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2025 Anesthesia > Exam 1: Lecture 6: Anesthesia Monitoring Equiptment > Flashcards

Exam 1: Lecture 6: Anesthesia Monitoring Equiptment Flashcards

1
Q

What does the effect ASA PS scores increasing have on mortality rates?

A

increases mortality rates

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2
Q

Which ASA PS level(s) have a mortality rate of 0.12%

A

1 and 2

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3
Q

Which ASA PS level(s) have a mortality rate of 2.9%

A

3

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4
Q

Which ASA PS level(s) have a mortality rate of 17.33%

A

5

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5
Q

Which ASA PS level(s) have a mortality rate of 7.68%

A

level 4

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6
Q

ASA PS levels ? have an increased risk of death and severe hypothermia in dogs, cats, rabbits, and pigs

A

greater than or equal to an ASA PS level of 3

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7
Q

Post-op death accounts for what percent of anesthesia related deaths?

A

47-64%

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8
Q

Up until what day in horses can anesthesia related death be blamed on the vet?

A

7 days

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9
Q

Up until what day in small animals can anesthesia related death be blamed on the vet?

A

48 hours

(2 days)

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10
Q

Finish the following:

ACVAA Monitoring Guidlines

  • Ensure adequate ?
  • Ensure adequate ?
  • Ensure ventilation is adequately ?
  • Ensure body temperature does not deviate from ?
  • Maintain legal records of significant events and enchance recognition of trends in monitored parameters
  • Ensure responsible person is aware of patient status at all times during anesthesia and recovery and is prepared to intervene when needed to alert vet in charge of the status
A
  • Ensure adequte blood flow
  • Ensure adequte arterial blood oxygneation
  • Ensure ventilation is adequately maintained
  • Ensure body temperature does not seriously deviate from normal
  • Maintain legal record of significant events and enhance recognition of trends in monitored parameters
  • Ensure responsible person is aware of patients status at all times during anesthesia and recovery and is prepared to intervene when needed or to alert vet incharge about the changes in status
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11
Q

What basic monitoring should be done for a patient under anesthesia?

A
  • Anesthesic depth signs
  • Heart rate, rhythm, and pulse quality
  • Respiratory rate and effort
  • Noninvasive blood pressure
  • temperature
  • Mucous membrane color
  • capillary refill time
  • Pulse Oximetry (Spo2)
  • End tital carbon dioxide (ETCO2) = capnography

All of these techniques are noninvasive, easy to use and provide reliable information about patients status

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12
Q

What anesthetic depth signs should we especially be using

A
  • eye position
  • muscle relaxation
  • respiratory rate and pattern
  • Response to stimulation
  • Jaw tone and anal tone

never rely on just one of these signs, but multiple

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13
Q

What is the best sign to use when monitoring a patient under anesthesia?

A

You (The doctor)

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14
Q

How can we gather Heart rate and Rhythm on a patient under anesthesia?

A
  • Palpate pulses or feel the heart beating
  • Esophageal stethoscope
  • Ultrasonic Doppler to detect sound of blood flow in the artery using the doppler shift principle
  • ECG
  • SpO2
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15
Q

What device can be used to monitor an animal under anesthesia that can detect the sound of blood flow in the artery

A

Ultrasonic Doppler

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16
Q

Which finger do you never use to get an animals pulse and why?

A

Never use your thumb, because it also has a pulse and you dont want to confuse the two

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17
Q

What is the normal systolic pressure in animals?

A

80 mmHg

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18
Q

If you get the animals systolic and diastolic pressure what did you just measure?

A

HR

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19
Q

Which pressure is the difference between systolic and diastolic pressure

A

Pulse Pressure

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20
Q

What are the sites in SA to feel pulse pressure

A

Femoral a
radial a
lingual a

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21
Q

What are the sites in LA to feel pulse pressure

A

Facial a
transverse a
facial a
metatarsal a
digital a
auricular a
femoral a
coccygeal a

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22
Q

On the ECG what represents Atrial depolarization

A

P wave

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23
Q

On the ECG what represents Ventricular Depolarization

A

QRS Complex

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24
Q

On the ECG what represents ventricluar repolarization

A

T wave

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25
Q

What is number 1

A

R wave

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26
Q

What is number 2

A

QRS complex

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27
Q

What is number 3

A

PR segment

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28
Q

What is number 4

A

P wave

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29
Q

What is number 5

A

PR interval

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30
Q

What is number 6

A

Q wave

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31
Q

What is number 7

A

S wave

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32
Q

What is number 8

A

ST segment

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33
Q

What is number 9

A

T wave

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34
Q

What is number 10

A

QT Interval

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35
Q

What are the clinical uses for an ECG besides HR and rhythm?

