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60 Cards in this Set

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  • Back
A/S anesthetic emergencies
A/S anesthetic emergencies
What is the tech role in an anesthetic emergency?
Recognize signs of crisis and alert DVM, aticipate needed supplies, assist DVM
Define geriatric
has met 75% of life expectancy
define pediatric
3 months of age or younger
What are some patient factors that increase chance of anesthetic emergencies?
geriatric, pediatric, brachycephalic, sighthounds, obese, c-section
By how much should you reduce anesthesic doses in geriatric pt?
Will the recovery time be prolonged or shortened in a geriatric pt?
Why should you avoid prolonged fasting in a pediatric pt?
hypoglycemia could occur
What anesthetic method is preferred in a pediatric pt?
What is a major concern when anesthetizing a brachycephalic pt?
airway obstruction
What drug should not be given to sighthounds?
What dose rate should you use in an obese pt?
Dose according to ideal weight
What dose rate should you use w/ a c-section? What drugs should be voided?
lowest effective dose
avoid ketamine/diazepam and barbiturates
What a condition caused by inadeuate tissue perfusion leading to cellular hypoxia, metabolic acidosis, and ultimaely death?
What are 4 types of shock?
hypovolemic, vasculogenic, cardiogenic, obstructive
What is hypovolemic shock? Causes?
decrease in circulating blood volume due to loss of fluid - hemorrhage, v/d, diuresis, burns
What is vasculogenic shock? Causes?
vascular space is increased leading to decrease in blood pressure - sepsis, anaphalaxsis, drug overdose
What is cardiogenic shock? Causes?
failure of cardiac output - dysrhythmias, valvular insufficiency, congenital defects, heart muscle problems
What is obstructive shock? Causes?
restriction in blood flow - GDV, pneumothorax
What are some signs of shock?
tachycardia, hypotension, tachypnea, hypothermia, weakness, restlessness, depression, decr urine output, coma and pupil dilation, leads to cardiopulmonary arrest
When tx shock, __ & __ medsare not absorbed since perfusion is poor Therefore it is a good idea to place an IV catheter before anesthesia.
IM &/or SC
What meds are given in a shock situation?
rapid IV fluids, Dopamine/dobutamine (incr contraction of heart muscle), lidocaine/propranolol(arrythmias), glucocorticoids, antibiotics (sepsis), diuretics (oliguria/anuria)
What are some things to check w/ the trach tube when the pt won't stay anesthetized?
in traches? lg enough? cuff inflated? kinked? firmly attached to machine?
What are some things to check w/ the vaporizer when the pt won't stay anesthetized?
connected to O2? connected to delivery system? correctly set? filled?
What are some things to check w/ the delivery system when the pt won't stay anesthetized?
leaks? O2 flow adequate?
What are some things to check w/ the O2 tank when the pt won't stay anesthetized?
On? adequate supply in tank?
What are some steps to take to avoid common errors that cause the pt to not remain anesthetized?
proper checkout of machine, premeasure trach tube, check cuff, confirm correct placement of trach tube
What are some signs that a pt is too deep?
dilated pupils, no reflexes, bradycardia, delayed CRT, hypoventilation, no muscle tone
What are some possible equipment errors that could cause a pt to be too deep?
incorrect vaporizer setting or calibration, incorrect anesthetic in the machine
What are some possible pt factors that could cause a pt to be too deep?
hypothermia, shock, pre-ex dz, drug dosages or interactions
What are some signs of resp depression?
reduced resp rate (< 10 rpm), reduced tidal volume, +/- cyanosis
What are some causes of resp depression?
too deep, anesthetic drugs, surgical positioning (pressure on chest or diaphgragm), CNS/metabolic dz
How do you tx resp depression?
lighten plane, bag, correct surgical positioning, can use doxapram if above not effective
ALL uncorrected cases of inadeuate ventilation can lead to ___-> ___->___->
resp arrest -> cardiac arrest -> death
What are some signs of abnormal breathing patterns?
increased effort/abdominal breathing, decr movement of chest or reservoir bag, cyanosis, unusual sounds (rales, crackles, muffled)
What are some causes of unusual breathing patterns?
too deep, misplaced trach tube, obstruction w/i resp system (aspirated material, mucus), obstruction w/i equipment, dz of resp system
How do you tx abnormal breathing patterns?
