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PCP > Anaesthesia > Flashcards

Anaesthesia Flashcards

1
Q

Factors affecting choice of breathing system (6)

A

resistance
rebreathing
fresh gas flow requirements
mechanical dead space
circuit drag
cleaning and maintenance

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2
Q

Circle

A
  • rebreathing
  • soda lime
  • low fresh gas flow requirement - 10ml/kg/minute
  • higher flow at start to avoid alveolar hypoxia from dissolved nitrogen in blood
  • economical use
  • expensive to buy
  • increased resistance
  • unidirectional valves prevent mixing - need maintenance
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3
Q

Magill

A

flow = 1*minute volume
can’t be used for IPPV

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4
Q

Lack

A

flow = 1*minute volume
either tube inside tube or parallel
can’t be used for IPPV

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5
Q

Mini Lack

A

flow = 1*minute volume
<10kg
parallel tubes
can’t be used for IPPV

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6
Q

T-Piece

A

flow = 2-3*minute volume
long tube, t connector, short tube with bag
<8kg
can use for IPPV

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7
Q

Bain

A

flow = 2-3*minute volume
co-axial tube
7-10kg
Can’t use for IPPV

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8
Q

Humphrey ADE

A

Lever up - lack
Lever down - t-piece
Circle
Can use for IPPV

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9
Q

Monitoring - temperature

A

hypothermia
rectal thermometer or oesophageal thermoprobe
core-periphery difference - early CV problem sign
low temperature –> increased pain, increased infection, delayed recovery

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10
Q

Causes of temperature fall (7)

A

Vasodilation
reduced shivering
reset thermoneutral point
open body cavity
cold gases
dry gases
wetting and prep

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11
Q

Monitoring - Pulse

A

Femoral
dorsal metatarsal (disappears with hypotension)
lingual
auricular

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12
Q

Monitoring - Pulse Oximetry

A

% oxygen saturation of hemoglobin
accuracy affected by - circulation, ambient light, movement of probe, pigmented skin
probe design not always suitable

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13
Q

Monitoring - ECG

A

to detect arrythmia

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14
Q

Monitoring - Capnography

A

CO2 breathed out
info on cardiac and respiratory function
info about - rebreathing, cardiac oscillations, ETT obstruction
increase ETCO2 - hypoventilation
decreased ETCO2 - hyperventilation
sudden drop - cardiac arrest

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15
Q

Monitoring - Blood Pressure

A

used with HR to determine cardiac output
non- invasive - sphygomanometry, oscillometric, doppler
invasive - cannula for direct BP measurement

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16
Q

Decreased blood pressure causes - anaesthesia (4)

A

IV fluid loss (hemorrhage)
failing myocardial function
sepsis
relative hypovolemia - vasodilation (sepsis, drugs)

17
Q

Monitoring - CNS

A

eye position
jaw tone
EEG - electrical output from brain (bispectral index from 100 (awake) - 60 (general anaesthesia) - 0 (flat line/dead))

18
Q

Common problems - recovery

A

Prolonged recovery - hypothermia, too much pre-med, too deep during maintenance, hypoglycemia, choice of inhalant, choice of induction agent
Airway obstruction - debris or gauze, body fluids
Agitated recovery - inadequate pre med or analgesia

19
Q

BOAS patients

A

sedate for recovery
supplementary oxygen
leave in IV
leave in ETT until sat up
retube if - cyanosis, distress, low SPO2, paradoxical breathing

20
Q

ETT

A

Red rubber - opaque, high pressure seal so can irritate, crack easy
PVC/silicon - less prone to kinking, non-irritant, less pressure, transparent
Armored - coil of wire through - kink resistant, need stylet to place, can be damaged if bite down, can’t reduce dead space
Cole Patter - human pediatric - exoticss

cats - lidocaine sprat
cuff with pilot balloon

21
Q

Supraglottic airway devices

A

sit above larynx and envelopes

cats and rabbits - v-gels

22
Q

Complications - ETT (5)

A

high pressure/low volume - tracheitis or pressure necrosis
disconnect when moved
leaks
over insertion
improper cleaning - infection, irritation

23
Q

IV placement

A

cephalic
saphenous - brachycephalics
jugular - right side, sampling
auricular - peripheral - rabbits and floppy ear dogs

24
Q

Complications - IV placement (5)

A

extravasation
thrombosis
thrombophlebitis
emboli
exsanguination

25
Q

Anaesthetic Machine Components (7)

A

pressure regulator - maintains constant gas flow
flow meter - tells oxygen level
vaporiser - contains anaesthetic agnt
check valve - stop backflow to vaporiser
back bar - contains pressure relief valve
common gas outlet

26
Q

Gas Colours

A

Tanks -
Oxygen - black with white top or just white
Nitrous oxide - blue

Wall sockets -
Oxygen - green
Nitrous - blue
Medical air - yellow

27
Q

Alternatives to oxygen tanks

A

cryotanks
oxygen generators

28
Q

Anaesthetic machine checks (5)

A

visual check
leak check - check alarms are working
bain - occlude end with syringe, pressure should drop
breath into circuit to check valve
soda lime colour

29
Q

Anesthetic machine safety features (6)

A

oxygen failure alarm
oxygen failure protection device
hypoxic mixture alarms
interlocks between vaporisers - one volatile agent at once
pin safety index system on gas cylinders
gas hoses with non-interchangeable valve connectors

PCP (10 decks)

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