Recovery of a patient Flashcards

1
Q

what do the following mucous membranes indicate

A

pale - shock
blue - lack of oxygen
yellow - liver failure
salmon pink - good health
brick red - infection or sepsis

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1
Q

4 cranial reflexes and what we should check for when monitoring anaesthesia

A

-Jaw Tone
-Eyes
-Pinch between the toes
- palpebral reflex

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2
Q

2 advantages and 2 disadvantages of a pulse oximeter

A

-works quickly - advantage
- non invasive - advantage

  • temp and skin thickness can reduce accuracy
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3
Q

What is Recovery

A

reverse of induction, the patient goes from an unconscious state to a conscious state with all the associated planes in between

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4
Q

Recovery

A

safe and comfortable recovery is the final objective of anaesthesia

recovery remains the most overlooked phase of anaesthesia

optimal recovery requires consideration of the patients changing neurologic status

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5
Q

Monitoring in the post - op Period

A
  • Just as essential
  • speed of recovery depends upon

-breed
-existing illness - renal, hepatic, respiratory, cardiac
-Temp
- Duration and type of anaesthesia
- Route of Drug administration

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6
Q

What do you want in the recovery area?

A

-Thermometer
-Syringe
- warming matt
- stethescope

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7
Q

When to Extubate

A

Early
-risks inhalation of FBs
- Best for cats
- Not for brachycephalic dogs
-allows pollution of atmosphere

Late
- airway protected until gag response returns
-best for potential airway obstruction
-risk of largyneal spasm in cats
- less pollution of atmosphere
-prolonged 02 breathing

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8
Q

What to monitor

A
  1. position of patient
  2. pulse
  3. respiratory rate and pattern
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9
Q

Pale MM - Cyanosis - Red

A

pale
- sympathetic vasoconstriction
- haemorrhage

cyanosis
-poor oxygenation
- poor circulation
- peripheral vasoconstriction

red - Toxaemia or Hypercapnia

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10
Q

Other things to monitor

A
  • Temp
    -Pain
  • Hydration
  • Wound management
  • Drug Therapy
  • Nutrition
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11
Q

Recovering from special procedures

A
  • Ophthalmic procedures
  • Abdominal surgery
  • Thoracic surgery
  • Orthopaedic procedures
  • Myelography - dye injected into spinal cord for study of the nervous system
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12
Q

How can supplemental oxygen be given ?

A
  • Flow - past
  • Oxygen tent
    -Mask
    -intranasal catheter
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13
Q

anaesthetic complications

A
  • cardiopulmonary arrest
  • airway obstruction
  • respiratory depression/ arrest
  • circulatory insufficiency
  • Hypothermia
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14
Q

Cardiopulmonary arrest

A
  • most common cause is overdose of inhalation agent
  • if monitoring is adequate you will spot the increasing anaesthetic depth
  • respiratory changes occur before cardiac arrest
  • electrical abnormalities will also be evident (if you are using ECG)
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15
Q

Signs of impending Arrest

A
  • changes to respiratory rate, depth and pattern
  • changes in pulse quality and rhythm
  • unexplained changes in anaesthetic depth
  • abnormal ECG rhythms
16
Q

Signs of Arrest

A
  • No heart sounds
  • no pulse palpable
  • no respiratory movements
  • fixed and dilated pupils
  • grey or cynanotic pupils
  • dry cornea with loss of reflexes
  • Arrhythmia on ECG
17
Q

Causes of Arrest

A
  • Anaesthetic overdose
  • Hypoxia and hypercapnia
  • Hypotension
    -Dysrhythmias
  • pre existing heart disease
  • hypothermia
18
Q

Cardiopulmonary resuscitation

A

Airway
Breathing
Circulation
Drugs
Electrical defibrillation
Follow up

19
Q

drugs which should be in your anaesthetic emergency box

A

Adrenaline
Atropine
Lidocaine
Furosemide

20
Q

What do we need in a crash box/kit

A
  • drugs
  • laryngoscope
  • IV equipment
21
Q

airway obstruction during or after anaesthetic

A
  • increased respiratory effort/noise
  • paradoxical chest wall movement
  • no movement of reservoir bag
  • Cyanosis
22
Q

How to Check ET tube is not blocked?

A
  • squeeze resevoir bag and look for movement of chest wall
  • remove and replace
  • Or use suction to clear tube
23
Q

causes of tracheotomy

A
  • Anaesthetic or opioid overdose
  • Chest wall movement inadequate
  • respiratory movements unable to inflate lungs
  • Tachypnoea
24
Q

signs of Trachneotomy

A
  • Reduced minute volume
  • Increased respiratory rate
  • Cyanosis
25
Q

Action of Trachneotomy

A
  • remove underlying cause
  • assess anaesthetic depth and pain levels
  • supply 100% O2
  • Use IPPV
26
Q

Circulatory insufficiency

A

signs
-weak peripheral pulses
- pale mms
- increased CPT
- low measured blood pressure
- Increased heart rate
- poor urinary output
- diminished bleeding

27
Q

action of circulatory insufficiency

A
  • assess depth of anaesthesia
  • rapid IV fluid infusion
  • reposition patient if possible
  • control haemorrhage
28
Q

Hypothermia causes

A
  • shivering is prevented under anaesthesia
  • heat generated by skeletal activity has stopped
  • Visceral surfaces are exposed in abdominal surgery
29
Q

prevention of hypothermia

A
  • thermovent
    -warming aids
    -monitoring iv fluids
  • monitoring
    -keep operating theatre warm
30
Q
A