Complications and Emergencies

Question 1

What is an accident?

Answer 1

• Avoidable incident

Question 2

What is an incident?

Answer 2

• Event which could cause severe risk to staff or patient

Question 3

What is an emergency?

Answer 3

• One big event or combination of smaller ones, which puts the animal’s life at risk

Question 4

What are the 5 different types of errors?

Answer 4

• Technical factors
• Organisational and supervision factors
• Environmental factors
• Personnel factors
• Human factors

Question 5

What are technical factors?

Answer 5

• Errors occur as a result of technical or equipment failures

Question 6

What are organisational and supervision factors?

Answer 6

• Caused by the organisation, individual, team, medications and delivery systems, physical environment and technical environment

Question 7

What are environmental factors?

Answer 7

• Lighting, noise, smells, clutter and room layout

Question 8

What are personnel factors?

Answer 8

• Miscommunication between individuals or when information is incomplete or unavailable

Question 9

What are human factors?

Answer 9

• Attentional failures
• Memory failures
• Rule-based mistakes
• Routine violations

Question 10

What are the 4 types of complications?

Answer 10

• Equipment
• Respiratory
• Cardiovascular
• Other (vomiting, hypothermia)

Question 11

Why do complications occur?

Answer 11

• Side effects of anaesthetic agent/drugs
• Pre-existing conditions
• Secondary to surgical procedure
• Poor anaesthetic management
• Inappropriate depth of anaesthesia

Question 12

What does the pre-anaesthetic assessment include?

Answer 12

• Clinical history
• Clinical examination
• Signalment
• Procedural considerations
• Anaesthetic considerations
• Other considerations

Question 13

List some equipment failures

Answer 13

• Lack of oxygen in cylinders
  Disconnection of piped oxygen supply
• Stuck or missing one-way valve
• Leaks in anaesthetic system or machine
• Ventilator failure

Question 14

How do you if the CO2 absorber is exhausted?

Answer 14

• Absorber should turn colour when exhausted
• If absorber not changed quickly, can return back to original colour, which could lead to potential hypercapnia

Question 15

List some endotracheal tube complications

Answer 15

• May become blocked by blood, mucous or saliva
• May be kinked or twisted

Question 16

List some APL valve complications

Answer 16

• Can accidentally be shut off in the closed position, which causes pressure to build up in the system, which leads to overinflation of the reservoir bag
• This result in barotrauma

Question 17

List some vaporizer complications

Answer 17

• Filling vaporiser with the wrong agent
• Sticking of the dial
• Underfilling the vaporiser can lead to the patient waking up intra-operatively
  Tilting the vaporiser can lead to overdosing the patient

Question 18

What may cause a delayed recovery?

Answer 18

• Hypothermia
• Hypoglycaemia
• Electrolyte disturbances
• Impaired circulation
• Impaired ventilation
• Drugs
• Medical conditions

Question 19

What is a laryngospasm?

Answer 19

• Occurs in cats when the laryngeal tissue is irritated by intubation, which leads to n airway obstruction

Question 20

How are laryngospasms prevented?

Answer 20

• Spray with local anaesthetic before intubation
• Ensure adequate anaesthetic depth

Question 21

How are laryngospasms treated?

Answer 21

• Spray local anaesthetic
• Deepen plane of anaesthetic
• If unsuccessful, tracheostomy should be placed