Anesthetic Emergencies Flashcards
What type of animal would be classified as an ASA I?
Normal, healthy patient (usually elective procedure)
What type of animal would be classified as an ASA II?
A patient with mild, well-compensated systemic disease
What type of animal would be classified as an ASA III?
A patient with severe, clinical systemic disease and/or multiple systemic diseases
What type of animal would be classified as an ASA IV?
A patient with severe systemic, decompensating disease that is a constant threat to life
What type of animal would be classified as an ASA V?
A moribund patient that is not expected to survive without the operation.
T or F: if you put an E after a patient’s ASA classification, it stands for ‘elective’
False - it stands for emergency
T or F: increased ASA status has been associated with higher risk of death in multiple studies in small animals, equines, and humans
T
Which types of patients are more likely to succumb to anesthesia-related mortality?
Horses, sicker patients (higher ASA status)
What two parts of anesthetizing a patient are the riskiest for the patient?
Induction and recovery
T or F: you should wait to get the CPR status of your patient only once the patient has arrested
FALSE - should get when you’re having the owners sign an informed consent form
What qualifies as pre-anesthetic blood work for an ASA I vs. any patient with an ASA > 1?
ASA 1: PCV, TS, Azostick, blood glucose
ASA >1: at least a CBC + chem
What are some examples of standardized practices that should occur prior to anesthetizing a patient?
Requiring pre-anesthetic BW Pre-surgical overnight fasting w/ free water access Pain scores pre-/post-operatively Standardize anesthetic equipment Checklists for crash carts Signing off on tx sheets/drug calcs
What are some examples of common anesthetic accidents or emergencies?
Drug miscalculations
Misadministration of drugs/IV catheter dislodgement
ET - intubation, tube obstruction/kinking, accidental extubation
Fluid misadministration/overdose
Anesthetic overdose
Cardiopulmonary arrest
What is an example of a drug than can cause serious damage if extravasation occurs?
The barbiturate, thiopental - can cause severe tissue damage and potential sloughing if accidentally given SQ
What are a few ways to confirm an ET tube is properly placed?
Direct visualization w/ laryngoscope
Using capnography to confirm CO2 presence
Thoracic auscultation
What can occur if the ET tube has accidentally been placed in the esophagus?
Can result in desaturation, hypoxemia, and arrest if uncorrected
What can be used in a very small or fluid intolerant patient in place of a drip set?
A roller Heska pump (fluid line goes through), Buretrol, or even a syringe pump
Stage I of Anesthesia
Voluntary movement (awake)
Stage II plane of Anesthesia
Involuntary movement (excitatory)
Stage III of Anesthesia
Surgical anesthesia (may be further classified as light, medium, or deep)
Stage IV of anesthesia
Impending cardiovascular collapse; hypotension with pupils central with no corneal reflex
At what rate should chest compressions be occurring during CPR?
100-120 bpm
What’s the best positioning and method for chest compressions for small patients?
Place in lateral recumbency with hands over where heart would be (4th-5th intercostal space-axilla)
What’s the best positioning and method for chest compressions for larger patients (>20kg)?
Thoracic pump theory - pumping only occurs via changes in intrathoracic pressure
Place in lateral recumbency and put hands over widest part of chest
What’s the best positioning and method for chest compressions for barrel-chested breeds, like English Bulldogs?
Place in dorsal recumbency and put hands over sternum (similar to humans)
What constitutes basic life support, and when should it be started?
Chest compressions and ventilation; should start if no pulse and monitors are not reading
