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31 Cards in this Set
- Front
- Back
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What is haemorrhage? |
-Blood loss during surgery causes hypotension & ultimately hypovolaemic shcok |
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What are the signs of haemorrhage? |
-Shed of blood at the surgical site -Tachycardia -Pallor -Weak pulses |
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What fluids should be administered during any surgical procedure? |
-Crystalloid -10 ml/ kg / hour -Considered sufficient to cover losses during normal surgical conditions |
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What is the primary goal of fluid therapy? |
-O2 delivery |
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What factors does fluid replacement depend on? |
-Estimated loss of blood -Speed of blood loss -Amount of haemoglobin |
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How can the loss of blood be calculated by? |
- weigh swabs; 1ml of blood = 1g in wt -Suction bottle contents; volume of flush in mls (A) & volume of the suction bottle (B) -B -A = volume of blood -Other losses; estimated blood lost on drapes, under patient & on the floor |
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What is the normal blood volume for dogs? |
- 80 - 90 ml/kg |
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What is the normal blood volume for cats? |
- 60 - 70 ml /kg |
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What is the calculation for the % blood lost? |
-Total blood lost (ml) divided by normal blood volume (ml) X 100 |
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What fluid therapy is administered if under 10% blood is lost? |
-Crystalloids such as Hartmanns solution |
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What fluid therapy is administered if over 10% blood is lost? |
-Colloids are infused |
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What fluid therapy is administered if over 20% of blood is lost? |
-Whole blood |
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What is hypotension? |
-Low blood pressure - Mean arterial < 600mmHg (millimeters of Mercury)
-Normal BP in dogs cats & horses = 90 - 120mmHg |
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Hypotension is common under anaesthesia due to what? |
-Anaesthetic drugs -Blood & other fluid losses |
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How is hypotension suspected? |
-Poor palpable pulse quality -Presence of an tachycardia |
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How is hypotension identified? |
-Measuring blood pressure |
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What are the causes of hypotension? |
-Excessive depth of anaesthesia -Marked blood loss -Inappropriate tachycardia or bradycardia |
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What is the treatment for hypotension? |
-Depends on the underlying causes -1st check the depth of anaesthesia, adjust if needed -Infuse IVFT |
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What are arrhythmias? |
-Irregularities in the heart rhythm may reduce cardiac output & cause hypotension -If left untreated some arrhythmias may deteriorate into more dangerous forms; ventricular fibrillation |
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What are the causes of arrhythmias? |
-Inadequate or anaesthetic overdose -Electrolyte & blood gas abnormalities -Pre - existing heart conditions -Some medical conditions e.g GDV |
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What is the treatment for arrhythmias? |
-Depends on the primary diagnosis with an ECG -Often ensuring adequate levels of anaesthesia & ventilation restores normal rhythm |
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What are the considerations for immediate post operative care? |
-Recovery period is 1 of the most high risk periods of anaesthesia due to poor monitoring -Allow the patient to recover in a quiet, warm room where there is easy access to emergency equipment |
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What should be monitored during the immediate post operative care period & until fully recovered? |
- Heart & pulse rate -Respiratory rate -mm colour & CRT -Temperature -Pain -Urine output ( 1- 2 ml /kg / hour) -Reflex responses |
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What are the considerations for extubation? |
-The cuff should be left inflated until the tube is ready to be removed -Dogs should be extubated ONCE gag reflex has returned -Cats should be extubated BEFORE gag reflex returns -The tube should always be removed gently in a downward arc to avoid damage to the larynx or trachea |
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What considerations are there for the removal of monitoring equipment? |
-Monitoring should continue until the patient is fully conscious, most equipment will need to be removed B4 such a time -Removed at extubation -Purse string sutures must be removed immediately after surgery is completed |
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What are the post operative considerations following myelography? |
-Maintain normal body temperature -Keep head raised when possible to prevent contrast media flowing intracranially; reduce the possibility of seizures -Monitor closely for seizures, have anti seizure drugs to hand -Maintain IV access -General nursing care for recumbent patient |
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What is the post operative care following head & neck surgery? |
-Treat as if myelography was performed -Following intra cranial surgery round the clock checks needed for 3 - 5 days -General nursing care of the recumbent patient |
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What type of IV catheters should never be used for indwelling? |
-Butterfly |
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What are the considerations when placing an IV catheter? |
-Gloves worn when placing -Once in place swab positioned between skin & catheter - Use chlorhexidine or povodine based cream can be placed around site -Place a 2nd swab over the catheter & bandage in place -Advisable to change peripheral catheter after 48 - 72 HOURS!! |
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What should be done to the IV catheter daily? |
-Change the dressing and inspect site for signs of phlebitis which can be indicated by erythema, oedema & heat over the site -Flush catheter with heparinised saline BID - QUID helps maintain patency |
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What should be done if there is suspicion of an infection around the catheter site? |
-The catheter should be removed |
