Pre-op evaluation Flashcards
what 3 things need to happen to achieve an ideal anesthetic technique
loss of consciousness, analgesia, and stability of organs/systems
what are some broad aspects that affect our anesthetic approach
breed, species, positioning, surgery vs diagnostics, risk to patient, risk to personnel, GA vs standing sedation, handling/accessibility, history
what are three ideal pieces of info for a pre-op evaluation
-history
-physical exam
-blood work
examples of an ASA score of 1
NORMAL/HEALTHY
Spay/Neuter, Uncomplicated fractures, Uncomplicated hernias
examples of an ASA score of 2
MILD SYSTEMIC DISEASE
Mild diabetes, Moderate anemia, Complicated fracture, Obesity, Pregnancy, “Localized” cancer, Wound repair
examples of an ASA score of 3
SEVERE SYSTEMIC DISEASE
Uncontrolled diabetes, Severe trauma, Complete intestinal obstruction, Cancer, Stable colic
examples of an ASA score of 4
SEVERE SYSTEMIC DISEASE THAT IS A CONSTANT THREAT TO LIFE
Cardiovascular disease that affects
significantly hemodynamic function,
Hemoabdomen, Ruptured bladder
examples of an ASA score of 5
A MORIBUND PATIENT WHO ISNT EXPECTED TO SURVIVE WITHOUT OPERATION
Ischemic bowel, Multiple organ dysfunction, Intracranial bleed
examples of an ASA score of E
EMERGENCY
Delay in treatment would lead to a significant increase in the threat to life or body part
what species has the worst anesthesia mortality risk
horses (worst) –> rabbits –> dogs –> cats –> people
what is the importance of blood work pre-op
it can lead to re-categorization of ASA score if it indicates an underlying disease we werent aware of initially
what organ is in trouble if there is elevated amylase or lipase
pancreas
what organ is in trouble if there is elevated creatine kinase
muscle
what organ is in trouble if there is elevated SDMA, creatinine or urea
kidneys
what organ is in trouble if there is elevated GGT, free/total bilirubin, Alk phos, ALT, albumin, globulin, TP
liver
what do we need to consider the effect of drugs on
cardiorespiratory system, drug interactions, pain management
what does proper anesthetic management involve
adequate knowledge of the
pharmacology of anesthetic drugs and their impact on the physiology of the patient
what does inadequate knowledge result in
results in undesirable/unexpected
anesthetic effects that may increase the risk to the patient you are handling
