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63 Cards in this Set
- Front
- Back
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Four reasons an anesthetic record is important
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- Provides an overview of the situation
- Allows for trouble shooting specific problems with the practice or patient - Legal documentation - May be required by law |
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How does ketamine affect muscles?
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Produces muscle rigidity
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How does ketamine affect the eyes? (3)
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- Eyes stare straight ahead (due to muscle rigidity)
- Nystagmus - Consistent pupillary dilatation |
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How does ketamine affect reflexes?
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Preserves them
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During what level of anesthesia is the eye centrally placed?
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Light and deep
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During what level of anesthesia does the eye rotate?
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Medium anesthesia
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In which species does the eye rotate ventrally during medium anesthesia?
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- Ruminants
- Dogs - Cats |
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In which species does the eye rotate rostroventrally during medium anesthesia?
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Horses
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Which reflex is lost when anesthesia is too deep?
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Corneal
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Three instances in which the pupil dilates during anesthesia
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- When pain is felt (anesthesia too light)
- When progressing into overdosage (anesthesia is too deep) - Ketamine usage |
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Which reflex is unpredictable during anesthesia?
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Anal
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Four things that BP is dependent on
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- Output
- Peripheral resistance - Volume - Rate |
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Target heart rate range during anesthesia for dogs
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70 - 160 bpm
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Target heart rate range during anesthesia for cat
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100 - 220 bpm
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Target heart rate range during anesthesia for horses
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28 - 60 bpm
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What color does vasoconstriction turn mucous membranes?
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Pale or gray
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What color does septic shock turn mucous membranes?
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Bright, brick red
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When will cyanosis not show on the mucous membranes?
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If Hgb is low
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Normal blood volume in the dog
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90 ml/kg
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Normal blood volume in the cat
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50 ml/kg
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Normal blood volume in the horse
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75 ml/kg
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How much blood loss can be tolerated in an anesthetized patient before shock sets in?
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20 - 25%
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About how much blood will a surgical sponge soak up?
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12 - 15 mL
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Normal systolic BP of an anesthetized patient
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90 - 150 mmHg
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Normal diastolic BP of an anesthetized patient
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40 - 60 mmHg
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Normal mean BP of an anesthetized patient
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60 - 90 mmHg
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What is the minimum mean BP?
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60 mmHg to prevent cardiac collapse and provide renal perfusion
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What's a good blood pressure monitor for cats and small animals?
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Cardell Veterinary Monitor
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How do you directly measure blood pressure?
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Insert catheter with probe into artery
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How is hypotension defined?
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< 60 mmHg mean BP for >20 minutes
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4 ways to treat hypotension
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- Decrease anesthesia
- IV fluids - Hypertonic saline - Inotropic drug |
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Two inotropic drugs used to reverse hypotension
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- Dopamine
- Dobutamine |
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3 circumstances that a pulse oximeter might fail
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- Vasoconstriction
- Hairy areas - Movement |
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O2 saturation of blood in room air
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>90%
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O2 saturation of blood with supplied gas
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>95%
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5 causes of abnormal readings with pulse oximeters
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- O2 supply
- ET tube in one bronchus - Hypoventilation - Pneumothorax - Compression of probe site |
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Two ways to check to see if it's the pulse oximeter or patient malfunctioning
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- Check for pulse/heartbeat
- Try probe on self |
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Normal tidal volume for a small animal
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15 ml/kg
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Normal tidal volume for a large animal
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12 ml/kg
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Respiratory rate of a small animal
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10 - 12 breaths per minute
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Respiratory rate of a large animal
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6 - 10 breaths/minute
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Normal reading of expired CO2 on capnography
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35 - 45 mmHg
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What might >45 mmHg CO2 indicate?
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Hypoventilation
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What might <35 mmHg expired CO2 indicate?
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Hyperventilation (or large arterial alveolar gradient)
- May also indicate the animal is too lightly sedated and is feeling pain |
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Two things that a slow inspiration rate might indicate
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- Metabolic dysfunction
- Organ dysfunction |
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3 things that might cause a rapid inspiration rate
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- Patient too light
- Patient too deep - Drug causing it |
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When does end-tidal CO2 drop to zero?
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Cardiac arrest
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Two responses from the heart in build up of CO2
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- Increase HR
- Increase BP |
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Normal urine output for a dog or cat
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1 ml/kg/hr
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Normal urine output for a horse
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0.5 ml/kg/hr
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4 ways to treat hypoventilation
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- Increase ventilation
- Oxygenate - Decrease anesthetic level - Respiratory stimulant as last resort (doxapram) |
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What drug improves renal perfusion?
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Dopamine
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At what BP can the kidneys not auto-regulate its blood flow?
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<60 mmHg
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When should the NMJ be monitored?
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When NMJ blocking drugs are used
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Which class of neuromuscular blockers produces an all or nothing reflex response?
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Depolarizing (succinylcholine)
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Which class of neuromuscular blockers produces a fading response?
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Non-depolarizing relaxants (pancuronium)
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Two main things you monitor in a paralyzed patient
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- HR
- BP Increases mean they're being lightened |
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When should neuromuscular blockade only be used?
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- When ventilation is controlled
- When patient is unconscious and analgesic |
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Primary benefit to a neuromuscular blockade
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Improves muscle relaxation without producing deeper anesthesia
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3 causes of hypothermia
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- Exposure of viscera when body cavities are open
- Contact with cold surfaces - Extensive surgical preparation (excessive alcohol or saline usage) |
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4 problems with hypothermia
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- Can kill the patient
- Slows recovery - Decreases drug metabolism - Effects MAC value of inhalants |
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First sign of hyperthermia
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Rapid change in soda lime coloration
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What is malignant hyperthermia?
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A genetic malfunction of muscle metabolism which leads to excessive heat production and death (and bacon)
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