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Anesthesia -Scott Newman & Janet King > Unit 3 notes > Flashcards

Unit 3 notes Flashcards

1
Q

Define induction period

A

taking an animal from a conscious level to an unconscious level
should be the shortest component of GA

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2
Q

2 types of induction agents used

A

Injectable (preferred)

Inhalant

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3
Q

Route of injectable induction agents

A

IV (followed by inhalant, give slowly and titrate to effect)

IM (2-3 times IV dose, cannot titrate to effect, fractious animals only)

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4
Q

Injectable drugs used

A

Barbituate
Cyclohexamine
Propofol

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5
Q

What is the “blast em technique”

A

setting a high O2 flow rate, and a high vaporizer setting

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6
Q

Disadvantages of inhalant drugs

A

Waste gas exposure
Less patient cooperation
Dramatic vasodilation

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7
Q

2 Types of inhalant drugs

A

Isoflurane

Sevoflurane

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8
Q

Bast em technique

A

setting a high O2 flow and vaporizer setting to quickly induct patient

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9
Q

Nice way technique

A

setting a high O2 flow rate and gradually increasing the vaporizer settings by 1/2% every minute

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10
Q

Who should the Nice way and Blast em techniques NOT be used on?

A

Brachycephalics

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11
Q

2 Types of ET tubes

A

Murphy-eye tube: inflatable cuff

Cole

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12
Q

5 Indications for intubating

A 
Provide airway
Prevent aspiration 
Provide efficient gas delivery 
Decrease dead space 
Provide controlled ventilations
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13
Q

Disadvantages of ET tube use

A 
Stimulation of vagus nerve
Some species have difficulties 
Risk of bronchi insertion
Risk of obstructed ET tube 
Can contribute to hypothermia
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14
Q

How to measure length of ET tube

A

Tip of nose to thoracic inlet

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15
Q

3 causes of difficult intubatioin

A

Poor patient positioning
Laryngospasms
Inadequate plane of anesthesia

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16
Q

Define maintenance period

A

Period of time following induction in which a STABLE level of anesthesia is reached

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17
Q

Stage I

A 
PA period 
Voluntary excitement phase 
-Conscious 
-All protective reflexes present
-Normal heart and RR 
-Disoriented 
-Slight decreased sensitivity to pain
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18
Q

Stage II

A 
Induction period
Involuntary excitement phase 
-goes to conscious to unconscious level 
-all protective reflexes present 
-normal heart and RR
-patient may be struggling
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19
Q

Stage III Plane I

A

Light Anesthetic Plane

  • Animal can be intubated
  • Sluggish reflexes
  • Jaw tone relaxed
  • Unable to withstand sx
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20
Q

Stage III Plane II

A

Medium Anesthetic Plane

  • Most sx procedures are done at this plane
  • Most reflexes absent
  • Slight increase in heart and RR due to sx stimulation
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21
Q

Stage III Plane III

A 
Deep Anesthetic plane
-Most reflexes absent
-Muscle tone slightly more relaxed
-No response to sx stimulation
Requires very close monitoring!!
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22
Q

Stage III Plane IV

A

Overdose of anesthetic

  • Patient in danger of cardiac arrest
  • Significant depression of body systems
  • Change planes immediately!!
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23
Q

Stage IV

A

CPR necessary for life!!
Crash cart
no longer GA— headed towards death

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24
Q

Palpebral reflex

A

“blink” reflex
gently touch medial canthis of the eye
lost at surgical plane

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25
Q

Pedal reflex

A

“toe pinch” reflex
pinch webbing of toes
lost at surgical plane

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26
Q

Nystagmus

A

Happens during middle of plane change

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27
Q

Eye rotation

A

Will rotate medial and ventral at stage III plane II

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28
Q

Ear flick

A

Only works with cats and equine

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29
Q

Jaw tone

A

Best reflex to watch
will never be completely gone
pull to 45 degree angle and feel for tone

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30
Q

BP normals

A 
Systolic= 100-160mmHg 
Diastolic= 60-100mmHg
Mean= 80-120mmHg
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31
Q

Hypotensive values

A

Systolic= <60mmHg

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32
Q

3 Things that contribute to BP

A

Blood volume
Cardiac output
Vascular resistance

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33
Q

Causes of hypotension

A

Hypovolemia
Overdose of anesthetic drugs
Decrease in cardiac output

34
Q

Managing hypotension

A

Bolus IV fluids (20ml/kg/hr.)
+/- decrease anesthetic %
Give + inotropic drugs

35
Q

3 ways to measure BP

A

Doppler machine
Oscillometric
Direct arterial BP

36
Q

2 Parts to place with DOPPLER & how to hook up

A

Cuff- should be 40% the circumference of leg, placed proximal to the crystal and attached to sphygmomanometer

Crystal- placed on artery, concaved side down

37
Q

Technique for using DOPPLER

A

Inflate cuff until you cannot hear pulse

gradually release pressure until you hear the pulse again

38
Q

Pulse Oximeter values & normals

A

Values=
Amount of Hgb saturated with O2 reported out as SpO2 or PaO2
Pulse Rate

Normals=
>95% (under anesthesia)
>90% when awake 
60-160bpm canine
110-220bpm feline
30-40 equine
39
Q

How to place Pulse Ox

A

Must be placed onto a moist, non-pigmented area such as:

tongue, webbing of toes, vulva, prepuce

40
Q

Causes for desaturation (Pulse Ox)

A 
V/Q mismatch 
Disconnected from breathing system
Blocked airway 
Inadequate flow rate
Erroneous readings (most common) 
Hypovolemia
41
Q

4 ways to monitor respiratory system

A

Capnograph
Res. Bag
Esophageal Stethascope, flutter valves, ET tub fog… etc
Rate and character

42
Q

Capnograph gives you what 3 things?

