Z A/s - Intro, Depth, And Monitoring

Front 1

Anesthesia - Intro, depth, and monitoring

Back 1

Anesthesia - Intro, depth, and monitoring

Front 2

What are the short term effects of exposure to waste anesthetic gases? How do they resolve?

Back 2

neurological effects that resolve when no longer exposed to the gases

Front 3

What are some long term effects of exposure to waste anesthetic gases?

Back 3

reproductive disorders, renal and hepatic damage, bone marrow abnormalities, chronic nervous system disfunction

Front 4

How is exposure to waste gases reduced?

Back 4

scavenging devices, perform prev maint on equip, alter/improve anesthetic techniques/protocols

Front 5

What are two hazards of compresed gas cylinders?

Back 5

Fire hazard, hazard of suddenly released pressure.

Front 6

Define anesthesia

Back 6

loss of feeling or sensation

Front 7

Define local anesthesia

Back 7

acts where applied, no effect on brain

Front 8

Define general anesthesia

Back 8

complete unconsciousness

Front 9

Define analgesia

Back 9

reflief from pain

Front 10

Define opioids

Back 10

*Synthetic* morphine derivative drugs that produce sedation and pain relief

Front 11

Define opiates

Back 11

*Natural* morphine derivative drugs that produce sedation and pain relief

Front 12

Define narcotic

Back 12

opioid or opiate that induces physical dependence and addiction

Front 13

Define neuroleptanalgesia

Back 13

combination of narcotic w/ a tranquilizer

Front 14

Define preanesthesia

Back 14

any drug given w/i 1 hour prior to induction

Front 15

Define induction

Back 15

admin of fast-acting drugs (usually IV) to cause loss of consciousness

Front 16

Define maintenance

Back 16

admin of drugs to keep pt under anesthesia

Front 17

Define surgical anesthesia

Back 17

depth of anesthesia under which surgical procedures can be safely and effectively performed (enough muscle relaxation) w/o pain to the pt

Front 18

Define tranquilizaton/sedation

Back 18

a state of calmness associated w/ some CNS depression

Front 19

What are 6 general reasons for using anesthesia?

Back 19

Restraint, examination, manipulation, general surgery, seizure control, euthanasia

Front 20

What are 5 goals of anesthesia?

Back 20

relax skeletal muscles, decrease protective reflexes, induce deep sleep, produce amnesia, and provide analgesia

Front 21

When checking to see if anesthesia goals were met one checks for signs of pain - what are 5 of these signs?

Back 21

inc heart rate, inc resp rate, gross movement, vocalization, abdominal pressing

Front 22

What is balanced anesthesia? How common is this technique?

Back 22

The practice of combining a general anesthetic w/ other drugs to minimize the neg effects of the general anesthetic - it is the most common anesthesia technique

Front 23

Does balanced anesthesia increase or decrease the amount of gen anesthetic needed?

Back 23

decrease

Front 24

What are four general considerations re: the pt to receive anesthesia?

Back 24

species variations, breed variations, indiv variation, and anesthetic risk

Front 25

What is species variation?

Back 25

the same anesthetic drug may have different effects in different species

Front 26

What is breed variation?

Back 26

same drug may have different effect in different breeds

Front 27

What dogs are vy sensitive to barbituates?

Back 27

sighthounds

Front 28

Do smaller breeds need a greater or lesser amt of anesthetic per pound of body wt in comparison to larger breeds? Why?

Back 28

greater amount because they have a higher metabolic rate

Front 29

Why do you leave brachycephalic breeds inubated as long as possible during recovery?

Back 29

They have a long soft palate and are suceptible to laryngospasm

Front 30

What can cause individual variation?

Back 30

poor condition, age, reproductive status, disposition

Front 31

Define "normal" anesthetic classification of risk

Back 31

animal is normal, apparently healthy

Front 32

Define "moderate" anesthetic classification of risk

Back 32

organ abnormality which does not affect overall health

Front 33

Define "poor" anesthetic classification of risk

Back 33

organ abnormality that does affect overall health - liver/kidney failure, pancreatitis

Front 34

Define "grave" anesthetic classification of risk

Back 34

organ abnormailty that makes anesthesia life threatening

Front 35

What are the two most important vital signs to look at when assessing the pts depth of anesthesia?

Back 35

resp rate and heart rate/rhythm/pulse

Front 36

As defined by our surg text, what is the normal resp rate for a normal awake dog? Cat?

Back 36

dog 10-30 rpm, cat 25-40 rpm

Front 37

What is a normal resp rate for an anesthetized dog or cat?

