16 Flashcards
The goal in the administration of general anesthesia is to provide a stage of reversible unconsciousness with adequate analgesia and muscle relaxation for surgical procedures in such a way that it does not jeopardize the patient’s health. Providing safe anesthesia requires knowledge, technical skill and an astute awareness of the patient’s status at all times.
The ___________is entirely responsible for patient care under anesthesia and must be continually aware of the patient’s status. The anesthetist is NEVER to leave the patient unattended or allow themselves to become distracted by other activities. Vigilance at all stages of the anesthetic procedure can warn of an impending crisis, usually with adequate time to take preventive or corrective actions.
anesthetist
Any questions or concerns should be brought to the attention of a supervising veterinarian or technician immediately. It is far better to call a ‘false alarm’ prematurely then to hesitate and risk a patient’s safety.
___________________
This is the time immediately preceding anesthesia in which a patient history and physical exam is obtained, anesthetic risk assessments are made, the patient is fasted as appropriate and ___________ are administered.
PREANESTHETIC PERIOD
pre-anesthetic drugs
Physical Examination
As an anesthetist you will be responsible for the welfare of your patient and will act as the patient’s advocate from the time of pre-medication through recovery. You will be expected to be thoroughly familiar with the intake exam findings and medical history and for assessing the animal again prior to anesthesia.
As part of the physical exam process, every surgical patient will be assessed for anesthetic risk factors. Any animal with potential increased risk must be evaluated by a supervisor before being accepted for surgery. A staff veterinarian will evaluate these cases and inform the client of potential risks involved.
Fasting
Food is withheld from the healthy adult patient for________ to minimize the risk of vomiting and regurgitation during anesthesia. Fluids need only be withheld for ______
8-12 hrs
2 hours.
Fasting
Food is withheld from the healthy adult patient for 8-12 hours to minimize the risk of vomiting and regurgitation during anesthesia. Fluids need only be withheld for 2 hours.
To avoid complications associated with hypoglycemia, pediatric animals (<4 months of age) are not fasted prior to surgery. Pediatric animals are fed a small meal at intake and the feeding time is recorded in the medical record and on the surgery board.
Pre-anesthetic Medication.
The most important reasons for the administration of pre-anesthetic agents are:
To calm or sedate an excited or vicious animal.
To reduce or eliminate possible adverse effects of general anesthetics.
To reduce the amount of general anesthetic required to induce anesthesia.
To decrease pain and discomfort in the postoperative period.
If you are asked to administer a pre-medication (or any drug):
Review the medical record
Consider species,
Assess the patient’s heart rate.
Administer the medication as directed.
Record the drug, dosage, route of administration and time (DDRAT)
Record the drug, dosage, route of administration and time (DDRAT)
– Be sure medication has not already been administered by another volunteer and that the animal’s condition has not changed since intake.
Review the medical record
Consider species, age, weight and condition to be sure that dose is appropriate for the patient
If you identify any inconsistencies or concerns about the patient’s condition, consult the anesthesia lead before administering the medication.
. If the heart rate is outside normal ranges, consult the anesthesia lead before administering.
Assess the patient’s heart rate
Administer the medication as directed.
Record the drug, dosage, route of administration and time (DDRAT) on the patient’s record
The time of pre-medication is also recorded on the __________ next to the patient’s name.
surgery board
Assessment Process
Assess animal (PRT, evaluate Hx) and verify suitability for anesthesia/surgery
Setup appropriate anesthetic monitoring equipment, breathing circuit and supplemental heat.
IV catheters are placed in most patients.
Calculate surgical fluid plan including type, amount and drip rate
Report physical exam and identifying information to Anesthesia Coordinator. The anesthetist will be expected to be familiar with the patient’s signalment, pertinent physical exam/history findings, current TPR, any medications administered and calculated fluid plan.
Ax Cleared - Anesthesia Coordinator will approve the patient for surgery or request additional assessment or diagnostics before proceeding. Once the patient has been cleared they can be taken to induction.