Induction & Intubation Flashcards
What is the main goal to an anesthetic induction?
Is to have atraumatic intubation of the trachea using a minimum effective dose of anesthetics.
Is there a perfect induction technique?
No - dosing and administration are based on each patient.
What do endotracheal tubes accomplish?
Creates a patent airway
Allows efficient delivery of oxygen, inhalation anesthetics and medications.
Helps prevent waste gas exposure
Allow for control of ventilation
Prevents aspiration of vomit, blood, saliva
Reduces dead space
Endotracheal tube risks
Can stimulate the vagus nerve
Brochi insertion
Cuff over-inflation
Tube obstruction-mucus plugs
What are the two different types of tubes
Low volume high pressure tubes
High volume low pressure tubes
What is the most common ET name?
Murphy (cuffed, eye at the end)
What is a definition of the Cole ET?
No inflatable cuff, shaped with a “shoulder”, shorter than Murphy.
How to chose an ET
Length - incisors to thoracic inlet
Diameter - use chart
What does the number on the tube reflect?
Inner diameter
What does giving “to affect” mean?
Just enough / to desired affect
What is the anesthetic affect we are looking for?
Jaw tone
How is cuff inflation handled?
Little at a time, wait for push back then stop.
Remember how much so you know to remove.
What is the equipment needed for intubation?
Laryngoscope 1-10ml syringe for cuff inflation lube or water Rolled gauze \+/- 2% lidocaine for cats (0.1 ml)
A complete chart includes
Surgical release form / estimate of cost
Exam results / patient history
lab results, radiographs
current status of animal and risk factors
DVM pre-surgical orders (i.e., drug requests.
What are some pre-surgical supplies needed?
Pre-surgical physical exam form and anesthesia monitoring form
Calculate dose required
Get drugs, needles, syringes, fluids, IV catheter ready
ET intubation supplies
Prepare the Ax machine
What is patient position for a 2 person intubation?
lateral and sternal recumbancy
What is the patient position for a single person intubation?
Dorsal recumbancy
How to confirm a proper intubation?
Patient may cough, but not always.
Should not be able to vocalize
Watch for movement from the reservoir bag & flutter valve.
Choices of anesthetic techniques based on a variety of factors. What are these factors?
Facilities Skill and Experience Temperment of patient Species and breed of animal Age and general health Site and nature of surgery Duration of surgery
What are the advantages of injectable anesthertics?
rapid onset of drug
ability to titrate dose and control / monitor depth
rapid recovery
What are some disadvantages of injectable anesthetics?
Small veins are hard to access without an IV catheter
restraint is critical
What are some common drugs for induction?
Ketamine & Diazepam (diazepam drawn first)
Telazol (Tiletamine and Zolazepam)
Propofol
What injectable induction agents are not often used anymore
Thiopental - can cause respiratory depression.
Etomidate - Expensive
Information regarding Masking and Induction chambers
Allow patient to breathe 100% 02 for 2-3 minutes.
Set anesthetic vaporizer to deliver 0.5%
Induction usually takes 5 - 10 minutes
Be cautious with waste gasses