A
  • Morphology of wave to locate disease
  • Cardiac oxygenation and adequate perfusion
  • Electrolyte abnormalities
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36
Q

If you have an increased in K+ what effect will it have on the ECG reading?

A

Increase in the T wave

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37
Q

How reliable is the ECG

A
  • Pulseless electrical activity (PEA)
  • Double counting
  • Electrical interference
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38
Q

What does it mean to have pulseless electrical activity (PEA)

A
  • May have electrical activity, but no mechanical activity
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39
Q

How do you place leads for an ECG on a small animal?

White lead = ?
Black lead = ?
Red lead = ?

A

White lead = right elbow
Black lead = left elbow
Red lead = Left stifle or abdomen

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40
Q

What lead do we use on small animal ECG?

A

Lead II

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41
Q

How do you place leads for an ECG on Large animals?

White lead = ?
Black lead = ?
Red lead = ?

A

White lead = right jugular furrow
Black lead = Left axilla region
Red lead = Any site remote from the heart

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42
Q

What lead do we use for large animals ECG

A

lead 1 or base apex

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43
Q

In Base Apex or Lead 1 ECG which electrical activity points away from + electrode

A

Large negative R waves

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44
Q

In Base Apex or Lead 1 ECG which wave is variable in horses

A

Variable P wave morphology

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45
Q

What is the reason for using Lead 1 or Base apex in large animals?

A

Accentuates the P wave, so it is easier to identify changes in morphology

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46
Q

When getting respiratory rate and effort what do you observe while the patient is under anesthesia?

A
  • Patients thorax
  • Movement of the reservoir bag
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47
Q

What two things can a respirometer determine in a pt under anesthesia?

A
  • Tidal volume (TV)
  • Minute volume
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48
Q

T/F: Capnograph can NOT display RR

A

Flase, it can

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49
Q

How can we effectively assess respiration while the pt is under anesthesia?

A

SpO2
- pulse Ox

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50
Q

What are two non-invasive non-indirect methods to get blood pressure

A

Doppler
Oscillometric

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51
Q

What device is used to inflate the cuff to occulde blood flow in the artery, as the pressure in the cuff is released the doppler detects the return of blood flow by reflection of sound waves from moving RBCs

A

Doppler

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52
Q

What items are needed for noninvasive blood pressure collection?

A

Sphygmomanometer
Ultrasonic doppler flow detector
with piezoeeletric crystal probe
ultrasound gel
+/- tape

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53
Q

Keep doppler reading _______ to be sure patient is not hypotensive

A

above 90 mmHg

54
Q

In cats, which machine best collets SAP?

A

Oscillometric

Doppler and optical plethysmogrpahy can also detect, just not as good

55
Q

Which BP machine in cats best predict direct MAP (Mean material pressure)

A

Doppler and OP

56
Q

What device uses blood flow through the arteries vibrations in the arterial wall = translated to air in the blood pressure cuff = detected and transduced into electrical signals to produce a reading?

A

Oscillometric blood pressure

57
Q

What is normal systolic pressure in animals

A

120 mmHg

58
Q

What is normal diastolic pressure in animals

A

80 mmHg

59
Q

What is the mean pressure of BP in animals?

A

around 90 mmHg

60
Q

What is the advantages of Doppler machines?

A
  • Audible pulse rate and rhythm
  • Some technical skills required to place, but able to quickly obtain SAP (systolic Arterial pressure)
61
Q

What heart sounds does the SAP show using the doppler machine

A

1st heart sound

62
Q

What are the disadvantages of using a Doppler machine to get BP

A
  • Does not give you MAP or DAP
  • Not as accurate as direct BP, especially as patient becomes hypotensive
  • Accuracy affected by selecting correct cuff size
63
Q

What are the advantages of using Oscillometeric BP machine?

A
  • Easy to place on the limb
  • Some can be set to automatically
  • Determines HR, SAP, MAP, and DAP
  • Actual pressure reading takes longer than doppler
64
Q

What are the disadvantages of using an Oscillometeric machine for BP?

