Recovery from anaesthesia Flashcards
When is the greatest risk of anaesthetic death?
within 3 hours of recovery
What increases the risk of anaesthetic death during recovery?
ASA III-V
Cats
What are the potential causes of anaesthetic death during recovery?
include hypothermia
cardiovascular problems
respiratory problems
small-size drug overdose
poor monitoring in recovery
intubation in cats
Airway obstruction (brachys)
Describe the end procedure sequence of events after a surgery
Describe how to disconnect a patient from the breathing system
Explain how the time the oxygen is switched off can change
if the inhalation agent has not been switched off for long but the patient starts to show signs of emergence, you might switch the oxygen off before disconnecting the patient to avoid the remaining inhalation agent mixed with the oxygen from leaking into the room (but make sure you don’t take too long to disconnect, otherwise, your patient will be trying to breathe through a system that has no oxygen supply in it).
If the agent has been switched off for a few minutes (meaning there will be none left in the breathing system) before you disconnect, then it is ok to switch the oxygen off after disconnection.
What do you need to wait for before extubating a dog?
Gag-reflex returns (swallowing, tongue flicking)
Extubate on inspiration
What should you deflate the ETT cuff?
just before extubation
why should you extubate on inspiration?
arytenoid cartilages are abducted so damage less likely
Describe the recovery of brachycephalic breeds
When should you extubate cats?
~15s before swallowing
What should you look for when timing the extubation of cats
increased jaw tone
palpebral reflex
tongue movement
ear flick
What is the risk of late-extubation of cats?
Extubation once cats are chewing, swallowing, coughing can lead to laryngeal spasm (obstructs the airway)
What position should patients be left in after extubation?
head and neck should be extended and tongue gently pulled forward to maintain patent airway
What is emergence delirium and what are the risks associated?
a dissociated state of consiousness => thrashing, paddling, vocalisation post extubation
Risk to patient and staff
How should you respond to emergence delirium?
Ensure there is adequate analgesia
Handle with caution (muzzle?)
Put patient on floor
Mild sedation?
Induction agent may be needed (propofol/alfaxalone)
What are important considerations for the recovery area?
What emergency equipment should be available in the recovery area?
What should be monitored during recovery?
Describe the importance of keeping patients warm in recovery
Hypothermia predisposes patients to a prolonged recovery
Shivering => up to 400% increase in oxygen demand (may need oxygen supplementation)
Contributes to pain and is painful
Have blankets, heat pads and warm fluids in recovery area
Prevention is better than cure
How long should patients be monitored for during recovery?
What are common causes of upper airway obstruction in recovery?
Describe the signs of airway obstruction
What should you do if a patient is showing signs of airway obstruction?
