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24 Cards in this Set
- Front
- Back
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ASA Physical Status Classification System
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1) a normal healthy patient
2) a patient with mild systemic disease 3) a patient with severe systemic disease 4) a patient with severe systemic disease that is a constant threat to life 5) a moribund patient who is not expected to survive without the operation 6) a declared brain-dead patient whose organs are being removed for donor purposes |
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Typical ASA status of dogs in junior surgery lab
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Status #1
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Respiratory tract =
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nose to lungs
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Ventilation
-measured by -why |
PaCO2
-increased CO2 ---> increased H+ ions --carotid and aortic bodies sense CO2 changes and send afferent signals through CN IX & X ---increased ventilation |
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Oxygenation
-measured by -depends on |
PaO2
-depends on: PAO2 |
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Alveolar gas composition depends on:
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-atmospheric pressure
-body temp -FiO2 -PaCO2 -metabolic state |
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Pulse oximetry
-use |
-indirect monitor of PaO2
-want saturation above 90% |
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Hypoxemia
-causes |
-decreased FiO2
-diffusion impairment -V/Q mismatch -shunt -hypoventilation (impact on O2 and CO2) |
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Hypoxemia
-causes for decrease in FiO2 |
-altitude
-empty tanks -flowmeter off -wrong flowmeter (wrong gas) -not plugged into fall -etc. |
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Hypoxemia
-discuss diffusion impairment |
-rare in small animals
-usually does not cause hypoxemia in dogs and cats |
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V/Q mismatch
-define |
-Ventilation / Perfusion
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V/Q mismatch
-extreme form |
-shunt
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V/Q mismatch
-causes |
-positioning
-gravity -drugs -etc. |
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V/Q mismatch is a problem in what animals?
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-horses
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Hypoventilation
-frequent cause -causes |
-drug related*
-opioids -pleaural disease (pneumothorax) -NMB -Myasthenia gravis -other neuropathies, myopathies -fatigue |
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Hypoventilation
-how to resolve perioperatively |
-IPPV
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Brachycephalic breeds
-reason to keep calm |
-high flows increase airway resistance ---> greater airflow restriction
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Brachycephalic breeds
-ultimate effect of airflow restriction |
-hypoventilation
-desaturation |
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Brachycephalic breeds
-problems with prep |
-danger with sedation
-difficult at intubation -danger at extubation |
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Possible dangers from extubation
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-obstruction common
-prop mouth open? -supplement O2 Prepare for reintubation (drugs, laryngoscope, endotracheal tube) |
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Neuromuscular blockade
-MOA |
-compete for acetylcholine at nicotinic muscle receptors (muscle, NMJ)
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Neuromuscular blockade
-describe |
Weak to complete paralysis
-monitor neuromuscular function with nerve stimulation Ensure ability to ventilate prior to recovery (ETCO2. ventilometer, ability to generate neg. pressure |
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Aspiration pneumonia
-define |
-aspiration of foreign material into lungs
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Aspiration pneumonia
-can be due to |
-regurgitation
-post op nausea/vomiting/regurgitation |
