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Surgery > Chapter 9 - Powerpoint Condensed > Flashcards

Chapter 9 - Powerpoint Condensed Flashcards

1
Q

True or False: Any time saved by skipping steps in surgical patient preparation is often offset managing problems that could’ve been prevented

A

True

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2
Q

What 4 components make up a basic Anesthetic Protocol?

A
  • Includes calculated dosages, routes and order of administration
  • calculated, checked and re-checked doses, oxygen flow rates and fluid administration rates
  • use patient minimum database, physical status and procedure to influence protocol
  • modified protocol for ill, pediatric or otherwise compromised animals
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3
Q

What are some examples of physiological abnormalities that need to be corrected before anesthesia?

A

Dehydration, Hypotension and Anemia

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4
Q

A bolus drug must be given ______ enough to produce a short-term stage 3 plane 1 anesthesia to intubate (slowly or quickly)

A

quickly

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5
Q

True or false: The quicker we can get intubation completed and move to inhalant anesthesia for maintenance, the faster the recovery will be and the safer the process will be

A

True

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6
Q

When giving anesthetic induction agents by ______ administration, the anesthetic depth will increase, peak and then gradually decrease

A

IM

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7
Q

True or False: Once an IM injection has been given for induction, the anesthetist has little control over changes in depth. If the depth is too light we can add more, but if the depth is excessive there is nothing to be done until the patient comes out naturally

A

True

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8
Q

IM induction is not ideal in ______ patients

A

geriatric

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9
Q

The technique used for short procedures (less than 10 mins) requiring general anesthesia typically includes:

A

IV injection and an Ultra-Short-Acting Agent such as Propofol or Etomidate

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10
Q

TIVA stands for ________ and meanst the patient is induced “to effect” and given additional boluses every ___ to ___ minutes as needed to maintain surgical anesthesia

A

Total Intravenous Anesthesia, 3-5 mins

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11
Q

The most commonly used agent for TIVA techniques is:

A

Propofol

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12
Q

What are 3 factors that may slow down the rate at which a patient is induced via Mask?

A

Patients respiration, Agent used and carrier gas flow rate, type and volume of breathing circuit

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13
Q

Sometimes during a struggle in induction via Mask, the animal will ____

A

Breath hold

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14
Q

True or False: The best technique for masking an animal for induction is introducing the mask quickly with a high flow rate to knock them out as quick as possible

A

False. A struggle will happen and breath holding will occur. The best way is to introduce the mask slowly with Oxygen only at first, then introduce anesthetic at 0.5% increments over 10-15 seconds each. Then turn it up high to pass the excitatory stage quickly

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15
Q

The most commonly used method of inducing and maintaining anesthesia in small animals includes:

A

IV induction and Inhalant maintenance

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16
Q

What equipment needs to be checked in preparation BEFORE induction begins?

A

Intubation equipment, syringes/needles/fluids, heating equipment, anesthetic machine, crash cart with emergency drugs

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17
Q

True or False: It is best to give the entire calculated dose of anesthetic induction IV

A

False. It is best to give about half, and try and intubate, if patient isnt ready then give the rest to effect

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18
Q

What is titration?

A

IV drugs given as a series of bolus injections and discontinued when desired effect is reached

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19
Q

With mask induction, it is hard to monitor what 3 parameters through the mask?

A

CRT, MM and Ocular indicators of anesthetic depth

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20
Q

True or False: It is appropriate to mask an un-sedated patient down for induction

A

False. This will produce a struggle and cause the release of epinephrine, and further struggle will come to induction and recovery. Use only on calm or sedated patients

21
Q

What are the disadvantages of induction via Chamber?

A

Stress, trauma, vomiting, airway blockage
Hard to monitor patient
Exposes personnel to waste anesthetic gasses

22
Q

True or False: The dose required for IM induction is generally about half the dose needed for IV induction

A

False. It is twice the corresponding dose.

