Patient Assessment (Pre-ana period)

Question 1

What is the 1st step to the pre-anaesthetic assessment?

Answer 1

Gathering relevant patient history + Physical exam

Question 2

Can a history and physical exam be performed by a VN or VS?

Answer 2

Both.

Dependent on the VP’s policy.

Question 3

List 9 questions to ask when obtaining a history from a Client

Answer 3

1. What procedure has the animal been admitted for?
2. How old are they? (Check pet ID)
3. Have they been fasted? (If appropriate)
4. Have they suffered from any previous illnesses?
5. Have they been exhibiting any signs of illness in the past 24-48hrs? (Coughing, Sneezing, V+, D+)
6. Are they on any current medication or previously?
7. Do they have any known drug or allergic reactions?
8. What is their vaccination + reproductive status?
9. Have you noticed any abnormalities? (Polydipsia, phagia, pain or struggling to urinate + defecate)

Question 4

If any abnormalities have been found out after obtaining a history, what must you do?

Answer 4

Notify the VS immediately, to allow for further investigation

Question 5

What should be recorded in writing and attached to patient records + consent form?

Answer 5

Patient history form

Question 6

Why is a thorough examination to all anaesthetic patients vital?

Answer 6

To illuminate any potential health problems which could adversely effect patient safety in the anaesthetic or recovery period

Question 7

At the very least, what should VNs take upon physical exam?

Answer 7

1. TPR
2. Head > tail check

Including a record, in writing:
* Name
* Species
* Breed
* Weight
* Sex
* Age

Question 8

What systems must be checked upon pre-anaesethetic examination?

Answer 8

All of them.

1. Central Nervous System
2. Cardiovascular system
3. Respiratory system
4. Haematological system
5. Hepatic system
6. Renal system

Question 9

When examining a Male patient for castration, what is the most important thing to check?

Answer 9

Presence of both testicles

Question 10

When examining a Female patient for castration, what is the most important thing to check?

Answer 10

Signs of:
1. Oestrus
2. Pregnancy
3. Pseudopregnancy

Question 11

List the 6 details that should be recorded on the Anaesthetic consent form

Answer 11

1. Name, address + phone number of the VP
2. Name, address + phone number of Owner
3. Pet’s species, breed, colour/markings, age, sex, neutering status + weight
4. Relevant history (Adverse drug reactoins, concurrent illness + current medications)
5. Details of procedure to be performed (no technical terms used + risks)
6. Owner signature + date (Only if over 16 + if not O, specify they are an agent)

Question 12

7..

List some pre-anaesthetic screening profile examples

Answer 12

1. Biochemistry
2. Haematology
3. Urinalysis
4. Blood gas
5. ECG
6. Radiography
7. Blood Clotting profile

Question 13

What is Anaesthesia?

Answer 13

A state of controlled + reversible unconsciousness characterized by lack of pain sensation (analgesia) and relatively depressed reflex responses

Question 14

Give the 3 reasons for providing Anaesthesia to patients

Answer 14

1. Humanitarian reasons
2. Practicality (Facilitate sx)
3. Legal obligations

Question 15

What 3 pieces of legislations cover the use of anaesthetics in the VP?

Answer 15

1. Animal Welfare Act of 2006
2. Animal Health and Welfare Act (Scotland) of 2006
3. Protection of Animals (Anaesthetics) Acts of 1954 & 1964

Question 16

What peice of legislation states that '’any animal requiring surgery into sensitive tissues requires anaesthesia’‘?

But excludes Injections, Bloods, Cytocetesis + De-horning

Answer 16

The Protection of Animals (Anaesthetics) Acts of 1954 & 1964

Question 17

What are the 4 purposes of providing anaesthesia to patients?

Answer 17

1. Prevent pain (Reducing inflammation, by NSAIDs)
2. Immobilise the patient (Muscles)
3. Facilitate surgery by providing muscle relaxation (Muscle tension causes more trauma, delaying healing)
4. Maintaining patient safety at all times

Question 18

What are 7 influences the choice of anaesthetic protocols for patients?

Answer 18

1. Facilities avaliable (Machines, circuits, masks, scavenging)
2. Assistance to restrain px
3. Skills + preference of VS
4. Patient factors (Old, young, aggressive, sick)
5. Surgical factors (Type, location, duration, site)
6. Post-op facilities
7. Money (Care, facilities, drugs)

Question 19

True or False.

The patient is conscious during GA.

Answer 19

False.

They are unconscious.