*Check popoff and bag first*, lighten plane, ventilate and watch (if resistance, probably an obstruction, disconnect & aspirate trach tube
At what bpm is considered bradycardia in dogs? cats?
<60 bpm in dogs, <100 bpm in cats
What are some possible causes of bradycardia?
too deep, increased vagal tone, hypothermia, metabolic problems, late stages of hypoxia
What are some tx for bradycardia?
lighten plane, support ventilation, keep pt warm, admin of anticholinergic (atropine)
What bpm are considered tachycardia in lg, med, and sm dogs? In cats?
>120 bpm in large dogs
>140 bpm in med dogs
>150 bpm in sm dogs
>200 bpm in cats
What are some causes of tachycardia?
too light? hypotension, shock, inadequate ventilation, drug induced (ketamine,anticholinergics), hyperthermia
How is tachycardia tx?
adj plane, fluid support, support ventilation, check temp/maintain normothermia
What are some signs of cardiac dysrhythmias?
irreg pulse rate & pressure, pulse deficits, irreg heart sounds, prolonged CRT, weak pulse, apllor, cyanosis, abnormal ECG tracings
What are some causes of cardiac dysrhythmias?
too light ot deep, drugs sensitized heart to effects of epinephrine (halothane, barbiturates), anesthetic drugs, hypoxia, surgical manipulation
What are some steps to take to prevent cardiac arythymias?
pre-surg PE and labs, correct hydration & metabolic imbalances beforehand, knowledge of drug interactions & proper protocols, fluids for cardiac support, proper anesthetic depth monitoring
Tx for cardiac arythymias?
asses & adj plane, ventilation, fluid therapy
What are some signs of cardiac arrest?
resp arrest, no pulse, no heart sounds, dilated/fixed pupils, lack of bleeding at surg sites, blue/gray tissue color, ECG changes
What are some causes of cardiac arrest?
inadequate ventilation -> resp arrest, anesthetic overdose, hypothermia, metabolic problems, cardioascular disturbances
Tx for cardiac arrest?
CPR, epinephrine, after resuscitation dopamine/dobutamine, evaluate CNS status
What are some causes of vomitting/aspiration/regurgitation?
drugs, light anesthesia (stage 2), feeding before anesthesia, stress, excitement, surgical manipulation
What are some signs of aspiration?
cyanosis, bronchospasm (wheezing, can't breathe in), apnea, tachypnea, pneumonia or pulmonary edema
How can you prevent vomiting/regurgitation/aspiration?
fast 12 hours before anesthesia, avoid stress & excitement, acepromazine (antiemetic), rapid intubation
Tx for vomitting?
place in sternal recumbency, keep mouth open & tongue out, tilt table downward, afterward examine and cleanse pharynx
Tx for aspiration?
suction airway/lavage w/ sterile saline, administer O2, admin of aminophylline & steroids if bronchospasm occurs, broad spectrun ABs, steam or mist, coupage
What is metabolic hyperthermia?
hypermetabolic state induced by drugs that leads to uncontrolled incr in temp, metabolic crisis, and may lead to death
What are some predisposingfactors for malignant hyperthermia?
genetic, infection, drugs, environmental stress & excietment
What are some early signs of malignant hyperthermia?
hyperventilation, tachypnea, incr body temp, skin nd mm flushed, tachycardia nad dysrhythmias, BP first incr then dramatically decr, muscle rigidity
What are some late signs of malignant hyperthermia?
muscle rigidity, core body temp 108-110, hemolysis, acuteremal failure, hypoglycemia, cerebral edema, death
Tx for malignant hyperthermia?
remove triggering agent ifpossible, IV fluids, cool body, O2, diuretics, corticosteroids