Anaesthetic Monitoring Flashcards
What are all of the things that need to be monitored during anesthesia?
Isoflurane %, oxygen level, respiratory rate, respiratory character, pulse/heart rate, pulse character, blood pressure, mucous membrane colour, capillary refill time, reflexes, palpebral (blink), pedal (paw pinch), jaw tone, eye position, pupil size.
What does CRT stand for and show?
Capillary refill time. It shows how well perfusion is in areas of the body.
What are the units for Isoflaurane levels?
%.
What are the units for oxygen levels?
L/min
What are the units for respiratory rate?
bpm (breaths per minute).
What are some examples of how respiratory character can be described?
Deep, shallow, thoracic, abdominal, other.
What order would you do the monitoring checks in?
Machine check (Isoflurane %, oxygen level),
Vitals (heart rate, respiratory rate + character),
Paw area (blood pressure, pulse character, pedal reflex),
Mouth (Jaw tone, MM colour, CRT),
Eyes (palpebral reflex, pupil size, eye position).
What is the palpebral reflex?
The blink reflex.
How often should the monitoring chart be filled?
At least every 5 minutes, ideally more often.
What are the normal HR ranges for dogs?
60-150 bpm
What are the normal HR ranges for cats?
100-200 bpm
What are the normal HR ranges for rabbits?
130-325 bpm
When should the temperature be taken?
Before surgery, after surgery and during recovery.
What are the normal temperature ranges for dogs?
38.3-39.2 degrees celsius
What are the normal temperature ranges for cats?
38.2-38.6 degrees celsius
What are the normal temperature ranges for rabbits?
38.5-40 degrees celsius
What are the normal RR ranges for dogs?
10-30 bpm
What are the normal RR ranges for cats?
20-30 bpm
What are the normal RR ranges for rabbits?
30-60 bpm
What are the normal HR ranges for dogs under 25kg?
65-180 bpm
What are the normal HR ranges for dogs over 25kg?
65-120 bpm
What does MM mean and show?
Mucous Membrane colour. It shows how well perfusion is in areas of the body.
What is the normal mucous membrane colour for cats and dogs?
Pink. Cats may have a slightly more pale pink than dogs.
What is the normal capillary refill time for cats and dogs?
1-2 seconds
What is the normal oxygen saturation for cats and dogs?
98-100%
What are the signs of Stage 1 anaesthesia?
- Voluntary responses are present but may be affected by premed
- The Induction of anaesthesia begins
What are the signs of Stage 2 anaesthesia?
- May see some initial involuntary excitement
- Loss of consciousness occurs
- Can still blink, swallow, clench jaws, withdraw limb etc
- Closest stage to being “asleep”
- Eyes are central
What are the signs of Stage 4 anaesthesia?
NODY – Not Officially Dead Yet
What are the signs of Stage 3, Plane 1 anaesthesia?
- Reflexes are strong, brisk and obvious
- Heart Rate (HR) and Resp Rate (RR) increase in response to pain
- Will withdraw limb in response to pinching of toes (Pedal Response)
- Obvious Palpebral Response
- Eyes are central and normal (looking at you)
- Intubation may be possible in dogs but not in cats
What are the signs of Stage 3, Plane 2 anaesthesia?
- This is our target plane. Medium Depth Anaesthesia
- HR and RR stabilise
- Palpebral is absent
- Pedal response absent – no withdrawal and no change in HR, RR
- Eyes have rotated ventrally. Pupil size? Medetomidine?
- Laryngeal reflex gone in dog but not in cat
- Good muscle relaxation for most surgeries
- BP, HR, RR, usually quite stable here
- No response to pain here
- This is your comfortable cruising altitude
- Try to stay right here until the procedure is complete
What are the signs of Stage 3, Plane 3 anaesthesia?
- Deep Anaesthesia
- No response to stimulus anywhere
- RR and HR can become erratic or depressed
- Eyes rotate centrally and corneas become dry and reflex lost
- Pupils dilated
- Time to decrease the anaesthetic
What are the signs of Stage 3, Plane 4 anaesthesia?
- You need to act quickly now to decrease the anaesthetic
- Pupils are central, dilated and fixed
- No reflexes
- Diaphragmatic breathing only
What anaesthesia stage and plane is used for surgery?
Stage 3, Plane 2.
What is the Greek meaning for anaesthesia?
Without sensation
What is the Greek meaning for analgesia?
Without pain
What does local anaesthesia affect?
Small area (numb fingertip)
What does regional anaesthesia affect?
Larger area than local (numb hand)
What does general anaesthesia affect?
The whole patient (numb body)
What is the goal of anaesthesia?
To provide reversible unconsciousness, amnesia, analgesia, and immobility
What are the risks of anaesthesia?
Death, hypotension/hypertension, bradycardia, arrhythmias, myocardial depression, vasodilation / vasoconstriction, hypoxia / hypercapnia
How is anaesthetic monitoring like flying a plane?
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What is Hg?
Mercury
What is mmHg?
A unit of pressure required to move a column of Hg by 1 mm.
What is Hgb?
Haemoglobin. A protein on the RBC that may or may not carry O2.
What is Ox-Hgb?
Oxygenated Haemoglobin.
What is deox-Hgb?
de-oxygenated Haemoglobin.
What is SO2?
Oxygen saturation. % of Hgb binding sites occupied by Oxygen.
What is PvO2?
The partial pressure of oxygen in venous blood.
What is PaCo2?
The partial pressure of carbon dioxide in arterial blood.
What is SaO2?
Arterial oxygen saturation. The % of arterial Hgb proteins carrying O2.
What is SvO2?
Venous oxygen saturation.
What is SpO2?
Peripheral oxygen saturation (an estimation of the SO2 by the Pulse Ox).
What is PO2?
The partial pressure of oxygen in the blood (dissolved oxygen).
What is PaO2?
The partial pressure of oxygen in arterial blood.
What is PvO2?
The partial pressure of oxygen in venous blood.
What is PaCo2?
The partial pressure in carbon dioxide in arterial blood.
What is FiO2?
Fraction or concentration of oxygen in the volume being measured.
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