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Vet. Anesthesiology & Sx proc. > Anesthetic monitoring > Flashcards

Anesthetic monitoring Flashcards

1
Q

Why do we monitor?

A

to keep the patient safe and to regulate anesthetic depth

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2
Q

What is key in monitoring?

A

Prevention

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3
Q

When does monitoring end and begin?

A

When animal is dropped off and after recovery period

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4
Q

What are the stages of anesthesia

A
  1. Pre medication
    2.Induction
    3.Maintenance: 1-4 planes
    4.Recovery
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5
Q

What to monitor during pre medication

A

HR, RR, perfusion, Pulses, Drooling/vomiting, level of sedation, reactions to medications

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6
Q

What to monitor during induction

A

HR/RR, perfusion, pulses, CNS reflexes-depth

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7
Q

What to monitor during maintenance

A

HR/RR, perfusion, pulses, CO2/O2 concentrations, bloop pressure, CNS reflex’s -depth, temperature

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8
Q

In the recovery stage, vitals should be monitored until awake/ambulatory every

A

5-10 minutes

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9
Q

_ is one of the most important stages of anesthesia morbidity is higher in this stage than any others

A

Recovery

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10
Q

What does the eye position do during anesthesia

A

pupils being in central position then move rostroventral in an adequate plane then move BACK central as the patient moves into a deeper plane

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11
Q

Eye position reflex check is ineffective is using which class of drugs

A

Dissociatives (ketamine- eyes are fixed centrally)

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12
Q

ACVA monitoring recommendation for class P1 and P2

A

Q5 monitoring

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13
Q

ACVA monitoring recommendation for class P3-P5 and horses on inhalant anesthesia and/or anesthetized over 45 min.

A

continuous monitoring

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14
Q

From stage I through stage IV of anesthesia there is a progressive decrease in

A

pain perception, motor coordination, consciousness, reflex responses, muscle tone and cardiopulmonary function

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15
Q

What stage of anesthesia is described?
-Period of voluntary movement
-P begins to lose consciousness
-Characterized by: fear, excitement, disorientation, struggling, urination, defecation, increased HR and RR
-Stage ends with loss of ability to stand and recumbency

A

Stage I

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16
Q

What stage of anesthesia is described?
-Period of involuntary movement; the “excitement stage”
-Characterized by: breathing irregular, vocalization, struggling, paddling, increased HR and RR, pupils dilated, muscle tone marked, reflexes present
-Actions are not under conscious control
-Stage ends with muscle relaxation, decreased respiratory rate, and decreased reflex activity

A

Stage II

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17
Q

What should be done during induction to prevent injury to animal, the restrainer, or the anesthetist

A

patient passed through excitement stage as quickly as possible

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18
Q

What stage of anesthesia is described
-Period of sx anesthesia
-Divided into 4 planes

A

Stage III

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19
Q

Stage III plane 1is not adequate for

A

surgery

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20
Q

Stage III plane 2 is a suitable depth for

A

most surgical procedures

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21
Q

In stage III plane 2, surgical stimulation may produce

A

-mild increase in HR, BP, or RR
-P remains unconscious and immobile
-PLR is sluggish; pupil size is moderate

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22
Q

Stage III plane 3 is

A

deep anesthesia- excessive for most procedures

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23
Q

Stage III plane 4 is _ _ _

A

early anesthesia overdose

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24
Q

What plane of stage III is described
-regular resp. pattern, no involuntary movements
-eyeballs start to rotate ventrally, pupils partially constricted, decreased PLR
-ET tube may be passed and connected
-Other reflexes are still present but decreased response

A

Plane 1

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25
Q

What plane of stage III is described
-suitable depth for most sx procedures
-characterized by: regular and shallow resp. w/ decreased rate, BP and HR middle decreased, relaxed muscle tone, pedal and swallowing reflexes are absent, ventromedial eye rotation
-Mild increase in HR, BP, or RR
-P remains unconscious and immoble
-PLR is sluggish, pupil size is moderate

A

Plane 2

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26
Q

What plane of stage III is described
-deep anesthesia- excessive for most procedures
-characterized by: low HR and RR, decreased tidal volume, reduced pulse strength, increased CRT, poor to absent PLR, reflexes totally absent , muscle tone is very relaxed

A

plane 3

27
Q

What plane of stage III is described
-abdominal breathing
-fully dilated pupils; dry eyes
-all reflexes absent
-marked depression of the CVS, pale MM, increased CRT
-flaccid muscle tone

