Anesthetic Accidents and Emergencies

Question 1

ASA status 4

Answer 1

A patient with severe systemic, decompensating

disease that is a constant threat to life

Question 2

Generally speaking, the literature shows that _________ and _________ are the riskiest times for the patient.

Answer 2

induction and recovery (particularly recovery and the post-

anesthetic period)

Question 3

ASA status 3

Answer 3

A patient with severe, clinical systemic disease

and/or multiple systemic diseases

Question 4

ASA status2

Answer 4

A patient with mild, well-compensated systemic disease

Question 5

ASA status 5

Answer 5

A moribund patient that is not expected to survive without the operation

Question 6

What is the meaning of an “E” on an ASA code

Answer 6

the patient is presenting for an emergency

Question 7

Esophageal intubation can result in _______, __________, and ___________ if uncorrected.

Answer 7

• desaturation
• hypoxemia
• arrest

Question 8

If the capnograph is reading above ___ mmHg, chest compressions are at least being adequately performed.

Answer 8

10 mmHg

Question 9

For larger animals (>20 kg), the thoracic pump theory is used. What does this mean?

Answer 9

This means that the patient is too large for direct cardiac compression to happen, so the pumping can only occur via changes in intrathoracic pressure. For these patients, they are placed in lateral recumbency, and the resuscitator places their hands over the widest part of the chest to perform compressions.

Question 10

Patients in general should be administered ______and low dose ______ for each cycle of CPR

Answer 10

• atropine

- epinephrine

Question 11

Before starting a procedure, you should obtain _________ and _________ from the owner

Answer 11

• informed consent

- CPR code

Question 12

_______ is one extreme example of this IV drugs causing serious issues if extravasation occurs, as its very basic pH of 11, would cause severe tissue damage and potential sloughing if it were accidentally administered subcutaneously.

Answer 12

thiopental (barbiturate)

Question 13

For small patients (less than 20 kg), the cardiac pump theory is utilized. What does this mean?

Answer 13

This means that the patient is small enough that direct compression of the heart can occur during compressions, so the patient is placed in lateral
recumbency and the resuscitator places their hands over where the heart would be (4-5th intercostal space, at the level of the axilla).

Question 14

CPR chest compression cycles should last for _________

Answer 14

2 minutes

Question 15

common anesthetic accidents/emergencies (6)

Answer 15

• drug miscalculations
• Misadministration of drugs/IV catheter dislodgement
• esophageal intubation, tube obstruction/kinking, accidental extubation
• Fluid misadministration/overdose
• Anesthetic Overdose
• Cardiopulmonary Arrest (CPA)

Question 16

____________ includes all drug administrations and patient monitoring that occur during CPR.

Answer 16

Advanced life support

Question 17

What changes about CPR if the patient is in ventricular fibrillation?

Answer 17

CPR should still proceed in cycles, but at every 2 minute interval, if the patient hasn’t converted, an additional shock should be administered.

Question 18

Basic life support is _____ and _______

Answer 18

• chest compressions

- ventilation

Question 19

examples of standard procedures for minimizing anesthetic risk

Answer 19

• PCV/TC
• BG
• BUN/creatinine
• CBC/chem
• pre-anaesthetic fasting
• pre-op pain scores
• standardized anaesthesia monitoring equipment
• checklists for anaesthesia and crash carts

Question 20

Methods of confirming proper placement of ET tube (3)

Answer 20

• direct visualization with a laryngoscope of the ET tube in the trachea
• using capnography to confirm presence of CO2
• thoracic auscultation

Question 21

ASA status 1

Answer 21

Normal, healthy patient (usually elective procedures)

Question 22

Chest compressions should occur at a rate of approximately ____-____ bpm in small animals.

Answer 22

100-120