Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
30 Cards in this Set
- Front
- Back
|
What should be considered before performing anaesthesia? |
-Pre - op assessment -Pre - op consent -Anaesthetic risk classes |
|
|
What is pre - op information for owners? |
-Instructions given to owner to enable them to prepare their pet for anaesthetic -Verbal vs written |
|
|
What information should pre - op instructions contain? |
-Procedure / surgery
-When to withhold food/ water -Appointment time -Other relevant information |
|
|
What is pre - op consent? |
-Informed -Discussed risks both surgically & specifically related to the anaesthetic -Most practices will have a standard form -Balance between making them user - friendly whilst still making the risk clean -Verbal explanation of the form will make a huge difference |
|
|
What are the pre - op assessment aims? |
-To check that the owner, nurse & vet are all clear about exactly what procedure is to be performed -To gather all relevant patient history & information -To check body systems specifically affected by anaesthesia & general health -To categorise the risk of anaesthesia to the patient |
|
|
What should the pre - op assessment include? |
-Signalment (age, sex, species,breed, weight) -History (previous / ongoing condition) -Physical examination -Pre - anaesthetic blood tests -Further diagnostic tests such as ECG, ultrasonography |
|
|
What does the physical pre op examination include? |
- General body condition -Cardiovascular; H.R, pulses, mm, CRT -Respiratory; R.R, upper airway conformation -Temperature -Hydration status - Mentation / behaviour (any CNS problems, & also assess temperament) |
|
|
Why are pre anaesthetics offered as an additional protocol for some surgery & anaesthetics? |
-Will identify individual animals that do have early signs of an condition/ disease such as rental failure -The protocol may be changed to reduce the anaesethetic risk associated with the identified problem |
|
|
What bloods are normally tested in a pre - anaesthetic blood test? |
-RBC count (PCV) = Oz carrying capacity -ALT/ ALP = Liver? -Urea / creatinine = Kidney? -Glucose = Diabetes / stress -Albumin / TP = low levels are a potential anaesthetic risk |
|
|
What factors can increase the anaesthetic risk? |
-Conditions affecting O2 uptake / transport -Inability to metabolise & excrete the drugs -Toxins predisposing to shock & cardiac arrhythmias -Hypothermia |
|
|
What has been developed to understand the risks associated with anaesthesia and how these can be classified? |
-American Society of Anesthesiologist (ASA) -Identifies the degree of risk, the condition of the animals and examples for each class/ category |
|
|
What is class I & how is it identified on the ASA scale associated with anaesthesia? |
-Minimal risk -Normal healthy animal -No underlying disease -Spay, castration -Radiographs for hip dysplasia |
|
|
What is class II & how it is identified on the ASA scale associated with anaesthesia? |
-Slight risk -Animals with slight to mild systemic disturbances -Animals able to compensate -No clinical signs of disease -Neonates, geriatrics -Fracture without shock -Well controlled diabetes |
|
|
What is class III & how it is identified on the ASA scale associated with anaesthesia? |
-Moderate risk -Animals with moderate systemic disturbances -Mild clinical signs -Anaemia -Low grade renal disease -Low grade heart murmur |
|
|
What is class IV & how it is identified on the ASA scale associated with anaesthesia? |
-High risk -Animals with pre - existing systemic diseases or disturbances or severe nature -Dehydration, shock -Uraemia =a raised level in the blood of urea and other nitrogenous waste compounds that are normally eliminated by the kidneys -Pyrexia -Uncompensated cardiac disases |
|
|
What is class V & how it is identified on the ASA scale associated with anaesthesia? |
-Grave risk -Life - threatening disease or disturbances -Includes all moribund animals not expect to survive 24 hours -Severe GDV -Advanced cardiac disease -Severe shock
|
|
|
What conditions can be considered special anaesthetics risks and have an increased difficulty? |
-Geriatrics -Neonates -Obese animals -Hepatic disease -Renal disease -Pyometra -Cardiac disease -Brachycephalics - Caesarian -Limb fractures -Exotics -Gastro Dilation & Volvulus sydrome |
|
|
Why do geriatric animals have an increased difficulty in anaesthesia? |
-Increased risk of poor organ function |
|
|
Why do neonates have an increased difficulty in anaesthesia |
-Increased risk of hypothermia & over hydration -Liver may not metabolise drugs efficiently -More difficult to place iv catheter & intubate |
|
|
Why do obese animals have an increased difficulty in anaethesia? |
-At risk of overdose with drugs (as much of b.w is fat with a very poor blood supply & should not e included in dose calculations
-Fat within chest impairs respiratory function -Doses should be calculated using an estimated lean b.w |
|
|
Why do brachcephalics have an increased difficulty in anaesthesia? |
-Risk of upper airway obstruction -Abnormally high vagal tone; slows HR, low B.P |
|
|
Why do animals with cardiac disease have an increased difficulty with anaesthesia? |
-Potential for arrhythmias is greater under anesthesia -Mild murmurs should cause few problems as long as the cardiac function is adequate -Decompensated heart disease provides a real challenge as it may be very difficult to get enough O2 in via the damaged lungs & circulation |
|
|
Why do animals with respiratory disease have an increased difficulty with anaesthesia? |
-Upper airway disease may reduce ease of intubation -If sedated, risk of obstruction may be greater as they unable to lift their head or change position -Lower respiratory disease will affect ability to exchange O2 |
|
|
Why do animals with hepatic disease have an increased difficulty with anaesthesia? |
- Many drugs require metabolism by the liver b4 excretion, so if function is impaired excretion of the drug may be slow -Clotting times may be increased |
|
|
Why do animals with renal disease have an increased difficulty with anaesthesia? |
-Excretion if many drugs requires a functional kidney -Dehydration may be present -In cases of urinary obstruction excretion of drugs via kidneys is impossible until the obstruction is relieved -Hyperkalaemia will cause bradycardia |
|
|
Why do animals having a caesarian have an increased difficulty in anaesthesia? |
-Dam: pressure on chest from abdominal contents -Offspring: anaesthetic agents cross placenta & may depress respiration & cardiovascular function even after birth |
|
|
Why do animals with a pyometra have an increased difficulty in anaesthesia? |
-Often toxins & bacteria cross the uterine wall & enter the blood stream, symptoms of shock -Kidneys are affected by both toxins & low B.P -Metabolic acidosis is common -Arrhythmias may develop due to toxins effect on heart |
|
|
Why do animals with limb fractures have an increased difficulty in anaesthesia? |
-Significant pre - op pain will be present; the fracture will need careful handling -Wherever trauma severe enough to cause a limb fracture is present, there is a high risk of pulmonary contusions which may impair respiratory function |
|
|
Why do animals with GDV have an increased difficulty in anaesthesia? |
-The enlarged stomach will compromise respiration & impair venous return to the heart from the abdomen -The circulation is quickly affected producing signs of shock -Toxins released from injuried stomach wall tissues can cause arrhythmia in heart & renal failure |
|
|
Why is the anaesthesia risk increased in difficulty in exotic animals? |
-IV assess often difficult, harder for administration & fluid support -Intubation may not be possible Different species react differently to each class of drugs & so need to understand the physiology of the animal -Aquatic reptiles can hold their breath for long enough to make inhalational agents noneffective -Fish need anaesthetics which dissolve in water |
