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46 Cards in this Set
- Front
- Back
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Respiratory
Rate and Rhythm |
Normal 10-30 rpm in awake dog
Normal 25-40 rpm in awake cat Normal 80-20 rpm in anesthetized dog or cat Less than 8 rpm - too deep |
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Tidal Volume
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Volume of air inspired with each breath - calculated as 10 ml/kg
anesthesia decreases tidal volume size of bag - 5 x Tidal volume = bag size in mls (green bag) |
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Tachypnea:
Dyspnea: Apnea: |
fast respirations
difficult respirations no respirations |
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Normal Heart Rate
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70-140 bpm in awake dog
110-220 bpm in awake cat |
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Bradycardia - slow HR
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<70 bpm - dog
< 100 bmp cat |
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Pulse deficits : listen and pulpate at the same time
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Femoral and lingual artery(small animal)
Facial, digital, coccygeal arteries (large animal) |
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Capillary Refill Time (CRT)
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Normal < 2 seconds dog, cat, horse
sites: Conjunctiva, oral mm, vilva/prepuce |
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Mucous Membrane Color:
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Normal: pink (sometimes pigmentated)
Abnormal: blue/purple= cyanosis(decreased O2) Brick Red = endotoxic shock Pale white or grey = poor prefusion (shock) no blood |
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Palpebral reflex
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use index finger to tap medial canthus of eye: will blink
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Pinnal reflex
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Stimulate outer ear canal by lightly touching hair in ear canal or blowing in near pinna will move - first to disappear, last to return
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Respiratory
Rate and Rhythm |
Normal 10-30 rpm in awake dog
Normal 25-40 rpm in awake cat Normal 80-20 rpm in anesthetized dog or cat Less than 8 rpm - too deep |
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|
Tidal Volume
|
Volume of air inspired with each breath - calculated as 10 ml/kg
anesthesia decreases tidal volume size of bag - 5 x Tidal volume = bag size in mls (green bag) |
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Tachypnea:
Dyspnea: Apnea: |
fast respirations
difficult respirations no respirations |
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Normal Heart Rate
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70-140 bpm in awake dog
110-220 bpm in awake cat |
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Bradycardia - slow HR
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<70 bpm - dog
< 100 bmp cat |
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Pulse deficits : listen and pulpate at the same time
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Femoral and lingual artery(small animal)
Facial, digital, coccygeal arteries (large animal) |
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Capillary Refill Time (CRT)
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Normal < 2 seconds dog, cat, horse
sites: Conjunctiva, oral mm, vilva/prepuce |
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Mucous Membrane Color:
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Normal: pink (sometimes pigmentated)
Abnormal: blue/purple= cyanosis(decreased O2) Brick Red = endotoxic shock Pale white or grey = poor prefusion (shock) no blood |
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Palpebral reflex
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use index finger to tap medial canthus of eye: will blink
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Pinnal reflex
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Stimulate outer ear canal by lightly touching hair in ear canal or blowing in near pinna will move - first to disappear, last to return
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Jaw Tone:
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Pull down on mandible: feel for resistance
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Pedal:
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Toe pinch Drive your thumb nail into patients nail bed: will withdraw paw ( go between web)
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Corneal:
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Use index finger to lightly tap on cornea: eyelids will close. Usually only used to confirm patient is deceased.