23
Q

True or false: When IM induction drugs peaks and the patient is still too light, an additional drug must be administered to get the patient to the point of intubation

A

True

24
Q

The ET tube conducts anesthetic gas directly from oral cavity to trachea and by passes the ____ and ____

A

nares and pharynx

25
Q

ET tubes help decrease anatomic dead space therefore reducing the risk of _______

A

atelectasis

26
Q

What equipment is needed for ET intubation? (8)

A
  1. 3 ET tubes of slightly different diameters
  2. 2 foot length of IV tubing or rolled gauze to secure the ET tube in place
  3. Gauze sponge to grasp the tongue
  4. 12 mL syringe to inflate the cuff
  5. Stylette for narrow diameter tubes
  6. Lidocaine spray to control laryngospasm in cats
  7. Laryngoscope with appropriate blade and a light source
  8. Lubricant for the end of the tube
27
Q

Ideally, you should choose an ET tube size so that the length extends from the tip of the nose to the _____

A

thoracic inlet

28
Q

When selecting the appropriate diameter of ET tube, it must be small enough not to cause _____ injury and large enough to provide a _____ with an inflated cuff

A

Tracheal, seal

29
Q

It is best to check the ET tube cuffs for leaks by:

A

Inflating them 10 minutes prior to intubation and ensuring they are still inflated

30
Q

When the ET tube is placed correctly, the tube will begin to _______ from within, then the patient is placed in ______ recumbency

A

Fog, lateral

31
Q

What are 3 ways you can confirm correct ET tube placement?

A

Watch the reservoir bag, unidirectional valve motion, patient coughs during intubation, fogging of tube during exhalation

32
Q

You should inflate the ET tube cuff until leaking just ceases at a breathing circuit pressure of _______

A

20 cm of water

33
Q

Laryngospasm is common in cats, swine and small ruminants and it makes intubation very difficult, which could lead to ____ or ______

A

Cyanosis or hypoxemia

34
Q

Forcing the ET tube into the Glottis can cause life-threatening complications including:

A

Tracheal rupture, pneumothorax and pneumomedistinum

35
Q

Despite all precautions, some intubated patients will develop minor tracheal irritation. Owners should be warned that it is common for animals to _____ for 1-2 days after anesthesia

A

Cough

36
Q

An alternatvive to ET intubation is ______

A

Supraglotic Airway Devices (SAD)

37
Q

What are the advantages of using SAD’s instead of ET tubes?

A

Increases efficacy of anesthetic gas delivery, redused anatomical dead space, reduced risk of laryngeal trauma

38
Q

True or False: When rotating an intubated patient, it is best practice to temporarily disconnect the ET tube from the anesthetic machine

A

True. Rolling or twisting an animal while it is still connected to the circuit may cause ET tube to twist or collapse, resulting in airway obstruction or lacerated trachea

39
Q

_______ should be instilled into th eyes of an anesthetized patient every 2-3 hours to increase patient comfort

A

Artificial tears or corneal lubricant

40
Q

True or false: Patient breed can influence the length and quality of the recovery period

A

true

41
Q

If a patient in the recovery stage is shivering even while under heating elements, the anesthetist can administer _______

A

direct oxygen

42
Q

True or false: During extubation it is best to remove the tube straight out and slightly upward

A

False. It is best to remove the tube in the same arch that it went in

43
Q

True or False: Remove the IV catheter as soon as the vaporizer is shut off and anesthetic is discontinued

A

False. Leave IV catheter in until patient is FULLY awake in case of emergency

44
Q

The _______ stage of anesthesia is often the most dangerous even for healthy animals

A

recovery

45
Q

After dental cleaning, oral surgery or any other procedure in which blood or other fluids are present in the oral cavity, what is the best way to remove the ET tube?

A

Leave the cuff slightly inflated during removal to sweep out fluid and prevent it from entering airway

46
Q

A recovering patient should be turned every 10-15 mins to prevent _______

A

Hypostatic congestion: Pooling of blood in the dependent lung and tissues

47
Q

What is a laryngospasm?

A

Reflex closure of the glottis in response to contact with object/substance

48
Q

2 ways to prevent Laryngospasm are to wait for the glottis to open before intubating and _________

A

spray with lidocaine

Surgery (11 decks)

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