Hazards, Complications and CPR Flashcards
Ketamine has been accidentally injected into yourself/ sprayed in your eyes or mouth, what are the possible hazards with this?
- Hallucinations and convulsions
Chronic abuse/ use: degeneration of white matter and brain atrophy + ulcerative cystitis
Opioids has been accidentally injected into yourself/ sprayed in your eyes or mouth, what are the possible hazards with this?
- Severe respiratory depression
- Addiction
Alpha 2 agonists has been accidentally injected into yourself/ sprayed in your eyes or mouth, what are the possible hazards with this?
- Respiratory depression
- Cardiovascular alterations
Etorphine (immobilon) has been accidentally injected into yourself/ sprayed in your eyes or mouth, what are the possible hazards with this?
- Severe respiratory depression, coma and death
caution: an antidote must always be at hand and a second person who can inject the antidote is needed
Accidental acute exposure to Nitrous Oxide can result in?
- Light headedness
- Shortness of breath
Chronic exposure to Nitrous Oxide in hospital staff can result in ?
- Reduced Fertility
- Spontaneous abortion
- Neurological disease
- Renal + liver disease
- Inhibition of B12 synthesis
- Bone marrow suppression
- Teratogenic effects
Accidental acute exposure to high concentrations of volatile agents may lead to?
- Headaches
- Irritability
- Fatigue
- Nausea
- Drowsiness
- Difficulties with judgement and coordination
- Liver and kidney disease
How many Scavenging systems are available, and what are they?
2
- Active Scavenging: exhaled gas is extracted from breathing system and expelled into the atmosphere
- Passive Scavenging: tubing leads to an open window or a hole in the wall
note: active scavenging is MUCH better than passive
How can we minimize work place pollution with anesthetic agents?
- Check the scavenging system!
- Intubate patients with cuffed endotracheal tubes and inflate cuffs
- Avoid face masks and induction chambers
- Connect breathing system before turning on anesthetic vapours
- Clear the breathing system from anesthetic vapours with high oxygen flow before diconnection
- Fill vaporizers at the end of the day
- Ventilate induction, operative and recovery areas
- Service equipment regularly
How do you recognize a Cardio-pulmonary arrest patient?
- Unconscious or unresponsive
- No heart beat or pulse
- Grey/ cyanotic mucous membranes
- Fixed, dilated, dry pupils
- Not breathing or agonal breaths
- No reading on pulse oximeter or capnograph
- ECG arrhythmias or asystole
What are the chances that a patient who has undergone CPR will return to spontaneous circulation?
35 - 40%
What are the chances of an animal surviving CPR and being discharged to go home?
2 - 10%
What are the steps of CPR in a hospital setting?
1) Chest compressions: 100-120/ minute for uninterrupted cycles of 2 minutes, and the operator needs to be changed every 2 minutes
2) Intubate trachea and ventilate: 10 breaths/ minute
Dogs: compression is done at the highest point of the chest
Cats: compression is done directly over the heart
Note: do NOT stop chest compressions during IPPV
ECG Monitoring:
1) Ventricular fibrillation can be shocked with a defibrillator
2) Pulseless ventricular tachycardia can be Tx with Lidocaine boluses
3) Sinus bradycardia can be Tx with Atropine
3) Vascular access: jugular, peripheral venous or intra-osseous
If vascular access is not possible, drugs can be administered intra-tracheal BUT 10x higher than the normal dose
What are the steps of CPR outside of the hospital/ when you’re alone?
1) 30 chest compressions
2) 2 quick breaths mouth-to-snout ventilation
Done for 2 minute cycles without interruption
What are the Advanced Life Support (ALS) Drugs needed?
- Epinephrine (adrenaline)
- Vasopressin
- Atropine
- Amiodarone
- Lidocaine
- Reversal Agents: Naloxone for opioids, and flumazanil for benzodiazepines
