Anaesthetic Emergencies Flashcards
How many anaesthetic procedures are without risk to the patient?
None
What can aid in reducing the risk of anaesthetics?
- Monitoring
- Adequate pre-anaesthetic assessments
- Appropriate use of anaesthetic drugs
What is the most common cause of anaesthetic emergencies
Human error
Why might human error occur? Name 4
- Fatigue
- Failure to take adequate history / pre-op assessment
- Personnel rushed or pre-occupied
- Lack of familiarity with circuits and drugs
- Inattentiveness
- Incorrect admin of drugs
What equipment errors may cause anaesthetic emergencies? Name 3
- Vaporiser problems
- Misassembly (though also human error)
- APL valve problems
- ET tube problems
- Empty O2 tank
- CO2 absorber exhausted
- HUMAN ERROR with equipment
Name 3 emergencies caused by anaesthetic agents?
- ACP used in hypovolaemic patients
- Halothane may cause cardiac dysrhythmias
- Not ensuring sedative and analgesic have been used
- Xylazine may cause bradycardia and vomiting
How is the risk of emergencies by anaesthetic agents reduced?
- Use of appropriate pre-med
How can patient variation create emergencies?
- Patient conditions
- Patient may suffer from a disease already
- Neonates unable to fully excrete drugs (liver not fully developed)
- Health conditions e.g. geriatric, obese
- Brachycephalics
- Predisposition e.g. dobermans and vonwillebrands disease, sighthounds dont have much body fat
What are the principles of emergency care? (Theres 5)
- Alert the VS
- Stay calm and don’t panic
- Prioritise
- Be aware where the emergency kit is kept
- Keep emergency drug dosage sheets in view or in easy access points
What 5 things should you check with the emergency crash kit?
- where is it located
- drug dosage sheets
- Replace used items
- Stock take regularly
- Check expiry dates regularly
Name the 8 drugs commonly found in the crash kit?
- Atropine
- Adrenaline (epinephrine)
- Lignocaine (without epinephrine)
- Diazepam (valium)
- Narcan (naloxone)
- Dopamine / dobutamine
- Doxopram (dopram)
- Atipamezole (antisedan)
What is the function of atipamezole?
Alpha-2-adrenoreceptor antagonist
- Reverse or partially reverse effects of medetomidine
What is the function of Doxapram (dopram)
- Analeptic drug
- Stimulates respiratory and central nervous system
Why is dopamine / dobutamine given?
- Increase force of myocardial contraction
What is Diazepam given?
- Treats seizures
Why is lignocaine given?
To treat arrhythmias
Why is adrenaline given?
- Indicated for bradycardia / cardiac arrest
- Increases heart rate and force of contraction
Why is atropine given?
Cases of bradycardia
Reduces vagal tone
What are the four common anaesthetic emergencies? (4)
- Patient too light
- Patient too deep
- Respiratory arrest
- Cardiac arrest
How many patient survive CPR (%)
10%
What key equipment is there for anaesthetic emergencies? (4)
- Defibrillator
- Self-inflating resuscitator bag (ambu bag)
- Urinary catheter
- IV catheter
When is a defibrillator used?
- In cardiac arrest
- To stimulate heart beat and myocardial contractions
- May be used in certain arrhythmias
When is a self-inflating rususcuitator bag used?
Respiratory arrest to provide IPPV
Why is a urinary catheter used in an emergency?
To administer drugs via ET tubes
Why is an IV catheter used in emergencies?
Emergency access for drugs, fluids etc.
What are the six key golden rules when there is an anaesthetic emergency?
- Stay calm and alert the vet
- Turn off the vaporiser
- Make sure you know how to deliver IPPV
- Be familiar with cardiac compressions
- Have a well stocked crash kit/box to hand with drug dosages
- Team work
