L&J Chi 5 Anesthetic Emergencies and Resuscitation Flashcards

1
Q

At the time of publication, what are the most recent measures of anesthetic-associated mortality in veterinary medicine?

A

Canine: 0.17%
Feline: 0.24%
Rabbits: 1.39%

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2
Q

What is the most common cause of anesthetic complications?

A

70% involved human error

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3
Q

Cardiopulmonary arrest

A

CPA
Dynamic, time-dependent process occurring secondary to failed cardiac contractility –> results in either ventricular asystole, PEA, pulseless VT, ventricular fibrillation

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4
Q

Aims of CPR?

A

Provide blood flow to the heart and brain until restoration of spontaneous circulation

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5
Q

Use of the term “cardiopulmonary resuscitation”

A

-Not used as a medical term until 1958 when tx of CPA shifted from open chest cardiac massage to closed chest compressions, defibrillation

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6
Q

At time of publication: initial CPR success/return of spontaneous circulation

A

Dogs: 28-35%
Cats: 42-44%

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7
Q

At time of publication: what are the survival to discharge rates following CPR?

A

Dogs: 4.1-6.0%
Cats: 7-9%
Every minute spent performing CPR adds significant morbidity and risk and the success rate decreases rapidly

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8
Q

Outcome of CPR

A
  • Depends on timely intervention of effective interventions
  • Regardless of initial training, there is always time-related decay of skills
  • Recommend refresher courses/simulation practice Q6 mo
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9
Q

CPR Equipment

A
  • Necessary emergency drugs, equipment should be organized in one place (ie crash cart)
  • Cart should be adequately stocked, regularly audited, placed in readily accessible area
  • Include supplies for venous access, airway management, initial pharmacological therapy
  • Surgery kit: emergency thoracotomy, tracheostomy, venous dissection
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10
Q

History Human CPR Guidelines:

A
  • 1992: International Liaison Committee on Resuscitation (ILCOR) was created to develop an internationally accepted CPR protocol
  • Composed of American Heart Association (AHA), European Resuscitation Council, and Heart and Stroke Foundation of Canada
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11
Q

What were the ILCOR protocols designed on?

A

Protocols based on research discussed at the International Consensus Conference for CPR and Emergency CV Science and Treatment

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12
Q

Publication of the ILCOR guidelines

A

-Published first international CPR guidelines in in 2000, revised protocol in 2005 and 2010

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13
Q

Veterinary CPR guidelines

A
  • 2012: Reassessment Campaign on Veterinary Resuscitation
  • Goal: provide evidence-based CPR guidelines for veterinary medicine, combo of ACVAA and ACVECC diplomates
  • Collaborative initiative that systematically evaluated published evidence regarding 75 topics relevant to SA CPR and generated CPR guidelines
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14
Q

BLS

A

Basic Life Support

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15
Q

Basic Life Support (BLS)

A
  • Recognition of CPA
  • Initiation of chest compressions
  • Airway management
  • Assisted ventilation

Quality of BLS performed directly related to ROSC and survival rate

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16
Q

Change to human guidelines in 2010 with BLS

A
  • Order of intervention for all age groups except newborns was: airway - breathing - circulation/chest compressions
  • Change: circulation/chest compressions - airway - breathing
  • Change was made partially due to fact securing an airway in humans is challenging; prolonged intubation time causes a delay in initiation of chest compression, which negative impacts ROSC
  • Large percentage of CPA in human DT primary cardiac disease
17
Q

Veterinary BLS Order Guidelines

A
  • ABC resuscitation still preferred
  • Many veterinary CPA cases due to ventilatory/pulmonary failure and not myocardial ischemia
  • In most small animals, fairly easy to intubate and secure airway
  • If CPA unwitnessed or not due to primary cardiac disease, traditional ventilation first or ABC resuscitation acceptable
  • If witnessed CPA due to primary cardiac disease, CAB recommended