Stages &Planes of Anes & Monitoring Flashcards
muscle tone (lessens or strengthens) as anesthesia deepens
lessens
it is recommended that patients in stage 3; phases 1 or 2 be monitored how often
every 5 min
when is it recommended an animal be monitored continuously
plane 3 or higher, horses on inhalent (gas anes)
ab how long induction period if anes given IV, or IM and gas
IV- <1min
IM or gas- several minutes
which stages encompass the induction period
stages I and II
what happens during stage I
concious, disoriented, decreased sensitivty to pain
stage I is also called the period of
period of voluntary movement
stage II is also called the period of
period of involuntary movement or excitment phase
what happens during stage II
loss of conciousness; may vocalize, paddle, or struggle, acts like its “fighting” the anesthesia
our goal is to pass which stage as quickly as possible
stage II
how to produce a short excitment phase during stage II and a shorter stage in general
give a more rapid administration
during which stage is the animal finally anesthetized
stage III
which stage III plane: ok for intubation/ minor procedures, some pain still felt, reflexes present but slow, good muscle tone, normal pupil size
plane 1- light anesthesia
which stage III plane: routine surgeries, HR/RR stable, many reflexes gone, eyes rotated ventromedial (crosseyed), pupils slightly dialated
Plane 2- medium anesthesia
which stage III plane: too deep for most surgery, OK for orthopedic surgery, HR/RR decrease, decreased pulse strength, absent/depressed reflexes, increased CRT, dilated pupils
Plane 3- deep anesthesia
what is the deepest plane we need to go
plane 3, no need to go any deeper
which stage III plane: jerky respirations, decreased RR and HR, pale MM, eyes central and dilated
Plane 4- early anes overdose
which stage: apnea, cardiovascular collapse, cyanotic MM, no reflexes, dilated pupils
Stage IV(4)- overdose
what to do when an animal enters stage IV
start CPR
what is seen in a normal recovery period (bodily changes)
shivering, swallowing, increased HR and RR, reflexes return
if the recovery time is prolonged you should
flip from side to side(ventral side down when rolling)
which vital signs to monitor every 5 min
HR and Rhythm, BP, RR, temp, reflexes
most anes and pre anes cause bradycardia, which cause tachycardia
ketamine, telazol, atropine
the minimal HR for dogs and cats
D= 70 bpm, cat= 100bpm
what a pulse deficit means
no pulse for every heartbeat
preanes and anesthetics that can cause arrythmias
xylazine, dexmedetomidine, barbiturates)
how to feel apical pulse
feel chest and beat of heart
thready v bounding pulse
weak v strong
normal blood pressure
120mmHg/ 80 mmHg
blood pressure is measured as a ratio of what
systolic (contraction of venticles) pressure / diastolic pressure(relax)
blood pressure should be no less that ____ in dogs
90mmHg/ 60 mmHg
direct means of measuring BP
arterial catheter inserted in artery (rare)
indirect means of measuring BP
sphygmomonometer, doppler flow probe, CRT, MM color
what is MAP (mean aterial pressure)
average pressure of complete cardiac cylcle
what is the best indicator of blood perfusion
MAP
how we calculate MAP
diastollic pressure + 1/3 (systolic - diastollic)
drugs that lower BP
xylazine, dexmedetomidine, acepromazine (peripheral vasodialation)
when not under anesthesia, what causes someone to breath?
high CO2 levels in blood
RR decreases bc CO2 has less influence over breathing
RR shouldnt drop below
8 bpm (breaths per min)
SpO2 normal
shouldnt be less than
norm= 97%
should be less than 95%
signs animals isnt getting enough O2
high CO2 in blood, decreased SpO2, inceased RR, struggling (if too light)
too much CO2 in blood and not enough O2 can cause
tachypnea (hyperventillation)
what it means if respiratory rhythm is shallow and jerky
anes too deep or ariway is blocked
length of inspiration v length of expiration
insp- 1-2 sec, exp- 2-4 sec
(1:2)
what is a pulse oximeter? (what it measures)
measures SpO2- est. % of hemoglobin binding sites saturated w O2 (saturation of peripheral O2)
also measures pulse w/ a plethysmograph, detects increase in volume as blood passes tho vessel
what a capnograph is and what it measures
sensor on ET tube, CO2 levels breathed in and out (the CO2 expired closely resembles CO2 in blood)
what a capnograph reading should be (insp v expiration)
insp- should be 0
expiration should be 35-45(end tidal CO2)
minimum body temp
95F
why an animal w lower body temp takes longer to wake
slower metabolism of drugs
what is alectasis, how do we prevent
collapse of alveoli caused by shallow breathing, prevent by bagging every 5min to inflate alveoli
drugs that can cause hypothermia
ace, a2 ag
who is most susseptible to hypothermia and why
old/ young- have poor thermoregulation
drugs that can cause hyperthermia
opiods in cats, ketamine
ways to treat hyperthermia
cool, give cold fluids, give 100% O2
what is malignant hyperthermia, who is it seen in and why
extreme fever (105+) (and muscle rigidity), rare in d/c, seen in pigs due to genetic defect
reflexes _____ with increasing anes depth
decrease
earliest reflex to go
swallowing
how to test pedal reflex
squeeze toe or webbing between toes, animal should withdraw leg if light enough
how to test ear flick reflex
touch outer ear canal enterance, ear should flick if animal is light enough
change in eyeball position from stage I and II to III to IV
I and II= central, III= ventromedial (desirable), IV= back to central position (bad sign)
excitment phase usually longer in induction or recovery?
recovery