Question 20

Name the 4 administration routes for administering GA

Answer 20

1. IV (most common)
2. IM (often induced this way)
3. Inhalational (how px are maintained)
4. Intra-peritoneal (IP) (rare)

Question 21

What likely anaesthesia is this patient undergoing here + what route is it being maintained?

Answer 21

1. GA
2. Inhalation (Presence of ET tube)

Question 22

What does Local Anaesthesia (LA) do?

Answer 22

1. Allows patient to remain consicous during the procedure
2. To minimise risks

Question 23

What type of anaesthesia would be used for a pregnant Ewe, who is undergoing a Caesarean?

Answer 23

Local Anaesthetic

Question 24

True or False.

LA is an type of Anaesthesia + Analgesia.

Answer 24

True

Question 25

List the **5 types** of **LA**

Answer 25

1. Topical 2. **Infiltrative** 3. **Block** 4. Epidural (spinal) 5. **IV Regional** (Inc ***tourniquet***)

Question 26

True or False. There is 5 types of LA and it can be used in conjuction with GA.

Answer 26

True

Question 27

List the 4 stages of GA

Answer 27

1. Pre-anaesthetic 2. **Induction** 3. **Maintenance** 4. **Recovery**

Question 28

List the **3 stages** of the **Pre-anaesthetic** period

Answer 28

1. Period of **fasting** 2. Pre-anaesthetic **assessment** 3. Pre-**medication**

Question 29

List the **2 stages** of the **Induction** period

Answer 29

1. **Administration** of **anaesthetic agent** 2. **Intubation**

Question 30

What occurs during the **Maintenance** period?

Answer 30

1. **Provision** of a **stable level of anaesthesia** 1. To **allow** for **surgery** to occur 1. Usually **inhalational**

Question 31

What **2** stages occurs during the **Recovery** period?

Answer 31

1. **Reversal** of **induction** phase 2. **Anaesthetic** is **eliminated** from the patient's system

Question 32

As general common sense, **why** is **anaesthesia** or **causing unconsciousness dangerous**?

Answer 32

**You're ssentially stopping** the **brain** from **controlling**: 2. **HR** 3. **RR** 4. Metabolism 5. Etc...

Question 33

Why do we fast patients?

Answer 33

1. To prevent vomiting 2. Reducing the fatal risk of aspiration pneumonia 3. **Decrease the risk of breathing due to limited lung expansion during anaesthesia**

Question 34

Name the 6 steps of the **pre-anaesthetic period**

Answer 34

1. Fasting 2. Assessment (History, thorough physical + accurate weight) 3. **Selection of Diagnostic procedures** 4. **Selection of Anaesthetic protocol** 5. Other VS recommended procedures (**IV catheterisation**) 6. **Prep** of ana **equipment**, **drugs** + **surgical equipment**

Question 35

# 8.. What **conditions** cause a **greater risk** of **regurgitation**?

Answer 35

1. Megaoesophagus 2. **Gastro-Oesophageal Reflux** (GOR) 3. **GORD** (Disease) 4. Oesophageal **stricture** 5. Oesophag**itis** 6. **Foregin bodies** 7. **Hatial + Sliding hernias** 8. Paraoesophageal Hatial

Question 36

True or False. **Small** mammals that **cannot regurgitate** do **not** require fasting, but the **food material** should **still be cleared** from the **Oropharynx**.

Answer 36

True

Question 37

List 9 questions to ask when admiting a patient for an anaesthetic procedure

Answer 37

1. **What procedure** has the ax been admitted for? 2. How **old**? *(Confirm pet ID)* 3. Have they been **fasted**? *(If appropriate)* 4. Have they suffered from any **previous illness**? 5. Has the ax **exhibited any signs of illness in the past 24-48hrs**? *(Coughing, sneezing, V+, D+)* 6. Have they recieved any **medication** recently? 7. Any **known drug reactions**? 8. What is their **vaccination + reproductive status**? 9. Has the O **noticed** any other **abnormalities**? *(Polydipsia, Polyphagia, Tenemus, Stranguria, Polyuria, Haematuria, Malezia etc)*

Question 38

What does the pre-ana exam consist of?

Answer 38

1. **TPR** 2. Concentrate on: * CNS * CVS * Respiratory * Hepatic * Renal * Haematological 3. **Pre-neutering check** *(Signs of Pseudocysis, pregnancy, presence of testicles or signs of season)* 4. **Record** all findings

Question 39

Why should you never write technical language such as "GA, OVH, GA Dental" on a consent form?

Answer 39

Because client's should recieve a copy of the form, and this is technical language