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Anesthesia&Surgery > Anesthetic Problems And Emergencies > Flashcards

Anesthetic Problems And Emergencies Flashcards

1
Q

Why do problems arise?

A

Human error
Equipment error
Adverse effects
Patient factors

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2
Q

Human errors that may result in anesthetic problems

A
  • Failure to obtain adequate history or perform a physical examination
  • Lack of familiarity with the anesthetic machine or drugs used
  • Incorrect administration of drugs
  • Fatigue
  • Inattentiveness
  • Distraction
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3
Q

Examples of equipment failure or operator carelessness

A
  • Carbon dioxide absorber exhaustion
  • Failure to deliver sufficient oxygen to the patient
  • Misassembly of the anesthetic machine
  • Failure of the vaporizer and pop-off valve
  • Endotracheal tube problems
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4
Q

Some patients are at increased risk for anesthetic complications because of Preexisting factors such as these

A

Old age
Organ failure
Recent trauma
Breed-related conformation

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5
Q

Why do geriatric patients have a reduced anesthetic requirement?

A

They have less reserve than younger patients

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6
Q

Like geriatric patients, these patients also require reduced doses of injectable agents

A

Pediatric patients

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7
Q

These patients are prone to hypothermia and hypoglycemia

A

Pediatric patients

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8
Q

What are the anatomic characteristics that make respiration difficult for brachycephalic dogs?

A

Have one or more anatomic characteristics that impede air exchange, including very small nasal openings, an elongated soft palate, and small diameter trachea

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9
Q

What should be done to brachycephalic dogs before induction?

A

Preoxygenate for 5 minutes before induction by gently restraining and administering oxygen through a face mask

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10
Q

Why should induction be rapid on brachycephalic dogs?

A

To gain control over the airway

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11
Q

What form of induction is preferred for brachycephalic dogs?

A

IV induction agents (propofol, ketamine-diazepam, methohexital) that are rapidly metabolized are preferred over mask induction

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12
Q

The Endotracheal tube that fits the trachea of a brachycephalic dog is larger or smaller than expected?

A

Smaller

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13
Q

Why should the Endotracheal tube be left in place for as long as possible in brachycephalic dogs?

A

The animal will maintain an open airway as long as the tube is in place

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14
Q

Brachycephalic dogs should be monitored for respiration difficulty particularly during this period.

A

Recovery period

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15
Q

Why should thiobarbiturates be used with extreme care in sighthounds?

A

Sighthounds show an increased sensitivity to anesthetic agents, particularly thiobarbiturates

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16
Q

Why do sighthounds have an increased sensitivity to thiobarbiturates?

A

Lack of body fat for redistribution of the drug

Inefficient hepatic metabolism of many drugs

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17
Q

What are the induction agents that can be safely used as alternatives to thiobarbiturates in sighthounds?

A 
Diazepam and ketamine
Methohexital
Propofol
Isoflurane
Sevoflurane
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18
Q

Why are anesthetics not efficiently distributed to fat stores?

A

The blood supply to fat is relatively poor

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19
Q

What is the difference between the dose of an obese patient and a normal patient?

A

Obese dogs require lower doses of drugs on a per kg basis than normal dogs

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20
Q

How is the dose of anesthesia determined for obese patients?

A

The dose is determined according to(Their IDEAL body weight) a weight halfway between the normal breed weight an the actual weight

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21
Q

Pregnant animals presented for a C-section are at an increased or decreased anesthetic risk?

A

Increased anesthetic risk

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22
Q

What are the various anesthetic techniques that are sometimes used as alternatives to inhalation anesthesia in C-section patients?

A

Epidural anesthesia
Balanced anesthesia
Neuroleptanalgesia

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23
Q

Almost all anesthetic agents may cause this to the fetuses

A

Depression of respiration and/or circulation

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24
Q

What is a common complication of cesarean surgery?

A

Hemorrhage from the uterus

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25
Q

What are the reversal agents that can be used in the new born fetuses

A

Naloxone and Doxapram 1-2 drops delivered under the tongue or 0.1-0.2 ml injected into root of tongue

If bradycardia, can give 1 drop of dilute Atropine (0.25mg/ml) under the tongue or injected

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26
Q

If possible, this should be done to trauma patients before anesthesia

A

Should be stabilized and thoroughly evaluated

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27
Q

This problem is common in trauma patients

A

Respiratory difficulties

28
Q

This may be present in the traumatized patient as a result of blood loss

A

Anemia

29
Q

Animals with cardiovascular or respiratory disease may require special anesthetic techniques such as these

A

Preoxygenation and Manual control of ventilation

30
Q

Why may prolonged recovery times be seen in hepatic or renal disease patients?

A

Hepatic or renal disease may delay excretion of injectable agents

31
Q

What is the most common cardiovascular problem seen by the veterinary anesthetist?

A

Bradycardia

32
Q

What are the anesthetic concerns for patients undergoing cesarean section?

