Patient assessment & preparation for anaesthesia

Question 1

Pre-anaesthetic considerations

Answer 1

• Pre-anaesthetic instructions for the client
• Medical history
• Physical examination
• ASA scoring and identifiable pre-anaesthetic risks
• Pre-anaesthetic lab tests
• Purpose of anaesthetic

Question 2

Pre-anaesthetic instructions

Answer 2

• Arrival time
• Fasting period
• Medication guideline - do they need meds prior to coming into practice? are they on any current meds that need to be stopped or continued as normal?
• Give clients info sheet of anaesthetic risks and details of procedure the patient is having
• Make sure they understand what an anaesthetic is and the risks involved
• Informed consent

Question 3

Medical history

Answer 3

• Check medical history to identify any potential risks or interventions that may be needed
• Patient identity
• Age
• Breed and species
• Neuter status
• History of adverse reactions
• Systemic diseases
• Medication history
• Previous medical history
• Records from previous anaesthetics or sedation

Question 4

Why are physical exams important?

Answer 4

• Allows for us to identify any abnormalities
• Promotes individual approach
• Necessary for us to create an individualised anaesthetic protocol
• Any abnormalities detected should be discussed with the vet surgeon

Question 5

ASA scoring

Answer 5

• Useful in identifying the pre-anaesthetic risks
• An intervention plan should be created with the vet surgeon
• Identifying any concerns or abnormalities may lead to further testing or assessment prior to anaesthetic
• Never assume that an anaesthetic is going to go smoothly
• Each anaesthetic involves some risk

Question 6

Pre-anaesthetic lab tests

Answer 6

• Pre-anaesthetic blood work is used to identify any underlying comorbidities, disease processes and indicator for organ failure
• Standard blood tests = Biochemistry, Haematology, Electrolytes

Question 7

Considerations

Answer 7

• Pre-anaesthetic instructions
• Obtain informed consent
• Physical examination
• Pre-operative bloods
• Intravenous fluid therapy and intravenous catheter
• Premedication plan
• Monitoring equipment and set up multi parameter
• Induction agent
• Endotracheal tube selection
• Safety checklist
• Crash trolley

Question 8

Placing IV catheters

Answer 8

• All patients undergoing general anaesthetic should have an IV catheter placed - in some cases multiple
  They allow for:
• Administration of IV fluid therapy
• Administration of drugs intravenously
• IV catheters should be placed ideally before the patient has their premeds as there is always the potential risk of adverse reactions
• EMLA should be used 20 mins prior to placing IV to numb the area and aid in patient compliance

Question 9

IV fluid therapy

Answer 9

Helps with:
- Replacing fluid loss
- Preventing dehydration
- Supporting organ function
- Supporting circulatory system