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56 Cards in this Set
- Front
- Back
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What are 3 things that can go wrong during the premedication phase of anesthesia?
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1) Wrong drug
-errors in drawing up drugs -mislabeling -Not reading label 2) Wrong dose -decimal points -kg vs lbs 3) Incompatible drugs |
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What are 4 general issues that can occur during induction?
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1) Drug administration
2) Apnea** 3) Excitement 4) Muscle rigidity, fasciculations -extensor rigidity w/ propofol |
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What are 4 examples of how drugs can be administered wrong?
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1) perivascular instead of IV
2) too fast, too slow 3) Wrong drug, amount 4) unexpected response -exaggerated -insufficient |
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What are 5 examples as to why you may not be able to have visualization when intubating an animal?
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1) Mass
2) Blood 3) Secretions 4) Regurgitated material 5) species e.g. rabbits |
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What are 6 things you need to be prepared for intubation?
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1) Stylets
2) Suction 3) Swabs 4) Capnography 5) Endoscopy 6) Tracheostomy kit |
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How can you prevent laryngospasm?
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Topical lidocaine
-have to wait 20s |
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What are 4 species prone to laryngospasm?
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1) Cats
2) Sheep 3) Goats 4) Pigs |
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What are 2 reasons that you may have regurgitation during intubation?
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1) Full stomachs
-trauma, emergencies -term pregnancy 2) Drug induced -etomidate- regurgitation right when losing consciousness |
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What are 7 questions to ask yourself if you think that you have esophageal intubation?
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1) Can you visualize tube b/w arytenoid cartilages
2) Can you seal the airway (cuff inflation) 3) Is patient staying asleep? 4) Problems w/ hypoxia? 5) Is stomach dilating? 6) Does reservoir bag move synchronously w/ ventilation efforts? 7) do you have a normal capnograph? |
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What are 2 risks of overinflating an endotracheal tube?
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Tracheal injury
Tracheal rupture (Cats) |
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What do you do if you accidentally poor isoflurane into a sevoflurane vaporizer?
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Drain it, rum oxygen through it with machine wide open to dry out residual inhalant
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Why should you not be able to turn on two vaporizers at once?
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Usually have two pins that won't allow them to both turn on at the same time
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What actually kills an animal when there's an increased intrathoracic pressure?
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Results in venous collapse---> cardiovascular collapse--> death
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What are 3 general things to check if anesthesia doesn't seem to be working properly?
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Oxygen on?
Vaporizer on? Gas in the tank? -running on empty -filling vaporizer during the procedure |
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**What is the most common anesthetic complication?
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Hypotension
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Hypotension is defined as systolic < ______ mmHg or MAP < _____ mmHg.
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Systolic < 90 mmHg
MAP < 60 mmHg |
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BP= _____ x ______
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CO x SVR
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CO= ______ x _______
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SV x Hr
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What are the 4 steps to treating hypotension***?
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1) Normalize HR & rhythm
2) Assess anesthetic depth -decrease if possible 3) Fluid bolus 4) Inotropes/ vasopressors |
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What is bradycardia in a horse? Large breed dog? toy breed dog? cats? ruminants?
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Horse <25 bpm
Large breed dogs: < 60 bpm Toy breed dogs < 90 bpm cats < 100 bpm Ruminants < 80 bpm |
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What are 3 causes of bradycardia?
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1) Drugs
2) Hypothermia 3) Procedures -ophthalmic -GI |
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What is the treatment for bradycardia?
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Anticholinergics
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What are 7 causes of tachycardia?
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1) Too light?
2) Pain 3) Shock/ hypovolemia/ hypotension 4) Hypercarbia 5) Hypoxia 6) Hyperthermia 7) drugs |
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What are 2 ways to treat tachycardia?
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1) Correct underlying cause
2) Pharmacology |
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What are the 3 most common tachyarrhythmias seen during anesthesia?
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1) Sinus arrhythmia
2) Premature atrial contractions 3) Premature ventricular contractions -need to distinguish from ventricular escape beats -significance depends on frequency |
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What are 2 possible respiratory complications?
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1) Apnea- bradypnea- hypoventilation
2) Hypercapnia |
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Hypercapnia is defined as PaCO2> _____ mmHg and you usually treat hypercapnia when PaCO2> ____ mmHg.
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45 mmHg
60 mmHg |
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Norma saturation is SpO2 of ______, mild desaturation is SpO2 _____ and severe desaturation is SpO2_______.
