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Anaesthesia > Introduction & Pre-anaesthetic Assessment > Flashcards

Introduction & Pre-anaesthetic Assessment Flashcards

1
Q

Apnoea

A

no airflow for >10 sec

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2
Q

anoxia

A

absence of oxygen

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3
Q

hypoxia

A

not enough oxygen content in the tissues

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4
Q

hypoxaemia

A

not enough oxygen content of the blood

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5
Q

how long does it take for hypoxaemia to affect the brain during anaesthesia? What does it do?

A

After about 10 mins it can lead to brain injury and cause serious complications

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6
Q

hypercapnia (hypercarbia)

A

circulating CO2 levels are above reference range so that it causes negative effects

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7
Q

hyperventilation

A

needs: abnormal RR w/ normal tidal vol, high RR w/ high tidal vol, or normal RR w/ high tidal vol
removal of CO2 faster than the body can produce –> leads to too low of CO2

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8
Q

Low CO2 leads to

A

vasoconstriction in the brain & brain injury

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9
Q

Hypoventilation

A

if ventilation is not efficient enough (CO2 accumulates in circulation because lungs are not removing it sufficiently
Will lead to accumulation of CO2 –> when measured, use arterial CO2 by blood gas analysis or measure PPCO2
Increase –> cardiac arrest, etc

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10
Q

Tachypnoea

A

rapid breathing

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11
Q

bradypnoea

A

slower than normal breathing

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12
Q

tachycardia

A

heart beats faster than normal

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13
Q

bradycardia

A

heart beats slower than normal

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14
Q

hypotension

A

lower than normal BP

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15
Q

hypertension

A

higher than normal BP

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16
Q

hypothermia

A

lower than normal body temp

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17
Q

hyperthermia

A

higher than normal body temp

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18
Q

tranquiliser

A

drug used to reduce tension or anxiety

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19
Q

sedative

A

drug for calming & sleep-inducing effect

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20
Q

anxiolytic

A

drug used to reduce anxiety

21
Q

hypnotic

A

drug used to induce sleep

22
Q

dissociative anaesthesia

A

drugs used to distort perceptions of sight & sound & produce feelings of detachment/dissociation from the environment & self

23
Q

neuroleptanalgesia

A

combo of potent sedative analgesic & tranquiliser

24
Q

analgesic

A

drug used to relieve pain

25
Q

analeptic

A

drug that stimulates the CNS

26
Q

What is the definition of general anaesthesia?

A

state of unconsciousness produced by controlled, reversible intoxication of the CNS

27
Q

What are the 3 reasons we use anaesthesia?

A
  1. to prevent suffering while doing invasive procedures
  2. to prevent operator risk
  3. to fulfill legal requirements
28
Q

What are the 3 main things done as pre-anaesthetic assessment & screening?

A
  1. take a detailed history
  2. physical/clinical exam
  3. tests
29
Q

What are the 4 reasons to assess patients pre-anaesthesia?

A
  1. to determine the extent of clinical dz
  2. to detect subclinical dz
  3. to assign an ASA category of physical status
  4. to reduce anaesthetic & surgical morbidity & mortality
30
Q

What are some signs in the history that may impact your pre-anaesthesia assessment?

A
  • nature & duration of illness & txt received
  • exercise intolerance not related to musculoskeletal issues/injuries
  • cough
  • dyspnoea
  • recent trauma
  • syncope
  • appetite
  • time of last meal
  • PU/PD
  • V/D
  • previous anaesthetic Hx
  • other: pregnancy, behaviour, seizures, etc
31
Q

What are some physical exam features that affect anaesthesia that are non-specific to the body systems?

A

demeanour of the patient
assessment of ‘real’ age (may differ from chronological age)
BCS out of 9
Breed (brachycephalics? sighthound?)
Hydration status
body temp
weight

32
Q

What physical exam features might you find abnormal in the cardiovascular system that may impact anaesthesia?

A
  • HR, rhythm, murmurs
  • femoral pulses
  • apex beat/thrills
  • mm colour/CRT
33
Q

When examining the respiratory system prior to anaesthesia, what are you specifically examining?

A
  • observations of the thx
  • comparing each side of thx
  • count RR
  • respiratory pattern
  • auscultate both sides of thx
  • tracheal ‘pinch’
  • mm colour
34
Q

What other body systems may be impact anaesthesia assessment?

A
  • GI & urinary systems & abdominal palpation
  • skin
  • neurological system
35
Q

For a young, non-pediatric, healthy patient (ASA 1 or 2) undergoing a routine Sx, is there a need for extra screening past a thorough clinical exam?

A
  • “Routine haematological and biochemical profiles are unnecessary (and constitute an extra expense) in apparently fit, healthy animals” (1998)
  • Additional screening detected changes of little clinical relevance (2008)
36
Q

What haematology/biochemistry is necessary for patients undergoing major Sx & trauma P’s or pediatric P’s (<6 mos old)?

A

minimum of:
- PCV, Hgb
- total plasma protein, albumin
- urea & creatinine (+-) iPO4
- ALT, AP (+- bile acids)
- USG & dipsticks

37
Q

What haematology/biochemistry is necessary in sick patients with an ASA score of 3 or higher?

A

Full haematology
biochemistry (renal & hepatic incl clotting, electrolytes)
Urinalysis

38
Q

if there is a suspected disease, you have to test for…

A

the suspected dz

39
Q

young animals, diabetics, insulinoma, septic patients require what blood test?

A

BG q 30-60 minutes

40
Q

if you have a patient with vomiting & diarrhea, what bloods need monitoring?

A

electrolytes (K, Na, Cl)
USG

41
Q

if you have a doberman or doberman cross, what blood tests do you specifically need to consider prior to anaesthesia?

A

BMBT
von Willebrand factor

42
Q

What patients may require thoracic radiographs prior to anaesthesia?

A
  • significant cardiac dz
  • respiratory dz
  • RTA/trauma P
  • tumours (esp mammary, splenic, bone)
43
Q

What patients may require ECG prior to anaesthesia?

A
  • significant cardiac dz, murmur, arrhythmias except sinus
  • breeds susc to DCM (Great Dane, St. Bernard, Irish Wolfhound, Newfoundland, Dobermans)
  • Cats w/ hyperthyroidism (HCM)
  • splenic tumours
  • if pulse deficit detected
  • sick sinus syndrome in mini schnauzers
  • diseases leading to arrhythmias (Hyperkalaemia, GDV, splenic tumour, post-traumatic myocarditis)
44
Q

When assigning ASA scoring, how do you note that it is an emergency patient?

A

Assign an E next to the score

45
Q

What patient gets an ASA 1?

A

normal, healthy P w/ no discernible organic disease scheduled for an elective procedure

46
Q

What patient gets an ASA 2?

A

mild, systemic dz, which does not limit activities

47
Q

What patient gets an ASA 3?

A

moderate to severe systemic dz that limits activities but is NOT a constant threat to life

48
Q

What patient gets an ASA 4?

A

severe systemic dz that is a constant threat to life

49
Q

What patient gets an ASA 5?

A

moribund p, not expected to survive without the operation

Anaesthesia (23 decks)

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