Anesthesia, Summer 09

Front 1

very minimal risk

Back 1

normal patient, no known underlying disease, elective surgeries

Front 2

slight risk

Back 2

slight to mild "systemic disturbances", things that the body can compensate for

neonates and geriatrics

elective procedures but with higher risk

Front 3

moderate risk

Back 3

obvious disease in patient

dehydrated, anemic, diabetes, thyroid, cushings, heart / liver / kidney disease, heart murmurs

Front 4

high risk

Back 4

obvious disease, severe condition

severe dehydration, GDVs, unregulated diabetes

Front 5

moribund

Back 5

highest risk, patient expected to die within 24 hours with or without surgery

Front 6

stage one anesthesia

Back 6

patients are conscious, have all reflexes, loopy, reduced pain sensitivity, fearful or anxious

increased <3/RR

Front 7

stage two anesthesia

Back 7

"excitement stage" - epinephrine release can occur

begins when animal is unconscious, but not to a surgical level

have reflexes, irregular breathing patterns, apnic

centrally located dilated pupils

stage ends when muscles relax and reflexes disappear

Front 8

stage three

Back 8

"surgical anesthesia"

broken up into four planes, once here they are surgically ready

Front 9

stage three, plane one

Back 9

mild procedures

eyes rotate ventral
pupils partially constricted
no pupillary light response
some reflexes could be present

Front 10

stage three, plane two

Back 10

light anesthesia - IDEAL PLANE

shallow, regular RR
<3 rate / BP decrease
weaker pulse
MM color / CRT slow
all reflexes gone

eyes centrally located, pupils slightly dilated

Front 11

stage three, plane three

Back 11

deep anesthesia

used briefly for orthopedics in certain parts of surgery

<3 rate / BP all down

pupils central and dilated

Front 12

stage three, plane four

Back 12

dangerously deep

<3 rate / BP VERY low
if not apnic, abdominal muscles will assist in breathing
pupils central and HUGE

lifesaving techniques performed here

Front 13

stage four

Back 13

death

apnic, circulatory collapse, going through process of dying, euthanasia stage

Front 14

normal systolic BP

Back 14

90-140 mmHg

Front 15

normal diastolic BP

Back 15

60-90 mmHg

Front 16

normal mean arterial pressure (MAP)

Back 16

determines perfusion

70-105 mmHg

Front 17

MAP guidelines - femoral pulse

Back 17

if felt, MAP is >60mmHg

Front 18

MAP guidelines - dorsal pedal pulse

Back 18

if felt, MAP is >80mmHg

Front 19

MAP critical low

Back 19

60+ mmHg

must be maintained for kidney, myocardium, and brain perfusion

Front 20

MAP critical high

Back 20

250-280+ mmHg

at risk for retinal detachment, hemmorhaging, IC edema, renal failure, LV hypertrophy, <3 murmurs

Front 21

blood pressure measurement

direct method

Back 21

placement of an arterial catheter

gives you continuous and accurate reading, but is dangerous and painful to place

Front 22

blood pressure measurement

indirect, oscillometric device

Back 22

DBP, SBP, MAH, HR

gives you a lot of info but shivering / movement / poor pulse can cause inaccurate readings

Front 23

blood pressure measurement

indirect, doppler ultrasound flow detector

Back 23

SBP, DBP, MAP, HR

pump up cuff until you no longer hear heart sounds, then release
first = systolic
second = diastolic

Front 24

pulse oximetry (SpO2)

Back 24

percent saturation of hemoglobin with oxygen

measure of the LUNGS to get oxygen into the blood

Front 25

normal Sp02

Back 25

96-100%

Front 26

PaO2

Back 26

amount of oxygen dissolved in the plasma; this is the oxygen used for perfusion

Front 27

hypoxemia conditions

Back 27

<80 mmHg PaO2
94.5% SpO2

Front 28

cyanosis conditions

Back 28

<50 mmHg PaO2
83.5%A SpO2

Front 29

low SpO2 reading causes

Back 29

anemia
dark pigmented skin
movement
thick area
poor lung function

Front 30

high SpO2 reading causes

Back 30

movement
dyshemoglobinemias
hypotension (cells get read ++)
vasoconstriction (cramped cells)

Front 31

ETCO2

Back 31

capnometry / end tidal carbon dioxide

measures amount of CO2 exhaled

indicator of ventilatory efficiency / perfusion - how well the tissues are eliminating Co2

Front 32

ETCO2 normal

Back 32

30-40 mmHg

Front 33

ETCO2 low

Back 33

45 mmHg

means that hypoventilation / excess rebreathing of carbon dioxide is occuring

Front 34

ETCO2 very low

Back 34

<25 mmHg

assuming normal heart function, the PaCO2 is low enough to cause vasoconstriction and decreased blood flow

Front 35

capnogram waveform
A-B

Back 35

baseline / inspiration (should be zero - pure oxygen coming in)

Front 36

capnogram waveform
B-C

Back 36

expiratory upstroke (mixing of gases in mouth and tube)

Front 37

capnogram waveform
C-D

Back 37

expiratory plateau

Front 38

capnogram waveform
D

Back 38

ETCO2 value (peak)

Front 39

capnogram waveform
D-E

Back 39

inspiration begins

Front 40

benefits of the capnogram

Back 40

validates ETCO2 value, visual assessment of airway, verify ETT placement, asses breathing circuit integrity