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Peri/post-operative Care > Peri/post-operative Care > Flashcards

Peri/post-operative Care Flashcards

Shock and fluid therapy Anaesthetic emergencies

1
Q

Why are there increased risk during peri/post operative care?

A
  • Reduced observation/monitoring
  • Oxygen and airway support removed.
  • Anaesthetic/sedative drugs still being metabolised.
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2
Q

What 7 factors to considered that can affect recovery?

A
  • Patient ASA grade
  • Temperature
  • Breed
  • Extremes of age
  • Weight
  • Duration of GA
  • Anaesthetic drugs administered.
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3
Q

Why do we check the patient ASA grade?

A
  • Hepatic, renal and endocrine disease alter drug metabolism.
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4
Q

Why do we check the temperature?

A

Hypothermia reduces clearance of drugs, shivering increases oxygen requirements.

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5
Q

Why do we consider the breed?

A
  • Sighthounds - relative drug overdose

- Brachycephalic dogs

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6
Q

Why do we consider extremes of ages?

A
  • Geriatric - reduced metabolic function.

- Neonates - limited hepatic/renal function and large surface area: volume ratio prone to hypothermia.

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7
Q

Why do we consider weight during recovery?

A
  • Drug overdose and hypothermia.
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8
Q

Why does GA duration affect recovery?

A
  • Longer duration, more likely to get hypothermia.
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9
Q

What can affect the factors of recovery?

A
  • Anaesthetic drugs administered.
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10
Q

How should the recovery area be?

A
  • Warm and draught
  • Quiet
  • Well Ventilated
  • Central observation area
  • Easy access to: - oxygen, emergency equipment and drugs.
  • Comfortable bedding
  • Power sockets
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11
Q

How should a handover process go?

A
  • Effective communication of information. - procedure and info from VS, analgesia, any other drugs e.g. dobutamine, any complications, pre-existing disease.
  • Assessment - ABC, temp, pain.
  • AVA Checklist
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12
Q

What to consider when checking the airway?

A
  • recovery begins once patient is removed from anaesthetic gases and oxygen supply.
  • Endotracheal tube (deflate cuff- laryngeal oedema in cats. Dental?
  • Removals - dogs - gag relfex, on extubation. cats - slight tongue movement prior to gag.
  • Head/neck extended, tongue forward.
  • Watch for signs for resp. distress e.g. increased respiratory rate/effort, cyanosis.
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13
Q

What to consider when recovering a patient with BOAS?

A
  • Brachycephalic Airway Obstruction Syndrome.
  • Long soft palates, obstruct larynx on extubation.
  • Recover in sternal recumbency
  • Support head and neck
  • Have propofol/laryngoscope/ETTs ready!
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14
Q

What to consider when recovering a patient to breath?

A
  • monitor resp rate, effort, character every 5 minutes.
  • Pulse oximetry - much more useful when breathing room air
  • Care - not to allow patient to damage.
  • Oxygen supplementation.
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15
Q

What to consider, when checking the circulation?

A
  • Pulse - peripheral, character and rhythm.
  • Blood pressure - MABP >60mmHg - Measure if: blood loss, hypotension during surgery, delayed recovery.
  • Mucous membrane colour and CRT
  • CVP.
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16
Q

What are the negative effects of hypothermia?

A
  • Delayed anaesthetic recovery
  • Hypoventilation
  • Hypoxaemia
  • Delayed drug metabolism
  • Arrythmias
  • CNS dysfunction
  • Increased oxygen demand from shivering.
  • Platelet dysfunction
  • Bradycardia
  • Delayed wound healing
17
Q

What are the factors that promote hypothermia?

A
  • Low ambient temperature
  • Inability to move (sedation, GA).
  • Starved patients reduced gut motility.
  • Extremes of age
  • Drugs causing vasodilation e.g. ACP
  • Radiant Loss
  • Cold and High FGF
  • Cold IV/Lavage fluids
  • Fluid spillage/urine soiling.
18
Q

How do we check the temperature?

A
  • check the rectal temperature on recovery. - every 30mins for patients with normal patients. - every 15mins for patients that are hypothermic.
  • Care not to over heat
  • Prevention of hypothermia is best.
19
Q

What is considered to keep the patient warm?

A
  • Heat lamp
  • Hot hands
  • IVFT warmer
  • Bear Hugger
  • Foil/aluminum cover

Peri/post-operative Care (1 decks)

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