A&E in anaesthesia Flashcards

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1
Q

Why might you get tachycardia, hypotension and apnoea immediately after propofol administration?

A

The induction agent was administered too quickly

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2
Q

What should you do next if you get tachycardia, hypotension and apnoea immediately after propofol administration?

A

Administer 1-2 breaths and give the patient time to start breathing spontaneously

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3
Q

What happens if a capnograph wave does not drop to zero for inspired CO2? What should you do?

A

the dog is rebreathing –> check the soda lime and the breathing system

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4
Q

What might cause tachycardia one hour into a surgery? 7

A
  • pain
  • light anaesthesia
  • hypovolaemia
  • hypotension
  • hypoxaemia
  • hypercapnia
  • hyperthermia
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5
Q

What should you do to determine why an animal has become tachycardic under GA?

A
  • palpate pulse
  • take BP
  • look at MM colour
  • evaluate blood loss
  • evaluate anaesthetic depth
  • check pulse oximeter, capnograph, blood gas (O2 and CO2)
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6
Q

How can you estimate blood loss?

A
  • count swabs (hold 5-8ml of blood each)
  • DOG = 80-90ml/kg normal blood
  • CAT = 60-70 ml/kg normal blood
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7
Q

What might you do in the case of blood loss causing tachycardia under GA? 5

A
  • calculate blood loss
  • administer a bolus of crystalloid fluid (if doesn’t work use a colloid, if not give a blood transfusion)
  • decrease anaesthetic depth
  • switch anaesthesia to a less cardio-depressant drug
  • last resort = start a dopamine infusion to increase BP
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8
Q

Why might you have a central eye position and a brisk palpebral reflex?

A

the depth of anaesthesia is too light (immediate actin = increase the vaporiser setting, then possibly administer more analgesia)

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9
Q

T/F: morphine causes respiratory depression

A

True

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10
Q

What should you do if you see an overinflated bag?

A

open the pop-off valve to relieve the pressure

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11
Q

What happens if the pop-off valve is closed? 2

A
  • gas flow from flowmeters has nowhere to escape

- increased intra-thoracic pressure as lungs inflate

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12
Q

What does increased alveolar pressure cause? 4

A
  • compression (collapse) of pulmonary capillaries (reduced preload)
  • compression of heart chambers (decreased filling)
  • compression of aorta (increased afterload) –> dramatic reduction in CO –> circulatory arrest
  • alveolar damage/rupture
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13
Q

What should you check for after increased intra-thoracic pressure? 4

A
  • check for pneumothorax
  • check HR goes back up to normal
  • check MM, SpO2
  • check for other problems too
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14
Q

Why might the SpO2 reading be too low? 3

A
  • there is an obstruction of the ETT (commonest cause in cats because it is a small tube)
  • medetomidine-induced vasoconstriction
  • anaemia
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15
Q

Why might airway obstruction occur? 3

A
  • kinking of the ETT
  • material within the ETT
  • overinflation of the tube cuff
  • ACTION: remove the ETT to check if obstructed.
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16
Q

List causes of prolonged anaesthetic recovery - 7

A
  • hypothermia
  • hypoglycaemia
  • hepatic or renal failure
  • very thin/fat animals
  • hypovolaemia
  • hypotension
  • cardiovascular collapse
  • If no recovery = brain death (brain hypoxia)*
17
Q

Why might a cat have a ruptured trachea when under GA? 2

A
  • cuff overinflation

- problems intubating the cat

18
Q

What should you do if you suspect a cat has a ruptured trachea?

A

take xray to check for pneumomediastinum or pneumothorax (depending on whether the rupture was cranial or caudal to the carina). Place chest drain +/- repair (if large).

19
Q

Define CPCR

A

Cardiopulmonary cerebral resuscitation

20
Q

What are the 3 main steps in CPCR?

A
  • Intubation
  • Ventilation
  • Cardiac massage (for 2 minutes then check ECG to see if anything is occurring)
21
Q

How many people do you need for CPCR?

A
3 people:
1.) feel pulses
2.) ventilate
3.) CPCR 
Swab round as CPR is hard work.