Admitting patients & pre-operative assessments Flashcards
What does the Anaesthetic triad consist of?
- Unconsciousness
- Pain relief
- Muscle relaxant
What does the pre-anaesthetic assessment consist of?
- Signalment
- History
- Physical examination
- Pre-anaesthetic blood tests
- Further diagnostic tests
What is the American Society of Anaesthesiologists (ASA) grade?
- 5 grades that show the level of risk from anaesthetic based on the animal’s health
What is the ASA class I minimal?
- Normal healthy animals with no underlying disease
What are examples of a ASA class I minimal?
- Spay
- Castrate
- Hip scores
What is a ASA class II slight risk?
- Animals with slight to mild systemic disturbances and animals that are able to compensate and have no clinical signs of disease
What are examples of ASA class II slight risk?
- Neonates
- Geriatrics
- Fractures without shock
- Well controlled endocrine disease
What is an ASA class III moderate risk?
- Animals with moderate systemic disturbances and mild clinical signs of disease
What are examples of ASA class III moderate risk?
- Anaemia
- Low grade heart murmur
- Low grade renal disease
What is ASA class IV High risk?
Animals with pre-existing systemic disease or severe disturbances
What are examples of ASA class IV high risk?
- Dehydration
- Shock
- Uraemia
- Pyrexia
- Uncompensating cardiac disease
What is ASA class V grave risk?
- Life-threatening disease or disturbances; all moribund animals not expected to last >24 hours
What are examples of ASA class V grave risk?
- Severe GDV
- Severe shock
- Advanced cardiac disease
What should be checked in the physical examination?
- Cardiac and thoracic auscultation
- Body condition score
- Hydration test
- Patient temperament
- Breed specifics
How is anaesthetic risk decreased?
- Premedication to reduce stress and anaesthetic requirements
- Oxygen supplementation and monitoring of respiratory and cardiovascular function
- Assessing cardiac rhythm
- Monitoring and support of body temperature
- Documentation of patient parameters during anaesthesia and recovery
What is on a standard pre-anaesthetic blood profile?
- Haematology
- Short biochemistry panel
- Maybe electrolytes ran
What do RBC & PCV test for?
-Dehydration
- Anaemia
What does a WBCC test for?
- Number of neutrophils, lymphocytes, monocytes, eosinophils and basophils
- Inflammation
- Infeciton
- Sepsis
- Neoplasia
What do platelets test for?
- Chronic inflammation
- Platelet clumping
- Immune destruction
What do TPs test for?
- Dehydration
- Infection
- Inflammation
- Protein loss
- Liver failure
What does albumin test for?
- Dehydration
- Protein loss
- Liver failure
- Infection
What does alkaline phosphatase test for?
- Steroid use
- Liver disease
What does alanine aminotransferase test for?
- Liver disease
What does bilirubin test for?
- Haemolytic anaemia
- Liver disease
- Bile duct obstruction
What does creatinine test for?
- Kidney disease
- Dehydration
- Muscle wastage
What does urea test for?
- Kidney disease
- Liver disease
- Dehydration
What does phosphate test for?
- Kidney disease
- Hyper/hyperparathyroidism
What does glucose test for?
- Diabetes mellitus
- Insulin overdose
- Insulinoma
- Sample storage issue
What are the risks of anaesthesia?
- Death
- Organ perfusion issues especially the brain and kidney
- Regurgitation leading to oesophageal ulceration and stricture
- Aspiration and pneumonia
- CNS abnormalities
Arrythmias and hypotension
What should food be withhold for dogs, cats, ferrets and reptiles?
- The anaesthetic relaxes the smooth muscle of the GI tract and the stomach content can reflux and be aspirated
Why should food not be withheld from rabbits, gerbils, guinea pigs, hamsters, rats and horses?
- Starvation can cause gut stasis as well as hypoglycaemia and they have a higher developed cardiac sphincter that prevents vomiting