A

Not as accurate as doppler method, especially in the following situations
- Hypotensive patient
- Small patients
- Patient movements
- Arrhythmias
- Vasoconstriction

65
Q

Where can you place thermometers for temperature monitoring

A

Rectal
Esophagus
Intrnasally

66
Q

What area of the body is not considered accurate for temperature monitoring

A

Axillary region

67
Q

How do you assess patient perfusion in animals
- EX: gums, vulva

A

Mucous membrane color

capillary refill time

68
Q

What is the normal CRT in animals?

A

1 to 2 seconds

69
Q

What is the normal color for a patients mucous membrane

A

Pale pink to pink

70
Q

What are abnormal mucous membrane colors in animals?

A

Pale to white / gray
Cyanotic
brick red
brown
yellow
petechiation

71
Q

T/F: Some drugs may cause decrease blood perfusion in animals = decreased MM and CRT

A

true

72
Q

What machine can be used to indirectly estimate % oxygen saturation of hemoglobin (Hb)

A

SpO2

73
Q

Define the use of an SpO2 machine

A

indirectly estimates % oxygen saturation of Hb (Hemoglobin)

74
Q

T/F: SpO2 can also show pulse rate (plethsmograph) true

A

true

75
Q

Spectrophotometric device is applied over non-haired skin with _______ blood flow?

A

Pulsatile

76
Q

What are some good areas to place a SpO2 probe?

A
  • nonhaired skin
  • light skin / lower pigmentation
  • Good blow flow
77
Q

Red and infrared light are absorbed (Similar / differently) by oxygenated and reduced (deoxygenated) hemoglobin. What is presented on the screen?

A

The difference is calculated and the % Hb saturation is displayed numerically

78
Q

What does a SpO2 monitor use to gain the difference between oxygen and deoxygenated blood

A

Emitter and photordector (sensor)

79
Q

What are the two types of SpO2 probes

A

Transmission
Reflectance

80
Q

SpO2 of 90% PaO2 of 60 mmHg = Severe?

A

Hypoxemia

  • need to intervene soon / ASAP to keep SpO2 around 95%
81
Q

Ideally, would prefer the SpO2 reading to be _______ = PaO2 of 80 mmHg (considered mild hypoxemia)

A

equal to or greater than 95%

82
Q

What effects accuracy of SpO2?

A
  • Poor circulation due to vasoconstriction, hypotension, hypothermia
  • Movement artifact
  • Pigmentation
  • Tissue thickness
  • Anemia
  • Carbon monoxide xyanide poisoning = falsely highly reading
  • Methemoglobinemia = reads in the mid 80’s
  • Ambient light
83
Q

What tool can be used to measure Inspired and Expired CO2 concentration?

A

Capnography

84
Q

Hypoventilaiton or hyperventilation?

Increased ECTO2

A

Hypoventilation

85
Q

Hypoventilaiton or hyperventilation?

  • Caused by malignant hyperthermia?
A

Hypoventilation

86
Q

Hypoventilaiton or hyperventilation?

Decreased ETCO2

A

hyperventilation

87
Q

Hypoventilaiton or hyperventilation?

  • Caused by hypothermia, decreased CO, disconnection and airway obstruction
A

Hyperventilation

88
Q

On the capnography where do you measure EtCO2

A

B(Beta)

89
Q

What is number 1 described as on the capnography

A

Respiratory baseline (Should be 0 mmHg)

90
Q

What is number 2 described as on the capnography

A

Expiratory upstroke

91
Q

What is number 3 described as on the capnography

A

Alveolar Plateau

92
Q

What is number 0 described as on the capnography

A

Inspiratory downstroke

93
Q

What does a capnography measure?

A

Measures the end title

94
Q

What is the normal value for EtCO2?

A

35 to 45 mmHg

95
Q

On the capnography what does A-B stand for?

A

Baseline

96
Q

On the capnography, what does B-C stand for?

A

Expiratory upstroke

97
Q

On the capnography, what does C-D stand for?

A

Expiratory Plateau

98
Q

On the capnography, what does D stand for?

A

End-Tidal volume

99
Q

On the capnography, what does D-E stand for?