A 
Hypoxemia
Hyperarbia
Hypotension
Bleeding
Acid-base imbalance
Tissue trauma
Arrhythmias
33
Q

Which is generally safer? The use of one or two drugs, or the use of multidrug protocols?

A

The use of multidrug protocols is generally safer than use of only one or two drugs.

34
Q

These patients are perhaps the most challenging for the anesthetist

A

Patients with respiratory problems

35
Q

Anesthesia should be delayed in respiratory disease patients until respiratory function has improved, but if surgery is absolutely required, this is preferable to general anesthesia

A

Local analgesia and gentle manual restraint

36
Q

The use of these drugs should be avoided in patients with hepatic disease

A

Ketamine and Diazepam and

Barbiturate agents

37
Q

Which are the drugs of choice for induction and maintenance of anesthesia on patients with hepatic disease?

A

Isoflurane or Propofol (require little or no hepatic function for elimination)

38
Q

The organs most involved in maintains the volume and electrolyte composition of body fluids

A

Kidneys

39
Q

Why is general anesthesia stressful for patients with renal disease?

A

General anesthesia decreases renal blood flow and renal function may be further compromised.

40
Q

Emergency care is ideally a team effort involving…?

A

All hospital personnel

41
Q

These things would be helpful to have in emergency care

A

Preauthorized emergency protocols

Periodic “dress rehearsals”

42
Q

What can cause an animal to not stay anesthetized?

A
  • Incorrect placement of Endotracheal tube
  • Incorrect vaporizer setting
  • Inadequate Endotracheal tube size
  • Respirations too shallow?
  • Oxygen flow rate adequate?
43
Q

Excessive anesthetic depth may result from this

A

Excessive administration of anesthetic agents or from Preexisting patient problems

44
Q

What is necessary to achieve a lighter plane of anesthesia in a patient who is too deeply anesthetized?

A

May be necessary to bag the patient with 100% oxygen to achieve a lighter plane of anesthesia

45
Q

Pale mucous membranes may be the result of this

A

Anemia
Hemorrhage
Poor perfusion

46
Q

Prolonged CRT suggests that this is presents

A

Hypotension

Shock if severe

47
Q

A CRT greater than this suggests that blood pressure is inadequate to perfuse superficial tissues

A

Greater than 2 seconds

48
Q

These drugs may also cause hypotension in susceptible patients

A

Acepromazine and the inhalation agents

49
Q

These anesthetic agents can cause vasodilation and decrease blood pressure, resulting in poor perfusion of capillary beds and pale MM

A

Particularly inhalation agents, Propofol, and Acepromazine

50
Q

Cyanosis is a critical emergency that arises because of this

A

Insufficient delivery of oxygen to the tissues

51
Q

What can cyanosis result from?

A
  • Machine problem
  • Airway or Endotracheal tube blockage
  • Respiratory difficulties from excessive depth
  • Pneumothorax
  • Respiratory disease
52
Q

How is oxygen delivery to the patient reestablished?

A

Masking
Intubation
Tracheostomy

53
Q

Abnormalities in cardiac rate and rhythm may result from this

A 
Administration of anesthetic agents
Electrolyte abnormalities
Hypercapnia
Hypoxia 
Many other factors
54
Q

Tachycardia can result from the administration of these drugs

A

Atropine
Ketamine
Epinephrine

55
Q

Tachycardia is present if the ❤rate is greater than this

A 
>140 bpm Large Dog
>160 bpm Small Dog
>200 bpm Cat
>60 bpm Horse
>100 bpm Cow
56
Q

Bradycardia may be secondary to the administration of these drugs

A

Alpha 2 agonists

Opioids

57
Q

Bradycardia is present if❤rate is less than this

A

<40 bpm Cow

58
Q

Respiratory arrest that is accompanied by cyanosis and/or bradycardia is considered this

A

AN EMERGENCY!!

Must be treated by ventilation with 100% oxygen

59
Q

Cardiac arrests should be treated by the principles of this

A

ABCD (CBADE in PPT)
A- establish a patent airway
B- bag the patient with 100% O2
C- initiate internal or external cardiac massage
D- administer epinephrine and other drugs

60
Q

Why is regurgitation and/or vomiting dangerous in the anesthetized animal?

A

Danger of airway obstruction and aspiration pneumonia

61
Q

How can postanesthesia seizures be treated?

A

May be treated by eliminating external stimuli (light, sound, touch) and administering diazepam
(Sedate animal with Propofol if diazepam is unavailable)

62
Q

Seizures in animals recovering from anesthesia can be caused by this

A

Administration of Ketamine
Diagnostic procedure: Myelography
Patient disorders: epilepsy or hypoglycemia

63
Q

Opisthotonus

A

Stiff forelimbs

64
Q

Dyspnea caused by laryngospasm or brachycephalic airway obstruction may be treated by ?

A

Treated by administration of oxygen by mask, reintubation of patient, or tracheostomy

65
Q

Animals experiencing prolonged recovery from anesthesia require this

A

Close observation and nursing care

Anesthesia&Surgery (13 decks)

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