Back 37

8-20 rpm

Front 38

a resp rate of less than __rpm may indicate that the anesthesia is too deep

Back 38

less than 8 rpm

Front 39

What is tidal volume? Does anesthesia increase or decrease?

Back 39

volume of air inspired w/ ea breath - anesthesia decreases tidal volume

Front 40

What is a normal pulse in an awake dog? Cat?

Back 40

Dog: 70-140 bpm
Cat: 110-220 bpm

Front 41

A pulse of less than __bpm in a dog may indicate bradycardia or that the pt is too deep. In cat?

Back 41

<70 bpm in a dog
<100 bpm in a cat

Front 42

Where are two spots to take a pulse from in an anesthetized pt?

Back 42

femoral artery, lingual artery

Front 43

What are 5 monitoring methods for pulse/heart rate in an anesthetized patient?

Back 43

palpate, esophageal stethoscope, ECG, pulse ox, blood pressure monitor

Front 44

Other than HR and RR, what are two other vitals that can be used to assess depth of anesthesia?

Back 44

CRT and MM

Front 45

What is a normal CRT?

Back 45

< 2 seconds

Front 46

What are some abnormal MM colors and what are they associated with?

Back 46

blue/purple - cyanosis (dec O2)
brick red: endotoxic shock
pale white/grey: poor perfusion(shock)

Front 47

What is a palpebral reflex? How is it tested?

Back 47

Blinking - tested by touching the corner of the eye

Front 48

What is a pinnal reflex? How is it tested?

Back 48

ear/pinnae movement - lightly touch hair in ear canal or blow in canal

Front 49

What is a pedal reflex? How is it tested?

Back 49

movement of foot in response to sensation/pain - pich toes or between toes

Front 50

What is a corneal reflex? How is it tested?

Back 50

eye - touching cornea w/ sterile object and seeing if the pt blinks and withdraws eye into orbital fossa

Front 51

How is jaw tone used to assess anesthetic depth?

Back 51

pull down on mandible, want no resistance

Front 52

What are two other patient responses that can be used to assess depth of anesthesia?

Back 52

eye position, pupillary light response (PLR)

Front 53

When is stage one anesthesia seen?

Back 53

From start of anesthetic administration to loss of consciousness

Front 54

If resp are reg, pupils are resp to light, eyes are central, and all reflexes are present, what stage of anesthesia is pt in?

Back 54

Stage 1

Front 55

What is stage 2 of anesthesia also called?

Back 55

Excitatory stage

Front 56

If resp is irreg w/ poss breath holding or hyperventalation, pupils are dilated, eyes are central w/ poss nystagmus, reflexes are present & poss exaggerated, tachycardia, chewing/yawning/vocalization, & vomitting &/or diarrhea are present - what stage?

Back 56

Stage 2/excitatory stage

Front 57

What is another name for stage 3 plane 1 anesthesia?

Back 57

Restraint anesthesia

Front 58

At what stage is a pt in if the following are present: regular resp w/ inc rate & depth, resp pupils, eye central moving toward VD, laryngeal reflex gone, losing palpebral, other reflexes present, HR regular & strong

Back 58

Stage 3, plane 1

Front 59

What is another name for Stage 3, plane 2 anesthesia?

Back 59

surgical plane

Front 60

What stage? RR reg rhythm & rate, dec tidal vol, pupils slightly dilated, eyes ventral-medial, reflexes - laryngeal, palpebral, & jaw tone gone, pedal diminished or absent, mild dec in blood pressure and HR

Back 60

Stage 3, plane 2

Front 61

What is another name for stage 3, plane 3?

Back 61

Orthopedic plane

Front 62

What stage? Resp slow & shallow, pupils moderately dilated, PLR dimished, eyes central or moving central, reflexes all diminished or absent, dec cardiac output, weak pulse, delayed CRT

Back 62

Stage 3, plane 3

Front 63

What is another name for stage 3, plane 4 anesthesia?

Back 63

TOO DEEP!

Front 64

What stage? resp - irreg, jerky, shallow, pupils dilated & fixed, eyes central, reflexes absent, pale MM, prolonged CRT, weak pulse, muscles flaccid

Back 64

Stage 3, plane 4 - too deep

Front 65

What is another name for Stage 4 anesthesia?

Back 65

Terminal stage

Front 66

What stage? resp arrest, cardiac arrest

Back 66

Stage 4

Front 67

At what stage may breath holding or hyperventiliation be seen?

Back 67

Stage 2/Excitatory stage

Front 68

At what stage may nystagmus &/or exaggerated reflexes be seen?

Back 68

Stage 2/excitatory stage

Front 69

At what stage may chewing, yawning, &/or vocalization be seen?

Back 69

Stage 2/Excitatory stage

Front 70

At what stage may vomiting or defecation be seen?

