Principles of minimising human exposure to waste anaesthetic gases: 1. Use an effective ... system 2. Perform ... test 3. Avoid ... induction and use masks with a good ... 4. If chamber induction is used remove box in a ... area 5. At end of procedure allow patient to breathe only ... 6. Speeding recovery= ... patient, block end of tube with ... open pop off valve and squeeze bag, anaesthetic from circuit is removed by ... system, purge using ... and repeat then close pop off as required and reconnect patient so they breathe only O2.

1. Scavenger 2. Pressure leakage 3. Mask induction, seal 4. Well ventilated 5. Oxygen 6. Disconnect patient, block with thumb, removed by scavenger, purge using by pass valve

Surgical And Theatre Flashcards by Brianna Lopez

Otomy definition

Temporary cut through tissue eg. Spey

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Ostomy definition

Creating a permanent opening in tissue eg. Tracheostomy

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Ectomy definition

Removing a structure eg. Spleenectomy

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Exploratory laparotomy means?

To open up the abdomen

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Minimum age of person giving informed consent

18 years old

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Routine food- withholding period for adult dogs and cats

3hrs (6-12hrs)

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Routine food-withholding period for puppies and kittens under 2wks (neonates)

0hrs

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From what time is water withheld from dogs and cats for routine surgery

Water is removed at time of pre-med

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Factors influencing scheduling of surgeries

Emergencies
Clean vs. dirty
Elective/ non-elective
Available staff

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ACEPROMAZINE

Purpose: … and … of induction agent dose

Other effects: …. which …. BP, … thermia, … of 3rd eyelid

Precautions: not used in … BP conditions (shock/ dehydration), do NOT use in …. breeds, not used in cases of …. or …

Purpose: sedation and reduction of induction agent dose

Other effects: vasodilation which reduces BP, hypothermia, protrusion of 3rd eyelid

Precautions: not used in low BP conditions (shock/ dehydration), do NOT use in boxer breeds, not used in cases of epilepsy or caesareans

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ATROPINE

Purpose: prevent or manage …, reduce … and … secretions

Other effects: … pupils, … eyes, reduces ….

Precautions: contraindicated if pre-exisiting … disorders

Purpose: prevent or manage bradycardia, reduce oral and respiratory secretions

Other effects: dilates pupils, dried eyes, reduces gut motility

Precautions: contraindicated if pre-exisiting cardiac disorders

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METHADONE (methone)

Drug group: ….

Purpose: … and …

Other effects: …. and ….

Precautions: contraindicated in cases of …. (intracranial pressure)

Drug group: opioids

Purpose: analgesia and sedation

Other effects: bradycardia and bradypnoea

Precautions: contraindicated in cases of head trauma (intracranial pressure)

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Advantages of IV induction over face mask or chamber induction:

Faster
Smoother induction
Reducing patient stress
Less anaesthetic agent used (ISO)

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Thiopental/ thiopentone

What class of anaesthetic agents?

It is a rapid induction agent?

Not irritant or highly irritant if injected perivascularly

Belongs to barbiturate class

Rapid induction agent

Highly irritant if injected perivascularly

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Is thiopental suitable for maintaining anaesthesia for long periods by topping up?

No, not suitable to be topped up to maintain prolonged anaesthesia

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What does a pressure regulator do?

Indicates quantity of oxygen left in tank and maintains constant pressure within cylinder

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Vaporisers should be ON/ OFF while refilling anaesthetic?

OFF

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Rebreathing circuits are also known as?

Circle systems

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Non- rebreathing circuits are also known as ?

T-piece circuits

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Parallel tubing is also known as?

Biaxial tubing

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Tube in tube is also known as ?

Coaxial tubing

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Disadvantages of non-rebreathing systems?

More O2 and ISO used

Lowers body temp due to cold and dry air

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2 ways to determine if soda lime needs replacing?

Colour change

No heat is generated when in use (soda lime should generate heat when efficiently removing expired CO2 from the circuit)

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Principles of minimising human exposure to waste anaesthetic gases:

Use an effective … system
Perform … test
Avoid … induction and use masks with a good …
If chamber induction is used remove box in a … area
At end of procedure allow patient to breathe only …
Speeding recovery= … patient, block end of tube with … open pop off valve and squeeze bag, anaesthetic from circuit is removed by … system, purge using … and repeat then close pop off as required and reconnect patient so they breathe only O2.

Scavenger
Pressure leakage
Mask induction, seal
Well ventilated
Oxygen
Disconnect patient, block with thumb, removed by scavenger, purge using by pass valve

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Reasons why ET tube is placed for maintenance of gaseous anaesthesia instead of face mask?

Less leakage of anaesthetic gases Control of airways (IPPV) Less dead space Eliminates chance of aspirating on vomit if placed correctly

ET tube is placed ?

From mouth entrance to the point of shoulder

Animal species/ group which Un-cuffed ET tubes are used ?

``` Reptiles Birds Neonates Ferrets Rabbits ```

Spontaneous ventilation where endobronchial intubation occurs 1. Can result in over inflation of inhabited lung? 2. Occurs when tip of tube lies within one bronchus? 3. Can result in severe hypoxaemia? 4. Can result in the collapse of the lung that is not intubated?

1. No 2. Yes 3. Yes 4. Yes

Endobronchial intubation causes hypoxaemia which doesn't respond to increasing ventilation or oxygen because there is a mismatch of ... and ... whereby the blood flowing from non intubated lung is deoxygenated which mixes with the blood from oxygenated lung.

Ventilation and perfusion

``` STAGES OF ANAESTHESIA Stage I Stage II Stage III Stage and plane ideal for routine abdominal surgery ```

1. Voluntary excitement 2. Involuntary excitement 3. Surgical anaesthesia Ideal stage is 3, and plane medium

Ideal maintenance flow rate on a RE-BREATHING (circle) system?