A

RR
ETCO2
InCO2

43
Q

Normal capnograph readings

A 
RR= 8-20rpm 
ETCO2= 35-45mmHg
InCO2= 0-5mmHg
44
Q

2 Types of capnographs

A

Mainstream: connecter that connects between ET tube and Y tubing. Computer crystal inside tubing reads vitals

Side Stream: Connecter connects between Y and ET tubing. Takes sample of air away from patient and analyzes it inside machine (cheaper)

45
Q

Define controlled ventilation

A

Controlling the volume of air, rate of respiration, and pressure of air being introduced into the animal

46
Q

How often do you ventilate with controlled ventilation and why?

A 
every 5 min 
to prevent:
atelectesis 
blow off excess CO2
Prevent hypoxemia
Prevent hypoventilation
Counteract decrease in tidal volume
47
Q

How to completely take over respirations

A

Res. bag

Mechanical ventilator

48
Q

How to ventilate with Res. Bag

A

Ventilate 12-16rpm
after 3-5 min patient will stop breating on their own
decrease ventilations (8-12rpm for remaining time)
Wean off ventilator by gradually decreasing ventilations

49
Q

How to ventilate with Mechanical Ventilator

A

Hook up machine to res bag port

Hook up to scavange

50
Q

3 types of mechanical ventilators

A

Pressure cycle ventilator- Bird mark 7
Volume cycle ventilator- Ohio Metomatic
Time cycle ventilator- Drager

51
Q

What 2 values does a ECG give you?

A

Heart rate

Heart rhythms

52
Q

ECG leads

A

white= right axillary
black= left axillary
red=left inguinal
green= right inguinal

53
Q

Most common artifacts on an ECG

A

movement
cautery pens
some dental equipment
drying out of electrodes

54
Q

Ventricular means theres an issue with ____

A

the AV node

55
Q

Sinus means

A

normal electrical function of heart

56
Q

PVC

A 
Pre ventricular contractions 
AV node firing before SA node 
wide appearance to QRS complex 
consistant R-Rs 
missing P wave 
QRS for every P 
Okay if occasional
57
Q

Uniform PVC

A

all QRS complexes have the same configuration

58
Q

Multiform PVC

A

QRS complexes have different configurations

59
Q

Causes of PVCs

A 
Electrolyte imbalance 
GDV 
Circulating catecholemines 
Drugs (barbiturates) 
Inhalant anesthetics (Halothane)
60
Q

Treatment of PVCs

A

(if seeing multiple)
Find underlying cause
Ventilate patient and decrease gas
(if unsuccessful, give lidocaine)

61
Q

Ventricular Tachycardia

A

3 or more PCVs in a row

62
Q

Causes of V-Tach

A 
Very bad cardiac output 
GDV 
Electrolyte imbalance 
Circulating Catecholemines
Drugs
63
Q

Treatment of V-Tach

A

lidocaine drip

64
Q

V-Fib

A

Ventricular fibrillation

Usually a terminal rhythm

65
Q

Treatment of V-fib

A

Defibrillator paddle

66
Q

Asystole

A

Animal must be dead for 3-5 minutes before you will even see this
No electrical function (flat line)
Give epinephrine

67
Q

Sinus Tachycardia

A

Increased heart rate
Regular rhythm
Patient is probably too light
deepen anesthetic plane

68
Q

Sinus Bradycardia

A

Decreased heart rate
Regular rhythm
Patient is probably too deep
evaluate patient and either decrease gas if too deep or give anticholinergic if at a good plane

69
Q

First degree AV block

A

Delay in conduction between SA node and AV node
Not a serious problem
everything appears normal, except there is an occasional delay between P and QRS waves

70
Q

Second degree AV block

A

Some impulses between SA and AV node are blocked
Not life threatening yet (treat if seen!)
some P waves have no QRS complexes
Treat with anticholinergics

71
Q

Third degree AV block

A

Have more than one lone P-wave in consecutive sessions
Life threatening
Treat with pacemaker

72
Q

Broadened and Heightened T wave

A

caused by myocardial hypoxia

very wide and broad T wave

73
Q

Spiked T wave

A

Caused by electrolyte imbalances (hyperkalemia)

Spikey and tall T wave

74
Q

Treatment for abnormal T waves

A

Ventilate and decrease anesthetic %

Change fluids if consistent spiky T waves

75
Q

Malignant Hyperthermia

A

a genetic disorder will have increased muscle activity leading to hyperthermia (very uncommon in small animals)

76
Q

Hypothermia causes

A 
Decreased muscle activity 
Decreased metabolic rate 
Intro of cold gas 
Surgical preparation
Open body cavity
77
Q

Ways to prevent Hypothermia

A 
Always keep something between patient and table
Circulating water blanket
Bear Hugger 
Monitor the patient 
Gauze around feet will keep heat in 
Camping blanket
78
Q

Hypothermia @ or above 96 degrees

A

No physiological effect on patient

79
Q

Hypothermia between 90-94 degrees

A

decreased anesthetic requirement due to depressed body system

80
Q

Hypothermia between 82-86 degrees

A

no anesthetic requirement due to significant depression of body systems

Anesthesia -Scott Newman & Janet King (13 decks)

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