Back 70

Stage 2/excitatory stage

Front 71

At what stage may eyes in a ventral-medial position be seen?

Back 71

Stage 3, plane 2/surgical plane

Front 72

At what stage is the laryngeal reflex gone, the palpebral diminishing, and other present?

Back 72

Stage 3, plane 1/restraint anesthesia

Front 73

At what stage are the laryngeal & palpebral reflexes gone, jaw tone gone, and the pedal diminished or absent?

Back 73

Stage 3, plane 2/surgical plane

Front 74

At what stage is a mild decrease in HR and blood pressure seen?

Back 74

Stage 3, plane 2/surgical plane

Front 75

At what stage is a decreased tidal volume seen w/ regular resp rhythm & rate?

Back 75

Stage 3, plane 2/surgical plane

Front 76

At what stage are resp slow & shallow?

Back 76

Stage 3, plane 3/orthopedic plne

Front 77

At what stage are all reflexes diminished or absent?

Back 77

Stage 3, plane 3/orthopedic plane

Front 78

At what stage is there dec cardic output, weak pulse and delayed CRT?

Back 78

Stage 3,plane 3/orthopedic plane

Front 79

At what stage are the pupils moderately dilated and the PLR diminished?

Back 79

Stage 3, plane 3/orthopedic plane

Front 80

At what stage are resp irregular, jerky, &/or shallow?

Back 80

Plane 4 - too deep

Front 81

At what stage are the pupils dilated & fixed which indicates brain hypoxia?

Back 81

Plane 4 - too deep

Front 82

At what stage are all reflexes absent?

Back 82

Plane 4 - too deep

Front 83

At what stage is there pale mm, prolonged CRT, and a weak pulse?

Back 83

Plane 4 - too deep

Front 84

At what stage are muscles flaccid?

Back 84

Plane 4 - too deep

Front 85

What should the tech do if signs of plane 4 present?

Back 85

Inform vet and lighten anesthesia by turning vaporizer off or down and ventilating at 8-12 rpm

Front 86

When does cardiac arrest occur?

Back 86

60-90 seconds after resp arrest

Front 87

What does tech do to start emergency procedures?

Back 87

turn off vaporizer, flush system 3x w/ pure O2, begin CPR, epinephrine

Front 88

What does an analeptic agent do? Example of?

Back 88

stimulates CNS and respiration - Doxapram

Front 89

What kind of drug is Doxapram?

Back 89

analeptic agent

Front 90

What is an indication for Doxapram?

Back 90

respiratory arrest

Front 91

What does a catecholamine drug do? Example of?

Back 91

stimulates sympathetic nervous system - epinephrine

Front 92

What is an indication for epinephrine?

Back 92

cardiac arrest

Front 93

What is a counterindication for epinephrine?

Back 93

when heart is still beating - can cause tachycardia & fatal arrhythmia

Front 94

What are two commom emergency drugs? What are they ea used for?

Back 94

Doxapram for rep arrest, epinephrine for cardiac arrest

Front 95

What are two manual methods for monitoring the anesthetized patient?

Back 95

visual & palpation

Front 96

What are 5 mechanical methods for monitoring the anesthetized patient?

Back 96

esophageal stethoscpe, ECG, Pulse Ox, Doppler blood pressure monitor, Capnography (CO2 monitor)

Front 97

What are some respiratory signs of anesthetic overdose?

Back 97

<8 rpm, irregular or exaggerated resps, decreased tidal volume

Front 98

What are some cardiac signs of anesthetic overdose?

Back 98

bradycardia, prolonged CRT, cyantotic MM, weak pulse

Front 99

Hypothermia may be a sign of what?

Back 99

anesthetic overdose

Front 100

What are some pupilary signs of anesthetic overdose?

Back 100

decreased PLR, dilated pupils

Front 101

What are some reflex signs of anesthetic overdose?

Back 101

greatly diminished or absent

Front 102

Recovery from anesthesia requires elimination of the anesthetic drug(s) from the ___

Back 102

brain

Front 103

What are three ways that gases are eliminated from the brain?

Back 103

exhalation, redistribution, and liver metabolism

Front 104

The ___ the anesthetic period, the longer the recovery time.

Back 104

longer

Front 105

What route of anesthetic admin has the greatest recovery time? The shortest?

Back 105

IM>IV>Inhalation

Front 106

What are some signs of anesthetic recovery?

Back 106

resp rate & depth increase, eyes rotate to next shallow stage, reflexes return in reverse order lost, shivering, tongue movement, chewing, movement, lifting of head, attempts to stand

Front 107

It is very important to watch for ___ during anesthetic recovery

Back 107

seizures