A

Inspiration

100
Q

_______ produced in cells from metabolism = carried to the lungs = exhaled

A

CO2

101
Q

ETCO2 relies on absorption of ____ light by CO2 molecules concentration of CO2 determined by comparing measured absorbance with a known standard

A

Infrared

102
Q

ETCO2 relies on the absorption of which light source by CO2 molecules?

A

Infrared light

103
Q

T/F: Capnography is not a good monitoring tool because:

  • RR and estimation of PaCO2
  • Diagnose diconnection or lead
  • V/Q mismatch , Alveolar dead space, bronchoconstriction, airway obstruction, decreased CO
  • Return of spontaneous circulation during CPR
A

Flase, it is a good monitoring tool

104
Q

T/F: During recovery, you do not have to monitor the animal unless they are sick?

A

Flase, you still need to monitor the animals, you just don’t have to record vital signs

  • For routine cases just visual monitoring along with ausculatation with a stethoscope and rectal temp are utilized
  • Unstable cases or those at risk of complications need to be continuous monitoring in an ICU setting
105
Q

What is the normal temperature in dogs, cats, horses and ruminants?

A

98 to 102.5

106
Q

What is the normal HR for dogs?

A

50-160

107
Q

What is the normal HR for cats

A

100-200

108
Q

What is the normal HR for Horses

A

28-50
- foals up to 80

109
Q

What is the normal HR for Ruminants

A

48-90 cows

60-150 sheep or goats

110
Q

What is the respiratory rate for most adult species

A

10-20

111
Q

In all species EXCEPT for Equine, what is defined as the MAP?
- Hypotension

A

Less than 60

112
Q

In all species EXCEPT for Equine, what is defined as the SAP
- Hypotension

A

Less than 80

113
Q

What should you keep Equine blood pressure (MAP)

A

greater than 70

114
Q

What is the normal SpO2 for all species

A

95-100

115
Q

What is the normal ETCO2 (mmHg) for all species?

A

35-45 mmHg

116
Q

What are some advanced monitoring techniques that we can use for patients under anesthesia?

A
  • Invasive blood pressure
  • Blood gases and lactate
  • Blood glucose levels
  • Nerve stimulator
  • Gas analyzer
  • Pleth variability index
  • Cardiac output
  • Central venous pressure
  • Urine output
  • Eletroencephalogram
  • Bispectral index
  • Co-oximetry
117
Q

Record vitals every _______ to ______ minutes. if you are unable to do this make a comment on why this was not performed

A

5 to 10 minutes

118
Q

What is the gold standard for monitoring blood pressure and is better than indirect monitoring

A

Direct BP monitoring

119
Q

How is organ perfusion determined using IBP

A

determined by MAP

120
Q

How is coronary perfusion determined using IBP?

A

determined by DAP

121
Q

What can you use to flush arterial cathers out with when usin direct or IBP?

A

Heparinized saline

122
Q

What is the normal urine production in dogs and cats?

A

0.5 to 2 mL/kg/hr

123
Q

What is the gold standard for assessing oxygenation (PaO2) and ventilation (PaCO2) status in a patient?

A

Arterial blood gas

124
Q

Increased lactate levels of ______ due to severe hypoperfusion in patient = tissue oxygen deficiency

A

greater than 5 mmol/L

125
Q

T/F: Blood glucose meters can be used in all species and humans

A

False! use species specific blood glucose meters

126
Q

What device can be used when a neuromuscular blockage agent is used to determine level of blockade and recovery from blockade at the end of the procedure

A

Peripheral nerve stimulator

127
Q

What device can be used to determine the end-tidal concentration of various anesthetic gases? this is the important number to look at for comparing to known MAC values and helping to correlate with anesthetic depths?

A

Gas analyzer

128
Q

What does a PVI (Pleth Variability index) measure ?

A

The dynamic changes in the ammplitude of the pulse oximeter waveform during one or more complete respiratory cycles, then expressed as a percentage

129
Q

What does Cardiac output monitoring determine

CO = HR x SV

A

Volume of blood being pumped by the heart within one minute

130
Q

What does CVP (Central Venous pressure) measure?

A

Hydrostatic pressure within the intrathoracic vena cava = right atrial (RA) pressure

131
Q

What is the EEG value while an animal is under general anesthesia?

A

around 40-60

132
Q

What does an EEG record?

A

Brain activity

2025 Anesthesia (9 decks)

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