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Anaesthesia > Assessment > Flashcards

Assessment Flashcards

1
Q

Non-rebreathing Circuit Advantages

A

Cheap to buy

Soda lime is not required

Low resistance (ideal for smaller patients)

Can change gas levels quickly

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2
Q

Non-rebreathing Circuit Disadvantages

A

High carrier gas/02 flow therefore more expensive to run

Expired moisture and heat is lost

Different flow requirements for different circuits

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3
Q

Rebreathing Circuit Advantages

A

Lower fresh gas/02 rates required (cheaper to run)

Expired moisture and heat is conserved

Less pollution than other systems

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4
Q

Rebreathing Circuit Disadvantages

A

Higher resistance

Expensive to buy

Soda lime must be replaced regularly when exhausted

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5
Q

Humphrey ADE

A

Can be used as a re-breathing or non re-breathing circuit depending on lever position

Can be run at very low flow rates

Tubing can be used to run as a t-piece, lack, magill or circle (by adding soda lime)

Can be used for IPPV

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6
Q

Anaesthetic Chambers

A

E.g. Cook’s Chamber

Must be durable and air tight

Needs gas/scavenging outlet

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7
Q

Safety Checks

A
  1. Is the circuit assembled correctly?
  2. Is the APL valve open?
  3. Are there any kinks/cracks/contamination to the tubing?
  4. Have you leak tested circuit?
  5. If using soda lime, have you checked for cracks/exhaustion?
  6. If using a chamber, are the connections secure and air tight?
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8
Q

Gas Cylinders

A

Carrier gases stored under pressure

Must be handled carefully

Range of sizes and colour coded

Gas cyinders/piped gases

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9
Q

Pressure Gauge

A

 Shows gas pressure and how much remaining

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10
Q

Pressure Reducing Valve

A

Safety mechanism

Reduces the pressure of gas coming from cylinder, making it easier to control

Avoids damage to patients respiratory tract

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11
Q

Flowmeters

A

Shows level of gas flow being supplied to the patient

Graduated glass tube with bobbin (read from the top), or ball (read from the middle)

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12
Q

Vaporisers

A 
	2 TYPES:
In Circuit (not common) vaporiser is in inspiratory limb and the animals own respiratory efforts control the amount of gas received

Out of Circuit

Glass boyle’s bottle

Tec- Allows controlled amounts of volatile agent to be delivered to the patent

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13
Q

In Circuit Vaporiser

A

(not common)

vaporiser is in inspiratory limb and the animals own respiratory efforts control the amount of gas received

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14
Q

Out of Circuit Vaporiser

A

Glass boyle’s bottle

Tec- Allows controlled amounts of volatile agent to be delivered to the patent

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15
Q

Safety Features of Anaesthetic Machinery

A

Pin-index cylinders

Pipeline connectors

Oxygen alarm

Vaporiser key fillers

Emergency 02 flush

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16
Q

Scavenging

A

Important to minimise exposure to gases

Passive
- Large tubing from APL valve to outside of building or activated charcoal

Active

  • Tubing is connected to a forced ventilation system
  • Best method
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17
Q

Passive Scavenger

A

Large tubing from APL valve to outside of building or activated charcoal

18
Q

Active Scavenger

A

Tubing is connected to a forced ventilation system

Best method

19
Q

Other ways to minimise exposure

A

All connections must be air tight (masks/ET tubes/circuits etc)

Using key fillers to top up vaporisers

Do not turn on gas until connected

Turn off gas and keep on 02 before disconnecting

Good ventilation

Regularly service equipment

20
Q

Endo-tracheal Tube Function

A

Maintains airway

Prevents aspiration pneumonia

Prevents laryngospasm

Reduces environmental pollution

Allows IPPV

21
Q

Equipment required ET tube

A

Suitable size ET tube

Tube tie

Mouth gag

Syringe to inflate cuff

Lubricant

Laryngoscope

Intubeaze

22
Q

ET Tube Types

A

Red rubber (low volume, high pressure)

PVC (transparent, high volume, low pressure)

Silicone (straight)

Murphy eye (hole in bevelled end near cuff)

23
Q

ET Tube Checks

A

Select correct size to minimise dead space

Ensure tube is clean/free from holes/blockages

Ensure cuff is working

Ensure in date

Uncuffed tubes for cats

24
Q

Checking Placement ET Tubes

A

Palpate within the trachea

Auscultate lung fields

Observe movement of reservoir bag

Check for air movement (using hair)

25
Q

ET Tube Disadvantages

A

Increased airway resistance if tube is too narrow

Kinking/occlusion of tube

Iatrogenic trauma to trachea

Irritation to mucosa if tube not rinsed

Over inflation of cuff can cause tracheal damage

Misplacement

26
Q

ET tube inserted into oesophagus

A

Patient light

No movement of bag

Low sp02)

27
Q

ET tube lodged in bronchus

A

Sp02 greatly reduced

Unilateral breath sounds

Patient wakes up

28
Q

Laryngospasm in cats

A

Use one spray of local anaesthetic

Wait and oxygenate

Use laryngoscope

29
Q

ET Tube blocked/kinked

A

Sp02 very low

Little movement of reservoir bag

Cyanosis

30
Q

Tracheal rupture

A

Sub cut emphysema

Reduced breath sounds

31
Q

Extubation

A

After pharyngeal reflexes have returned

Ensure oropharyngeal area is clear of blood/debris

Wait until swallow returned (dogs)

Extubate before swallowing (cats)

32
Q

Osophageal Stethoscope

A

Plastic tubing attached to a stethoscope head piece

Passed into the oesophagus until it lies level with the heart to detect HR/RR

Should be checked it is clean, secure and lubricated before use

33
Q

Pulse Oximeter

A

Measure patients arterial oxygen saturation (sp02)- Percentage of oxygen that is bound to haemoglobin in the arterial bloodstream

Useful monitor for cardiovascular/respiratory function

Low readings can indicate tissue hypoxia

Probe is attached to area on non pigmented skin e.g. toes, tongue

Normal range: 95% or above

34
Q

E.C.G.

A

Measures electrical activity across cardiac muscle

Provides information regarding HR/rhythm and is good for detecting arrhythmias

Electrodes are attached to the patient via crocodile clips/adhesive pads with surgical spirit or electrode gel

35
Q

Blood Pressure Monitoring

A

Direct/ Indirect

36
Q

Direct Blood Pressure Monitoring

A

IV catheter placed directly into a peripheral artery

This is connected to a pressure transducer that converts into an electrical signal that can be measured

Requires skill, potential for sepsis at site

37
Q

Indirect Blood Pressure Monitoring

A
  1. Oscillometric (humans)

2. Doppler (cuff attached to manometer that is manually inflated and an ultrasound probe)

38
Q

Central Venous Pressure

A

Long IV catheter passed down jugular to lie at thoracic inlet

Catheter attached to pressure manometer

Measures adequacy of venous return to the heart

Requires skill

39
Q

Capnography

A

Measures C02 concentration in inspired and expired gases

Allows early detection of respiratory problems

2 types

  • Main stream
  • Side stream

End tidal carbon dioxide (ETC02) is the C02 breathed out at peak of expiration (35-45mmHg normal range)

40
Q

Apnoea Monitor

A

Detects gas movement through ET tube

Anaesthesia (9 decks)

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