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Pharmacology II > Lecture 30: Peri-anesthesia monitoring and complications-IV > Flashcards

Lecture 30: Peri-anesthesia monitoring and complications-IV Flashcards

1
Q

What do you check to monitor patients oxygenation

A
  1. SPO2
  2. Pulse rate
  3. Change in SV
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2
Q

What does SPO2 tell you

A

Oxygenation

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3
Q

What does pulse rate tell you that ECG does not

A

If the heart is actually beating

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4
Q

What is a normal PaO2

A

95 (80-100)mm Hg

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5
Q

What is normal SaO2

A

98 (95-100) %

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6
Q

What is normal PvO2

A

45 (40-45) mm Hg

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7
Q

What is normal SvO2

A

75 (70-75)%

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8
Q

What is the ideal maintenance of SPO2

A

95%

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9
Q

What is the minimum for SPO2

A

90%

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10
Q

SPO2 is an estimate of ___

A

SaO2

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11
Q

What is the definition of hypodermic

A

PaO2 <60mm Hg

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12
Q

A PO2 of 60mmHg is equal to __SO2%

A

90%

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13
Q

How do you assess accuracy of SPO2

A
  1. Waveform- constant/ good waveform
  2. Pulse rate/rhythm matches actual HR or PR
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14
Q

What can affect reliability of pulse ox

A

Motion, pigment, tissue perfusion, thickness of tissue

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15
Q

Where do you place pulse ox probe

A

Tongue, lips, toes, toe nails

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16
Q

If pulse ox not working what can you apply to tongue and what does it do

A

Dry cause- cushioning effect- prevent collapsed capillary

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17
Q

What is definition of cyanosis

A

deoxyhemoglobine >5g/dl

18
Q

Cyanosis corresponds with what SPO2 and PaO2 values

A

SPO2 <80%
PaO2 50mm Hg

19
Q

T or F: pink MM always means adequate oxygenation

A

False

20
Q

If you can’t reliably assess low SPO2 what do you do

A

Arterial blood gas- check PaO2

21
Q

What is gold standard for assessing oxygenation level

A

Arterial blood gas analysis

22
Q

What are 5 causes of hypothermia

A
  1. Low FiO2
  2. Hypoventilation
  3. V/Q mismatch
  4. Diffusion impairment
  5. Right to left shunt
23
Q

What should you do if low FiO2 is causing hypoxemia

A

Check O2 flow meter is on and check source of O2 (is it empty)

24
Q

What do you do for hypoxemia caused by hypoventilation

A

Manual or mechanical ventilation

25
Q

V/Q mismatch is very significant in what species

A

Large animals

26
Q

How do you tx V/Q mismatch

A

Avoid/treat atelectasis, improve BP if hypotensive

27
Q

What can cause diffusion impairment leading to hypoxemia

A

Pneumonia, pulmonary edema, pulmonary parenchymal disease

28
Q

What are some causes of Right to left shunt

A
  1. Patent foramen ovale
  2. Ventricular septum defect
  3. Pulmonary embolism
29
Q

What is the easiest way to prevent hypoxic situations during anesthesia induction

A

Pre-oxygenate with mask for minimum of 3 minutes

30
Q

How long do you have til hypoxemia if you don’t preoxygenate

A

30 secs

31
Q

How long do you have if before hypoxemia if you preoxygenate with mask for 3 minutes

A

187 secs

32
Q

When actually pushing the drugs, what do you want to do to avoid respiratory depression/ apnea

A

Slow titration/ injection and only use enough to induce

33
Q

You should wait __after each injection of induction agent to see maximum effect

A

30 seconds

34
Q

What 4 things are involved in BOAS

A
  1. Stenotic nares
  2. Hypoplastic trachea
  3. Everted laryngeal saccules
  4. Elongated soft palate
35
Q

How do you prevent hypoxemia in brachycephalic breeds during ax recovery

A
  1. Keep intubated until absolutely impossible
  2. Keep sternal
  3. Monitor SPO2
36
Q

What is a plethysmograph

A

Pulse oximeter waveform

37
Q

Each triangle of a pulse ox represents __

A

Each heart beat

38
Q

Area under the curve of a pulse ox is proportional to __

A

Stroke volume

39
Q

Looking at the Plethysmograph and SV is a great tool to assess ___

A

Degree of clinical effects of arrhythmias

40
Q

What do blue and red circles and arrows indicate. Which is worse clinically, top or bottom photo

A

Red circles- VPC, corresponding with red arrow showing decrease SPO2/SV

Blue: normal sinus rhythm corresponding with blu arrows showing normal SPO2/ and good SV

Top photo is worse because the SPO2, therefore the SV decrease more with a VPC than in bottom photo

Pharmacology II (36 decks)

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