2. DateSingle
Jeopardy
Final
Jeopardy
PRIZE !!

3. 100
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local
anesthetics
analgesics sedation
more
sedation
fun facts
SINGLE JEOPARDY

4. Appropriate alternative locale
anesthetic for patient with
reported allergy to procaine?
Topic I 100 Question

5. What is any Amide local
anesthetic?

7. Amides Esters
• Lidocaine
• Mepivacaine
• Bupivacaine
• Prilocaine
• Procaine
• Benzocaine
• Tetracaine
Topic I 100 Answer
Go To Single
Jeopardy

8. DOUBLE JEOPARDY
2 local anesthetics which can
cause methemoglobinemia
Topic I 200 Question

9. What are:
Topic I 200 Answer
Go To Single
Jeopardy
Benzocaine and Prilocaine

10. A one year old boy, 10 kg, has
just been bitten by a cockapoo...
Topic I 300 Question

12. No, of course not, it was a pit bull...

14. He will require extensive
laceration repair. Calculate the
maximum doses of lidocaine 1 %
with and without epinephrine?
PRIZE !!

15. What are:
4.5 cc plain, 7 cc with epi?

16. % solution = gram/dl ;
0.5% = 5 mg/ml, 1.0 % = 10 mg/ml
• Lidocaine 1%: Max dose 4.5 mg/kg plain,
7 mg/kg with epinephrine
• Mepivacaine 1 %: Max dose 5 mg/kg plain,
7 mg/kg with epinephrine
Topic I 300 Answer
Go To Single
Jeopardy

17. Topic I 400 Question
While injecting lidocaine to
anesthetize a laceration, your
patient complains of her
tongue feeling numb. Instead
of thinking “crazy patient”,
you should prepare for the
following 2 problems:

18. What are:
CNS Toxicity (seizures, coma)
and
Cardiovascular Toxicity
(dysrhythmias, myocardial
depression)

19. Toxicity of local anesthetics
• All with dose-dependent CV toxicity via
sodium channel blockade (myocardial
depression and dysrhythmias)
• Bupivacaine highest CV toxicity
• CNS toxicity
• Early sx: lightheadedness, peri-oral
paresthesias, tongue numbness, twitching
• Seizures-->anticipate VT
Topic I 400 Answer
Go To Single
Jeopardy

20. 5 ways to decrease the pain of
infiltration of local
anesthetics?
Topic I 500 Question

21. What are:
1. Inject slowly
2. Buffer with sodium bicarbonate
3. Inject through open margins of wound
4. Use warm anesthetic
5. Use small needle
6. Reassure patient/distraction
Topic I 500 Answer
Go To Single
Jeopardy

22. Safe and appropriate oral
analgesic choice for patient
reporting an allergic reaction of
vomiting to codeine
Topic II 100 Question

23. What is:
Anything except
codeine

24. Analgesic Classes
• Phenanthrenes: Morphine, Hydromorphone,
Codeine, Hydrocodone, Oxycodone, mixed
agonists/antagonists
• Phenylpiperidines: Fentanyl, Meperidine
• Diphenylheptanes: Methadone
Topic II 100 Answer
Go To Single
Jeopardy

25. Analgesic just removed from US
market on 11/19/2010
Topic II 200 Question
PRIZE !!

26. What is propoxyphene?
Topic II 200 Answer
Go To Single
Jeopardy
(darvon, darvocet)

27. The correct increasing order of
potency for the following ORAL
analgesics
• oxycodone
• hydromorphone
• codeine
• morphine
• hydrocodone
Topic II 300 Question

28. What are:
• codeine 200 mg
• hydrocodone 30 mg
• morphine 30 mg
• oxycodone 20 mg
• hydromorphone 7.5 mg
Topic II 300 Answer
Go To Single
Jeopardy

29. This relative of clonidine has
sedative and analgesic properties
and reportedly very little
respiratory depression
Topic II 400 Question
PRIZE !!

30. What is dexmedetomidine?
Topic II 400 Answer
Go To Single
Jeopardy

31. Leave blank
Topic III 100 Question

32. Leave blank
Topic III 100 Answer
Go To Single
Jeopardy

33. ASA physical status
classification for patient with
well controlled asthma requiring
procedural sedation
Topic III 200 Question

34. What is II?

35. Topic III 200 Answer
Go To Single
Jeopardy

36. Amount of time recommended
by ASA to wait before sedation
after patient has drank clear
liquids
Topic III 300 Question

37. What is 2 hours?

38. ASA guidelines
• 2 hrs for clear liquids
• 4 hrs for breast milk
• 6 hrs for other milk or a light meal
Topic III 300 Answer
Go To Single
Jeopardy

