Other Anesthetic Complications Flashcards
what are 5 ways that overdosing can occur
- wrong math
- syringe swapping
- wrong drug concentration
- not waiting long enough before redosing
- drawing up the wrong drug
how can you prevent overdosing/math errors
- always label syringes
- check concentration in body
- double check math
- have reversals available
pain at injection into an IV is common in _____ with what drug
cats; propofol
what are some catheter problems to avoid
- non-patent catheter causing your drugs to extravasate
- phlebitis with long-term catheters
- multiple attempts when placing causing a leaky vein
how can you make it easier to intubate due to lack of visualization and how do you know youre in the right hole
- use a stylet or guide tube
- use a scope to visualize
- look for condensation
- capnograph
what are signs of esophageal intubation (BAD)
- no movement of rebreathing bag
- cant get a seal
- very low or no CO2 wave on capnograph
- animal waking up
- hypoxemia
during what time does temperature drop the most during anesthesia
first hour
why do we see hypothermia under GA
- loss of thermoregulation
- vasodilation
- cold anesthetic gases
- cold fluids
- cold operating room
- cold prep
- lavage during surgery
is hypothermia better or worse in patients with a large surface area to body mass ratio
worse (i.e. small patients)
what are some consequences of hypothermia (8)
- risk of anesthetic overdose (because metabolism drops)
- prolonged recovery
- post-op infectioon
- impaired coagulation
- discomfort on recovery
- increased blood viscosity
- bradycardia that DOES NOT respond to anticholinergics
- arrhythmias and cardiac arrest <23C
what are the best ways to prevent hypothermia
- keep animal covered
- forced air blankets and heating pads
what are iatrogenic causes of hyperthermia during anesthesia
- warming devices
- large heavy coated animals undergoing procedures associated with little heat loss
what are diseases that can cause hyperthermia
- malignant hyperthermia
- serotonin syndrome
- hyperthyroidism and cushings
- HYPP
- seizures
- opioids in cats
what are consequences of hyperthermia
- seizures
- organ dysfunction
- metabolic acidosis
- increased ETCO2
- increased HR and RR
- hypermetabolism
how do we treat hyperthermia
- stop all warming
- take out fleeces
- active cool down
is regurgitation and active or passive process
passive
why do we see regurgitation and GER during anesthesia
the drugs we commonly use relax the LES
what are consequences of regurgitation
- esophageal strictures and esophagitis
- nasal and pharyngeal irritation
- aspiration pneumonia
how can we prevent regurgitation in dogs and cats
cisapride and metoclopramide
how can we treat regurgitation
antacids (omeprazole, famotidine)
position head down
suction
esophageal lavage
what are causes of hypoglycemia
- neonates
- very small patients
- diabetes
- insulinoma
- hepatic disease
what are consequences of hypoglycemia during anesthesia
- seizures
- prolonged recovery
how do we treat hypoglycemia during surgery
dextrose (CRI or bolus)
what are causes of seizures during anesthesia
- hyperthermia if severe
- metabolic disease (low Ca, Na, glucose)
- cerebral ischemia
- intracranial disease/trauma
- epilepsy
- post-myelogram contrast injection
what are causes of waking up during surgery
- inadequate monitoring
- disconnection of IV/tube
- forgot to turn on iso
- apnea
- hypoventilation
what are the 3 main causes of poor recoveries
1) pain
2) emergence delirium
3) dysphoria
what is emergence delirium
quick wake up from GA accompanied by psychomotor agitation
what causes emergence delirium
- anxious animals
- no sedation
- noises and stimulation
what do you do if your patient is having a rough recovery
- check last dose of opioids
- palpate surgical site for pain
- minimize noise and light
- administer sedatives to slow transition
- reverse opioids with naloxone (TITRATE)
- give time