30mL/kg/min

Ideal maintenance flow rate on a NON-REBREATHING (t-piece) system?

300mL/kg/min

I general what is a safe flow rate to start a RE-BREATHING circuit on?

2L/min

Which system with usually achieve faster mask induction?

Non-rebreathing

An animal with poor circulation will be anaesthetised by MASK induction MORE/LESS quickly than expected? Will they be anaesthetised by IV induction MORE/LESS quickly than expected?

An animal with poor circulation (heart failure/shock/dehydration) will be MORE quickly anaesthetised by induction with a face mask and LESS quickly than normally expected by IV induction

2 values of ARTERIAL BP

Systolic | Diastolic

Units to measure ARTERIAL BP

mmHg (mm of mercury)

Units used to measure VENOUS BP?

cmH2O

Methods to measure ARTERIAL BP?

Doppler | Oscillometric cuff

Hypotension is present if SYSTLOIC arterial pressure is below?

<80mmHg

Organ injury is expected if MEAN arterial pressure remains below?

<60mmHg

PQRST wave P represents? QRS represents? And generates what? T represents?

P presidents atrial contraction QRS represents ventricular contraction and generates a palpable pulse T represents repolarisation

Which of the following correct low SpO2 1. 100% oxygen 2. Assisted ventilation 3. Reducing depth of anaesthesia 4. Correcting endobronchial intubation 5. Giving drugs which increase cardiac output 6. Giving IV fluids

All of the above

1. Capnography gives approximation of ... levels. | 2. ETCO2 stands for ...

1. Blood CO2 levels | 2. End tidal CO2

Hypercapnia means

Increase levels of CO2 in blood

Units to measure blood CO2

MmHg (mm of mercury)

Causes of hypercapnia?

Hypoventilation Dead space Expired soda lime therefore rebreathing CO2

Hypercapnia results in the mucous menbrane colour changing to ... or ... or ... caused by sympathetic response

Brick red Injected Flushed

HYPOcapnia is cause by

Hyperventilation

Major determinant as to when an ET tube is removed in dogs is the ?

Return of swallow reflex

In cats the major determinant as to when the ET tube is removed is return of ?

Movement (limbs, ear twitches, tongue flicking, tail movements)

Fluid commonly used in prolonged surgeries

Hartmanns (lactated ringers solution)

Rate of IV fluids in a prolonged surgery

Generally 10mL/kg/hr (Dogs 5-10mL/kg/hr) (Cats 3-7mL/kg/hr)

Conditions where fluids are contraindicated?

Heart failure | Brian trauma

Obese animals should have their dose of IV anaesthetic calculated on their ... ?

Estimated lean body weight

Obese animals require increased effort to what?

Breathe

Reasonable recommendation for managing post induction apnoea?

1 bag squeeze every 30 seconds

Which of the following conditions is supplemented oxygen beneficial in? 1. Respiratory failure 2. Toxaemias 3. Head trauma 4. Circulatory failure (shock)

All of the above

An epidural injection is made where?

On top of the outer meningeal layer of the spinal cord

AUTOCLAVE 1. Pack size ? 2. Pack orientation? 3. Pack separation? 4. Bowls? 5. Screw caps? 6. Sterilisation indicator placed?

1. Small 2. Upright 3. Loose 4. Sideways 5. Screw caps loosened 6. Deep

STERILE FIELD 1. Instrument table? 2. Patient? 3. Torso? 4. Arms?

1. Yes within sterile drapes 2. Yes within sterile drapes and scrubbed area 3. Yes front of body within waist to mid thorax 4. Yes up until elbows

List 2 common Needle holders

Olsen hegar Mayo hegar Other 2 types (gillies, Matthieu)

3 SCISSORS and purpose

1. Mayo: heavy dissection 2. Metzenbaum: fine dissection 3. Surgical scissors: sharp blunt used for sutures and general purposes

What are dressing forceps is used for?

Holding swabs and delicate tissue?

Forceps with teeth are called ?

Ads on rats tooth thumb forceps

Use of mosquito forceps?

Clamping delicate vessels

Use of allis tissue forceps

Holding tissue

Use of Carmalts?

Clamping thick fatty vascular stumps (uterine stump, ovarian pedicle)

Bowel clamps used for?

Clamping intestine

3 types of towel clamps

Roeder Backhaus Crossaction

Hohmann retractors (BONE LEVERS) use??

Dislocating joints | Retracting/ levering muscles, tendons, ligaments

Gelpi retractor use?

Exposure of deep joints and muscles

Weitlaner retractor use?

Exposure of muscles and joints

Balfour used for?

Commonly used in ex-laps | Abdominal retractors

Periosteal elevators used for?

Lifting periosteum off bone

Bone curettes used for?

Debriding bone

Oestotome and bone chisel used for?

Cutting bone

Rongeurs used for?

Nibbling bone

Point to point reduction forceps

Clamping into bone

Jacobs chuck used for?

Driving pins into bone

Wire twisters and wire passers used for?

Twisting wire | Passing wire around a bone

Swaged (atraumatic) needles DO/DONT have an eye through where suture is threaded?

DON'T

Protect open wounds using ... or ...

Saline soaked swabs | Sterile lube

Decubital ulcers are more simply known as ...

Pressure sores