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Stages of Anesthesia:
Stage 1: From start of anesthetic administration to loss of consciousness(premed) |
Resp: regular
Pupils: responsive to light Eye position: central Reflexes: all present |
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Stage 2: Excitatory stage (do not want animal in this stage)
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Resp: irregular, breath holding, hyperventilation
Pupils: dialated Eye position: central (possible nystagmus)movement Reflexes: all present (possible exaggeration) Tachycardia Chewing/yawning/vocalization vommiting &/or defecation |
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Stage 3:
Plane 1: Restraint anesthesia |
Resp: regular, increased rate and depth, increase in response to pain
Pupils: responsive to light Eye position: central moving toward ventro-medial Reflexes: all present; starting too lose palpebral; laryngeal gone Heart: mild decrease in blood pressure and heart rate |
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Plane 2: Surgical plane (spay's neutors)
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Resp:regular rythum and rate; decreased tidal volume(shallower breath
Pupils; slightly dilated Eye position: ventro-medial Reflexes: laryngeal gone, palpebral fome, jaw tone gone, Pedal diminished or absent, corneal diminished or absent Heart; mild decrease in blood pressure and heart rate |
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Plane 3: Orthopedic plane (cutting bone)
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Resp:slow and shallow
Pupils: moderately dilated;PLR diminished Eye position: moving central or central Reflexes: diminished or absent Heart: decreased output, weak pulse, delayed CRT Reflexes: diminished or absent Heart: decreased output, weak pulse, delayed CRT |
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Plane 4: Too deep
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Resp: irregular, jerky, shallow
Pupils: dialated and fixed (brain hypoxia) Eye position: central Reflexes: absent Heart: pale mm,prolonged CRT, weak pulse Muscles flaccid (no tone) Inform Vet Lighten anesthesia - turn vaporizer off or down - ventilate at 8-12 rpm |
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Stage 4 Terminal Stage
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Respiratory arrest
Cardiac arrest; 60 - 90 seconds after resp. arrest Begin emergency procedures: Turn off vaporizer, flush system 3x with pure O2 Begin CPR, Epinephrine |
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Emergency Drugs:
Doxapram:(doxopram hydrocloride) |
Analeptic agent- stimulates CNS and respiration
any route (drop under tounge, put in trachia) Iv fastest and preferred increases respiratory rate and increased tidal volume Conc. 20mg/ml Cats and Dogs: 1-5mg/kg May repeat Indication: respiratory arrest |
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Epinephrine: (Epinephrine hydrochloride
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Catecholamine - stimulates sympathetic nervous system(fight or flight)
SQ,IM,IV,PO, intercardially Increases systolic and diastolic blood pressure, cardiac acceleration and Myocardial contraction Dogs: 0.05-0.5ml Cats: 0.05 -0.5ml IT or IV Indication: Cardiac Arrest (also used for allergic reaction) Contraindicated when heart is beating; can cause trchycardia leading to Gatla arrhythmia |
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Naloxone
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Specific antagonist for narcotics
Increases tidal volume and causes panting 0.002-0.02 mg/kg IV, IM |
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Sodium Bicarbonate:
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Treatment of acidosis either respiratory or metabolic
IV only ' Base |
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Monitoring the Anesthetized Patient
Manual Methods: |
Esophageal stethoscope
cheap simple to use can be attached to audible monitor ECG Pulse Oximeter >95 Doppler blood pressure monitor Capnography (CO2 monitor) measures the difference between expired and inspired CO2 Used ot evaluate patient status, CPR efforts, soda lime |
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Signs of Anesthetic Overdose:
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Respiratory < 8rpm, decreased tidal volume; irregular or exaggerated respirations
Cardiac; bradycardia, prolonged CRT, cyanoticmm, weak pulse Hypothermia -big surgery, open abdomen keep animal warm Pupils; decreased PLR, dialated pulpils Reflexes greatly diminished or absent |
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Recovery from General Anesthesia: Requires elimination of anesthetic drig from the brain
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Exhalation: gas anesthetics are exhaled chemically unaltered
Redistribution: anesthesia leaces blood and enters another tissue (fat) |
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Liver metabolism: most injectable drugs are biotransformed by the liver before being excreated
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Enzyme dependent
Temperature dependent Hydration dependent If liver or kidney failure drugs are not broken down |
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Signs of Recovery
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REspiratory Rate and depth increase
Eyeballs rotate to next shallower stage (central ventromedial central) Reflexes return in reverse order of loss(corneal,palpebral, jaw tone, pinnal, pedal, laryngeal Shivering Tongue movement, chewing Movement, lifting of head, atempts to stand |
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IV Catherterization: reasons
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Allows administration of blaanced electrolyte solution or saline during surgery
Allows reapid and easy administration of emergency drigs Constant infusion of anesthetics, analgesics, electrolytes, or drugs For drugs that can be irritating ig injescte in perivascular(vein)i.e. thiopental |
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Catheter Types
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Over the needle
Butterfly through the needle - juglar |
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Risks or Catheterization
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Introduction of air (emboluism)
Broken catheter tip leading to catherter embolus Accidential overhydration leading to edema Catheter leading to induced sepsis - poisioning of bloodstream Overrapid administration of drugs (best if given slowly) |
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Fluid administration rates
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Maintenance Fluids
Large dogs 2ml.kg/hr Small dogs/cats 4ml/kg/hr |
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Fluids given during anesthesia
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>7-10 kg 10-15 drips/ml catheter
<7-10 Kg 60 drips/ml catheter (more acurate-easier to measure) |
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Standard fluid infusion rate
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5-10 ml/kg/hr
1st hr 20 ml / hr maintence 10 ml/hr Cats shouldn't exceed 20 ml/kg/hr unless in shock If excessive blood loss occurs ensure that 3 mls of fluids are given for every 1 ml of blood lost |
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Shcok pateints
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Rapid flow rates
up to 90ml/kg for 1st hr in dogs up to 50 ml/kg for 1st hr in cats Often 10-20 ml/kg bolus given and patient re-evaluated carefully monitor total amount of fluids being given |
