Recovery Flashcards
How should you position the patient for Recovery?
Sternal Recumbency
What else do you have to do for the patient in Recovery?
Patent and clean airway
deflate endotracheal tube
What do you do if regurgitation happens during recovery?
Postural drainage (nose low)
Swab posterior pharynx with gauze before awakening
Remove ET tube with cuff inflated
What kind of monitoring do you do for patient recovery?
TPR IN ALL PATIENTS!
Pulse Ox in brachycephalics, upper or lower airway disease, or pulmonary pathology
Blood pressure in patients with hemorrhage, sepsis, hypovolemia
How long do you monitor the patient in recovery?
until they can hold head upright and maintain sternal recumbency
What should you be cautious about in recovery?
Bandages around the head or neck
Bandages around the thorax
Brachycephalics
What kind of supportive care should you provide in recovery?
Use active and passive warming to maintain or raise body temp
Stimulate patient if needed to increase level of consciousness: Change position or auditory and tactile stimulation
What kind of complications can you find in recovery?
Pain Dysphoria Hypo- or hyperthermia Hypoventilation Hypoxemia Prolonged recovery
What signs should you look for with pain?
TPR changes Vocalization Posture/gait Interacting with caregivers Guarding of painful sites Behavior changes
What are the CV effects of pain?
Increased cardiac work load
What are the respiratory effects of pain?
Hypoventilation or hyperventilation, hypoxemia
What are the GI effects of pain?
Ileus
What are the Renal effects of pain?
Oliguria
What are the Hematologic effects of pain?
Risk of thromboembolism
What are the Immunologic effects of pain?
Impaired immune function
What are the Psychological effects of pain?
Anxiety, fear
What are the most painful surgical procedures?
Thoracotomy amputation ear resection pelvic repair cervical disc
What are the moderately painful surgical procedures?
Mastectomy Mandibulectomy T-L Disc Fracture stabilization cranial abdominal procedure oavriohysterectomy enucleation corneal transplant
What are moderate to mildly painful surgical procedures?
Tracheostomy aural hematoma castration caudal abdominal procedure phacoemulsification
What are the two keys to analgesia?
Multi-modal
Pre-emptive
Opioid dysphoria
uncontrollable/unpleasant thoughts, difficulty with concentration, unpleasant bodily sensations, nervousness, anxiety
What happens to a dysphoric patient with additional opioids?
will become more distressed
What are the considerations you need to make to distinguish Pain v. Dysphoria?
What analgesics have been administered
Procedure
Patient temperment and breed
Surgical site pain
If you administer short-acting opiod and it gets better….
Pain
If you administer short-acting opiod and it gets worse….
Dysphoria
What are the most effective treatments for warming?
Forced hot air device
Radiant heat device
“Hot Dog”
What are the less effective treatments for warming?
Circulating warm water blanket
Heated Cage
Heated objects
What is a dangerous treatment for warming?
Heating pads
What causes hyperthermia?
Drugs
Airway obstruction
Pain
Treatment of Hypoventilation
Delay extubation and continue IPPV
Clear airway
Reverse drugs
Causes of Hypoxemia
Airway obstruction
Pulmonary pathology
Treatment of Hypoxemia
Address the underlying cause
Position properly
Warming
Oxygen support
What are the types of recovery?
Free recovery
Assisted Recovery
What are types of assisted recovery?
"Hand" Ropes inside recovery stall Ropes Outside recovery stall Sling recovery Pool recovery
Alpha 2 agonists for horses
xylazine
romifidine
Triple Drip
Guaifenesin
Ketamine
Xylazine
What are alpha 2 agonists used for with equine anesthesia?
Visceral colic pain
What is used for visceral pain in horses?
butorphanol
What is used for somatic pain in horses?
somatic pain
What are common complications with ruminant recovery?
Regurgitation +/- aspiration
Bloat