39. Medication used for procedural
sedation which is associated with
adrenal insufficiency and myoclonus
Topic III 400 Question

40. What is Etomidate?

41. Buzz words for:
PROPOFOL
• No analgesia
• Decrease ICP
• Hypotension
• Anti-emetic
• Anti-epileptic
• Infection
• “propofol syndrome”
• ?more resp. depression
ETOMIDATE
• No analgesia
• Decrease ICP
• Hemodynamic
stability
• Vomiting
• Adrenal insufficiency
• Myoclonus
Topic III 400 Answer
Go To Single
Jeopardy

42. An increasingly popular mixture
of two procedural medications
has this name and contains this
common ratio of the medications
Topic III 500 Question

43. What is Ketofol?
• Single-syringe 1:1 mixture of 10 mg/mL
ketamine and 10 mg/mL propofol
• Usually requires approximately 1 mg/kg
(0.5 mg/kg of each)
• Academic Emergency Medicine 2010;
17:194–201
Topic III 500 Answer
Go To Single
Jeopardy

44. The reason not to use Ketamine
in small children with active
URIs
Topic IV 100 Question
PRIZE !!

45. What is Laryngospasm?
Topic IV 100 Answer
Go To Single
Jeopardy

46. The most appropriate induction
agent for an 18 yo male brought
to ED after a single GSW to the
abdomen with a BP of 70/40 who
is not protecting his airway
Topic IV 200 Question

47. What is Ketamine?
(would also accept Midazolam)
Topic IV 200 Answer
Go To Single
Jeopardy

48. Contraindication to use of Nitrous Oxide
Topic IV 300 Question
PRIZE !!

49. Topic IV 300 Answer
Go To Single
Jeopardy
What is/are: pneumothorax, SBO, middle
ear effusion, balloon tip catheter use? Also
head injuries, psych, intoxication

50. Patient responding to verbal/light touch
with adequate spontaneous ventilation
after etomidate sedation is at this
sedation level
Topic IV 400 Question

51. What is Moderate Sedation?

52. 1. Anxiolysis/Minimal Sedation
2. Moderate Sedation
3. Deep Sedation
4. General Anesthesia
Topic IV 400 Answer
Go To Single
Jeopardy

53. Three requirements prior to the
safe discharge of a patient from
the ED after procedural sedation
Topic IV 500 Question

54. What are:
1. Stable Vital Signs
2. No respiratory distress
3. Has ride home with responsible adult
4. No significant N/V, able to take po
5. Awake, at neuro baseline, ambulatory,
following instructions
Topic IV 500 Answer
Go To Single
Jeopardy

55. Alternative method of delivery for
Fentanyl besides IV and Transdermal
and Intranasal
Topic V 100 Question

56. What is Inhaled?
• In Australian study of children with long
bone fractures, 1 mic/kg inhaled Fentanyl
similar analgesia to 0.2 mg/kg IM morphine
Topic V 100 Answer
Go To Single
Jeopardy

57. These two drugs are used in the
treatment of Complex Regional Pain
Type I (reflex sympathetic dystrophy)
Topic V 200 Question

58. What are corticosteroids and
calcitonin?

59. Complex Regional Pain I/II
• Type I (RSD), is due to prolonged
immobilization or disuse
• Type II (causalgia) from peripheral nerve
injury
• Both types with same presentation early:
burning pain, edema, warmth, local
sweating
• Tx both with steroids, Type I also with
calcitonin

60. Topic V 200 Answer
Go To Single
Jeopardy

61. What the abbreviation EMLA
stands for
Topic V 300 Question
PRIZE !!

62. What is:What is: Eutectic Mixture ofEutectic Mixture of
Local AnestheticsLocal Anesthetics
(prilocaine and lidocaine)

63. • TAC (tetracaine, adrenaline, cocaine 11.8%)
• LET (Lidocaine, Epi 1:1000, Tetracaine)
• EMLA (Lidocaine + Prilocaine), occlusion
• ELA-Max/LMX (Liposomal Lidocaine), no
occlusion
Topic V 300 Answer
Go To Single
Jeopardy

64. This high potency ultra-short
acting opioid is on the horizon as
a sedative/analgesic
Topic V 400 Question

65. Topic V 400 Answer
Go To Single
Jeopardy
What is remifentanil?

66. FINAL JEOPARDY
Analgesia

67. Ketamine can be used in this dosing
regimen as a sub-dissociative drip for
pain control (recently discussed on EM-
RAP for trauma patients).

68. FINAL JEOPARDY
What is 0.3 mg/kg IV bolus
then drip of 0.3 mg/kg/hour
IV?

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