propofol (other Hypnotics)
   4. Succinylcholine
   5. Non Depolarizing muscle relaxant.