Emergencies in Anaesthesia Flashcards
What is normal SpO2 in anaesthetised dog/cat?
98-100%
IF SpO2 drops and patient is intubated, what can we check?
Pulse oximeter - reposition Pressure gauges on machine Flow rate Breathing system - attached and not leaking Cylinder turned on Pipeline plugged in
What causes a potentially difficult intubation and how can we help this?
Laryngeal mass/anatomical issues, e.g. brachycephalic dogs
Pre-oxygenation with mask
Have all equipment and drugs on hand
May administer corticosteroids (hydrocortisone)
What can cause an abnormal breathing pattern in an anaesthetised patient?
Panting - inadequate anaesthesia Paradoxical ventilation (abdomen rises and thorax falls on inspiration and vice versa) - respiratory tract obstruction
What can cause an anaesthetised patient to stop breathing?
Post-induction apnoea common
Too light anaesthesia may mean breath-holding
Too deep anaesthesia may result in loss of respiratory drive due to depression of respiratory centre in brain
What can we check if an anaesthetised patient is not breathing?
Squeeze the bag
Blockage in expiratory gas pathway - T-piece twisted? APL valve closed? Kinks in breathing system tubing? ET tube or airway blocked?
External mechanical issue
What can cause tachycardia during anaesthesia?
Inadequate depth - adjust for noxious stimuli, consider additional analgesia
Hypercapnia - inadequate respiration, follow steps for SpO2 falling
Hypovolaemia/hypotension - stabilise dehydration/haemorrhage prior, manage fluid deficit
Drug action - direct / indirect (anaphylaxis)
What can cause bradycardia during anaesthesia?
Deep anaesthesia - decreased resp. rate/hypotension, adjust for non-noxious stimuli
Drug action - can be treated with atropine (anti-cholinergic)
High vagal tone/vagal reflex stimulation - e.g. brachycephalic dogs, stimulated occulocardiac reflex, can use anti-cholinergics
What is hypotension due to?
Reduced inflow to heart
Reduced pumping function of heart
Reduced vascular resistance
What causes hypotension during anaesthesia?
Anaesthetic drugs
Blood loss
Pre-existing conditions
Anaphylactic reactions
How do we manage hypotension during anaesthesia?
Turn down/off anaesthetic
IV crystalloid bolus
Positive inotrope admin, e.g. dopamine/ephedrine
What are the multiple factors that can cause emergencies during anaesthesia?
Sick animal - stabilise prior / postpone procedure
Human error - checklists, communication, think HALT
Equipment failure - check beforehand!
Inadequate preparation
Inadequate monitoring
What are the multiple factors that can cause emergencies during anaesthesia?
Sick animal - stabilise prior / postpone procedure
Human error - checklists, communication, think HALT
Equipment failure - check beforehand!
Inadequate preparation
Inadequate monitoring
What are the multiple factors that can cause emergencies during anaesthesia?
Sick animal - stabilise prior / postpone procedure
Human error - checklists, communication, think HALT
Equipment failure - check beforehand!
Inadequate preparation
Inadequate monitoring
What are the common human errors during anaesthesia?
Leaving APL valve closed Drug administration errors Airway management errors Errors with positioning Inadequate eye protection