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Normal: 95-100
Mild: 90-95 Severe < 90 |
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What are the 'perfect' values for SpO2, PaO2 and mucous membranes?
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SpO2 100
PaO2 > 100 mmHg No cyanosis |
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What are the 'normal' values for SpO2, PaO2 and mucous membranes?
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SpO2> 95%
PaO2 80-100 mmHg No cyanosis |
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What is the SpO2 and PaO2 of mild hypoxemia? Cyanosis?
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SpO2: 90-95%
PaO2: 60-80 mmHg No cyanosis |
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What is the SpO2 and PaO2 in an animal with severe hypoxemia? Cyanosis?
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SpO2 < 90%
PaO2 <60 mmHg Cyanosis present |
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What are 5 causes of hypoxemia?
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1) Decreased FiO2
2) Hypoventilation 3) Diffusion impairment 4) Ventilation/ perfusion (V/Q) mismatc 5) Intra- and extra-pulmonary shunting |
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V/Q mismatching has the greatest impact on ______ with little impact on end tidal O2 and CO2.
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Oxygenation
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What are 4 causes of tachypnea (hyperventilation)?
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1) Hypoxia
2) Inadequate anesthetic depth 3) Pain 4) Hyperthermia |
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What are 4 causes of airway obstruction?
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1) Secretions
2) Kinking of ET tube 3) Brachycephalic syndrome 4) Masses, hematomas |
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What is the most common temperature complication associated with anesthesia?
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Hypothermia
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What should you do to your anesthesia settings if your patient is hypothermic?
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Decreased MAC so decreases anesthetic requirements
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What is the most effective supportive method employed for hypothermia?
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Bair hugger
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What is malignant hyperthermia?
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Rare, fatal genetic defect
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Regurgitation/ aspiration is a common problem with _____.
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Ruminants
-regurgitation= neutral pH so not an issue |
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Why is regurgitation/aspiration a problem with monogastrics?
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Have gastroesophageal reflux so have an acidic pH which can cause scarring/ strictures
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What are 2 things you can do when an animal regurgitates?
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Protect airway- inflate cuff
suction, lavage |
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Does movement= awareness?
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No
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What are 2 common causes for a patient becoming too light during anesthesia?
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1) Failure to recognize changing depth of anesthesia
2) Sudden changes in level of stimulation |
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What are 4 ways that you should respond to an patient that is too light/ becoming aware?
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1) Turn up vaporizer
2) Turn up O2 flow 3) Support ventilation 4) Injectable anesthetic supplementation -Opioids -Propofol -Ketamine |
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What are the 3 V's of anesthesia?
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Ventilate, ventilate, ventilate!!
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What are 2 postoperative causes of airway obstructions?
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1) Brachycephalics
2) Post airway surgery (swelling, edema) |
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When you notice an animal experiencing delirium post op, what should you consider? What can you do to minimize this?
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Is it pain or delirium
-treat for pain first -tranquilziers sedatives |
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When you notice an animal experiencing delirium post op, what should you consider? What can you do to minimize this?
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Is it pain or delirium
-treat for pain first -tranquilziers sedatives |
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What are 4 things to evaluate if you have a slower than expected recovery?
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1) Hypothermia?
2) Hypoventilation? 3) Hypoglycemia? -issue in neonates & toy breeds 4) Occult hemorrhage? |
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What are 4 things to evaluate if you have a slower than expected recovery?
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1) Hypothermia?
2) Hypoventilation? 3) Hypoglycemia? -issue in neonates & toy breeds 4) Occult hemorrhage? |
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What are 3 components of supportive therapy that can be applied to an animal with a delayed recovery?
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1) Fluids
-diuresis may aid elimination of drugs, metabolites 2) glucose 3) Supplemental warming |
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What are 3 components of supportive therapy that can be applied to an animal with a delayed recovery?
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1) Fluids
-diuresis may aid elimination of drugs, metabolites 2) glucose 3) Supplemental warming |
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If a patient wakes up from anesthesia blind, what should you ask the anesthesiologist?
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Were there periods of hypoperfusion/ hypoxia to retinas?
-high metabolic activity so very sensitive to hypoxia Cerebrovascular accident? |
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If a patient wakes up from anesthesia blind, what should you ask the anesthesiologist?
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Were there periods of hypoperfusion/ hypoxia to retinas?
-high metabolic activity so very sensitive to hypoxia Cerebrovascular accident? |
