Lesson 1Preoxygenation techniques and strategies to optimize oxygen reserveExplains goals and techniques of preoxygenation, including mask fit, flow rates, duration, and strategies for high-risk patients, to maximize oxygen reserve and delay desaturation during induction.
Physiologic goals of preoxygenationMask seal, flow rates, and FiO2 settingsPreoxygenation in obese and pregnant patientsHead-up and ramped positioning benefitsAssessing adequacy of preoxygenationLesson 2Allergic/anaphylactic reaction: recognition, immediate nursing interventions, emergency drugs and documentationDetails recognition of allergic and anaphylactic reactions, immediate nursing interventions, emergency drug preparation, airway support, and thorough documentation for legal and quality purposes.
Early clinical signs of anaphylaxisImmediate airway and breathing supportPositioning and circulatory support stepsPreparing and assisting with epinephrinePostevent documentation and reportingLesson 3Standard intraoperative monitoring standards (ECG, NIBP, SpO2, ETCO2, temperature, anesthetic agent monitoring)Reviews standard intraoperative monitoring, including ECG, NIBP, SpO2, ETCO2, temperature, and anesthetic agent monitoring, with emphasis on setup, alarm limits, and interpretation of key changes.
ECG lead placement and rhythm recognitionNoninvasive blood pressure setup and cyclesPulse oximetry use and artifact reductionCapnography and ETCO2 waveform basicsTemperature and anesthetic agent monitoringLesson 4Airway difficulty and failed intubation: immediate actions, oxygenation strategies, calling for helpAddresses recognition of difficult airway and failed intubation, immediate oxygenation strategies, adherence to algorithms, timely call for help, and assisting with rescue devices and emergency front-of-neck access.
Predictors of a difficult airwayRecognizing failed intubation earlyMaintaining oxygenation between attemptsAssisting with supraglottic airway devicesSupporting emergency front-of-neck accessLesson 5Common intraoperative complications: recognition and stepwise nursing responses for hypotensionDetails early recognition of intraoperative hypotension, structured assessment, and stepwise nursing responses, including positioning, fluid management support, vasopressor preparation, and communication with the anesthesiologist.
Defining and grading intraoperative hypotensionRapid assessment of causes and contributing factorsImmediate nonpharmacologic nursing measuresSupporting fluid resuscitation and blood productsPreparing and assisting with vasopressor therapyLesson 6Patient positioning principles for laparoscopic procedures and pressure-area protectionExplores safe positioning for laparoscopic surgery, including Trendelenburg and reverse Trendelenburg, limb alignment, pressure-area protection, and regular checks to prevent nerve injury, pressure sores, and compartment issues.
Positioning for gynecologic laparoscopyPositioning for upper abdominal laparoscopyPadding and protection of pressure pointsPrevention of nerve and ocular injuriesPosition checks during long proceduresLesson 7Assisting with induction: roles during drug administration, airway device selection, and cricoid precautionsClarifies the nurse’s role during induction, including preparation, drug safety checks, airway device selection support, cricoid pressure application, and maintaining situational awareness for complications.
Preparation of induction drugs and equipmentPatient identification and safety checksSupporting airway device selection and sizingCorrect application of cricoid pressureMonitoring and reporting induction responsesLesson 8Glucose monitoring intraoperatively: targets, frequency, and insulin/IV fluid considerationsCovers intraoperative glucose monitoring indications, target ranges, testing frequency, and coordination of insulin and IV fluids, emphasizing safe titration, documentation, and prevention of hypo- and hyperglycemia.
Glycemic targets for common surgical patientsPoint-of-care glucose testing frequencyInsulin infusion and bolus coordinationIV fluid selection in diabetic patientsRecognition and treatment of hypoglycemiaLesson 9Documentation practices during intraoperative phase: times, events, drug administration, interventionsDescribes accurate, timely intraoperative documentation of times, events, drugs, fluids, monitoring trends, and interventions, emphasizing legal, safety, and continuity-of-care aspects of anesthetic records.
Core elements of the anesthesia recordTime-stamping critical intraoperative eventsRecording drugs, fluids, and blood productsCharting monitoring values and trendsDocumenting complications and responsesLesson 10OR setup for general anesthesia: equipment checklist (anesthesia machine, suction, airway cart, difficult airway trolley)Outlines systematic OR preparation for general anesthesia, focusing on anesthesia machine checks, suction readiness, airway cart organization, and difficult airway trolley setup to ensure safety and rapid response capacity.
Daily anesthesia machine safety checksSuction setup and patency verificationStandard airway cart layout and restockingDifficult airway trolley contents and labelingBackup oxygen and power supply checksLesson 11Hemodynamic monitoring targets and interpretation in ASA II with hypertension and diabetesExplains hemodynamic targets and monitoring for ASA II patients with hypertension and diabetes, including blood pressure, heart rate, and perfusion goals, and nursing actions for deviations.
Baseline assessment in hypertensive patientsBlood pressure and heart rate targetsManaging intraoperative hypertensionMonitoring for myocardial ischemia signsBalancing fluids in diabetic patientsLesson 12Thermoregulation and active warming measures for laparoscopic casesCovers intraoperative thermoregulation in laparoscopic cases, including risk factors for hypothermia, active warming methods, fluid warming, and continuous temperature monitoring to prevent complications.
Risks and consequences of hypothermiaForced-air and conductive warming devicesWarming IV fluids and irrigation solutionsTemperature monitoring sites and methodsAdjusting warming strategies over timeLesson 13Intraoperative communication: SBAR handovers, briefings with anesthesiologist and surgical teamFocuses on structured intraoperative communication using SBAR, pre- and intraoperative briefings, and closed-loop communication with anesthesiologist and surgical team to reduce errors and improve teamwork.
SBAR structure for anesthesia handoversPreinduction and timeout briefingsCommunicating critical events and trendsClosed-loop communication techniquesHandover to PACU or ICU staff