A

plane 4

28
Q

Stage IV is a period of

A

anesthetic overdose

29
Q

Stage IV is characterized by

A

-cessation of respiration
-circulatory collapse
-death

(resuscitate immediately to save the patient)

30
Q

Objectives of surgical anesthesia

A

-P doesn’t move, isn’t aware, doesn’t feel pain, no memory of procedure

31
Q

Vital signs of circulation

A

HR and rhythm, pulse strength, CRT, MM, bp

32
Q

Vital signs of oxygenation

A

MM, CRT, Hg saturation, inspired oxygen, arterial blood oxygen

33
Q

Vital signs of ventilation

A

RR and depth, breath sounds, end-expired CO2 levels, arterial CO2, blood pH

34
Q

What causes bradycardia in anesthesia

A

-alpha2 agonists and opioids
-excessive anesthesia depth
-adverse effects of drugs

35
Q

What causes tachycardia in anesthesia

A

-anticholinergics and cyclohexamines
-inadequate anesthetic depth
-pain
-hypotension
-blood loss and shock
-hypoxemia and hypercapnea

36
Q

Causes of arrhythmias

A

Drugs, medical states or diseases

37
Q

How to detect 1st or 2nd degree heart block

A

use ECG to detect

38
Q

What cardiac arrhythmia is described?
-HR coordinated with respirations
-Decreases during expiration
-Increases during inspiration
-Normal in dogs, horses, and cattle
-NOT normal in cats

A

Sinus arrhythmia (SA)

39
Q

What cardiac arrhythmia is described?
-Abnormally slow heart rate
-Common during anesthesia: excessive anesthetic depth and drug reactions
-Correct with reversal agents or anticholingerics

A

Sinus bradycardia

40
Q

What cardiac arrhythmia is described?
-Abnormally fast HR
-Inadequate anesthetic depth, drug reactions, surgical stimulation
-Tx according to cause

A

Sinus tachycardia

41
Q

What cardiac arrhythmia is described?
-Delay or interruption of electrical impulse conduction through the AV node

A

AV heart block

42
Q

What does a first degree AV heart block look like

A

prolonged P-R interval

43
Q

What does a second degree AV heart block look like

A

occasional missing QRS complexes

44
Q

What does a third degree AV heart block look like

A

-atrial and ventricular contractions occur independently
-randomly irregular P-R intervals

45
Q

_ and _ degree AV blocks can be seen in normal resting horses

A

first and second

46
Q

When are first and second degree blocks commonly seen

A

after admin. of alpha2agonists or with high vagal tone, hyperkalemia, or cardiac disease

47
Q

What does third degree block indicate? - is not commonly seen in anesthetized patients

A

a cardiac disease

48
Q

What is a supraventricular premature complex (SPC)?

A

one or more normal QRS complexes closely following the previous QRS complex

49
Q

What is supra ventricular tachycardia

A

a series of 3 more more SPCs in a row

50
Q

What is ventricular premature complexes (VPC)

A

one or more wide , bizarre QRS complexes closely following the previous QRS complex

51
Q

What is ventricular tachycardia

A

a series of 3 or more VPCs in a row

52
Q

What is fibrillation

A

chaotic, uncoordinated small muscle bundle contractions within the atria and ventricles

53
Q

What fibrillation is described?
-fine undulating baseline
-absence of P-waves
-tachycardia
-normal QRS complexes at irregular intervals

A

Atrial fibrillation

54
Q

What fibrillation is described?
-Undulating baseline
-Absence of QRS complexes

A

ventricular fibrillation

55
Q

What is PEA

A

cessation of heart contractions and/or palpable pulse in the presence of normal or nearly normal ECG

56
Q

BP evaluates _ _ during anesthesia

A

tissue perfusion

57
Q

Factors involved in blood pressure

A

heart rate stroke volume, vascular resistance, arterial compliance (elasticity), blood volume

58
Q

Systolic pressure is produce by

A

contraction of the left ventricle

59
Q

Diastolic pressure is

A

the pressure that remains in the arteries when the heart is in the resting phase between contractions

60
Q

What is the best indicator of blood perfusion to internal organs

A

Mean arterial pressure (MAP)- average pressure through the cardiac cycle

61
Q

What does a MAP of <60mmHg in small animals and ruminants indicate?

A

decreased organ perfusion

62
Q

What does a MAP <70mmHg in horses indicate?

A

decreased organ perfusion

63
Q

How to maintain and correct hypotension

A

IVF at a rate sufficient to maintain BP, administer dopamine and dobutamine as needed

64
Q
A

Vet. Anesthesiology & Sx proc. (8 decks)

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