intro and pre-anesthetic evaluation Flashcards
tranquilization
behavior change
relief of anxiety
patients are relaxed but aware of surroundings
sedation
central depression, drowsiness
patient unaware of surroundings but responsive to pain
narcosis
drug indued state of sleep
hypnosis
artifically induced sleep
patient readily aroused
pain
unpleasant sensory and emotional experience associated with actual or potential tissue damage
analgesia
freedom or absence of pain in presence of stimuli that would be painful
nociception
reception, conduction and processing of nerve signals generated by stimulation of nociceptors
neuroleptanalgesia
combination of opioi and tranquilizer
dissociative anesthesia
induced by drugs that dissociated the thalamocortical and limbic systems
cataleptoid state (eyes open, swallow reflexes intact, hypertonus)
bolus injfection
injection that is given over short (seconds) peroid of time
constant rate infusion (CRI)
injection given over longer peroids (hours to days) at a constant rate to maintai steady drug levels in plasma
patient evaluation
signalment
temperament
hx
PE
lab exam and diagnostics
patient prep
ASA status
signalment/temperament
age
sex
breed
species
weight
BAR/QAR vs exciable vs aggressive
hx
nature, duration of illness
co-morbidities
level of debilitation
previous or current drugs
anesthetic history
PE
BCS
Cardiopulmonary
Hepatic
Renal
Reproductive
Gastrointestinal
musculoskeletal
integument
temperament!
laboratory tests
Big 4: PCV, TP, BUN, glu
other: CBC, Chem, Liver fcn tests, UA, crossmatch, thoracic rads, ECG, clotting times
patient preparation
fasted? (except neonates, exotics/small mammals
necessary medications received
stabilized/underlying conditions treated: dehydration, hypovolemia, electrolyte abnormalities, arrythmias, thoracocentesis
ASA status
assesses risk of patients
I: normal, healthy
II: mild systemic disease
III: severe systemic disease
IV: constand threat to life
V: not expected to survive 24 h
adequate plane of anesthesia
eye signs-eye positionm, palpebral reflex (absent), corneal reflex (present)
physical signs: jaw tone, other reflexes
circulation
palpate pulse
palpate, auscult heart beat through chest wall
ECG
non-invasive blood pressure
oxygenation
goal: ensure adequate arterial oxygen content
mucous membrane color-cyanosis requires >5g/dl deoxygenated Hgb
pulse oximetry
oxygen analyzer
ABG (PaO2)
ventilation
goal: ensure adequate delivery of O2 and inhalant and expulsion of CO2
observation of chest wall, rebreathing bag
auscultation of breath sounds
capnography (ET CO2)
ABG (PaCO2)
