Monitoring anaestheisa Flashcards
What does the anaesthetic period consist of?
Pre anaesthetic assessment Pre medication Induction Maintenance Recovery period
What is involved within the pre anaesthetic assessment?
Assessing patient risk - class 1 to 5
What are advantages of giving agents I/V via a catheter?
Reduces risk of extravascular injection
Rapid I/v access for emergencies
Rapid deepening of anaesthesia
Admin of fluids (if required)
What are disadvantages of giving I/V agents via a catheter?
Vein damage
Sepsis - may introduce bacteraemia
What are the aims of monitoring anaesthesia?
To provide an appropriate depth of anaesthesia for the procedure
To maintain normal physiological function in the patient
Which body systems have prioritised monitoring during anaesthesia?
Cardiovascular
Central nervous
Respiratory
Temperature
What is included when monitoring cardiovascular function?
HR and rhythm Pulse quality C.R.T MM colour Hb saturation Perfusion
What is the normal HR in dogs and cats
Dog = 70-140bpm Cat = 100-120bpm
Where is the plapation of superficial arteries taken from?
Femoral Sublingual Nasal Ulnar Palmar Meta-carpal
When is the apex beat palpated?
In small animals or when the pulse is low
What does a stethoscope monitor?
Rhythm, rate, valve function and contractility
What does a ECG monitor?
The electrical activity of the heart. Doesn’t indicate cardiac output or mechanical activity
What normal variations can be seen within the cardiovascular system?
Sinus arrhythmia - normal variation in HR that occurs during respiration (pulse is regularly irregular)
Inspiration - HR increases
Expiration - HR decreases
How can pulse quality be measured indirectly?
Palpation - use small peripheral arteries as are more sensitive to changes in BP
Oscillotometry - pneumatic cuff around the limb, very expensive and can be inaccurate in hypotension
Ultrasonic - doppler
How can pulse quality be measured directly?
by direct BP measurement - accurate but invasive
What is capillary refill time normal?
Colour should return within 2seconds
What can cause a delay to capillary refill time?
hypotension
Vasoconstriction
What is the normal colour for mucous membranes?
Pink
What can cause a change in mucous membrane colours? and to what colour?
Hypercapnia = bright pink
Cyanosis = blue
Hypertension/blood loss = white
What is used to measure haemoglobin saturation? How does it measure?
a pulse oximeter
Uses red and infrared light beams to detect presence of oxygenated arterial blood
How is perfusion measured?
Pulse pressure
C.R.T.
Pulse oximetry
What is normal for good perfusion?
Red blood at site
What does poor perfusion look like?
Dark oozing blood
What are the cranial nerve reflexes?
palpebral Jaw tone Pupil diameter Salivation Tongue curl Eye position Corneal reflex Lacrimation
