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?

Assessment Flashcards by Vicky Main

Non-rebreathing Circuit Advantages

Cheap to buy

Soda lime is not required

Low resistance (ideal for smaller patients)

Can change gas levels quickly

How well did you know this?

Not at all

Perfectly

Non-rebreathing Circuit Disadvantages

High carrier gas/02 flow therefore more expensive to run

Expired moisture and heat is lost

Different flow requirements for different circuits

How well did you know this?

Not at all

Perfectly

Rebreathing Circuit Advantages

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

Expired moisture and heat is conserved

Less pollution than other systems

How well did you know this?

Not at all

Perfectly

Rebreathing Circuit Disadvantages

Higher resistance

Expensive to buy

Soda lime must be replaced regularly when exhausted

How well did you know this?

Not at all

Perfectly

Humphrey ADE

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

How well did you know this?

Not at all

Perfectly

Anaesthetic Chambers

E.g. Cook’s Chamber

Must be durable and air tight

Needs gas/scavenging outlet

How well did you know this?

Not at all

Perfectly

Safety Checks

Is the circuit assembled correctly?
Is the APL valve open?
Are there any kinks/cracks/contamination to the tubing?
Have you leak tested circuit?
If using soda lime, have you checked for cracks/exhaustion?
If using a chamber, are the connections secure and air tight?

How well did you know this?

Not at all

Perfectly

Gas Cylinders

Carrier gases stored under pressure

Must be handled carefully

Range of sizes and colour coded

Gas cyinders/piped gases

How well did you know this?

Not at all

Perfectly

Pressure Gauge

 Shows gas pressure and how much remaining

How well did you know this?

Not at all

Perfectly

Pressure Reducing Valve

Safety mechanism

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

Avoids damage to patients respiratory tract

How well did you know this?

Not at all

Perfectly

Flowmeters

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)

How well did you know this?

Not at all

Perfectly

Vaporisers

	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

How well did you know this?

Not at all

Perfectly

In Circuit Vaporiser

(not common)

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

How well did you know this?

Not at all

Perfectly

Out of Circuit Vaporiser

Glass boyle’s bottle

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

How well did you know this?

Not at all

Perfectly

Safety Features of Anaesthetic Machinery

Pin-index cylinders

Pipeline connectors

Oxygen alarm

Vaporiser key fillers

Emergency 02 flush

How well did you know this?

Not at all

Perfectly

Scavenging

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

How well did you know this?

Not at all

Perfectly

Passive Scavenger

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

Active Scavenger

Tubing is connected to a forced ventilation system

Best method

Other ways to minimise exposure

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

Endo-tracheal Tube Function

Maintains airway

Prevents aspiration pneumonia

Prevents laryngospasm

Reduces environmental pollution

Allows IPPV

Equipment required ET tube

Suitable size ET tube

Tube tie

Mouth gag

Syringe to inflate cuff

Lubricant

Laryngoscope

Intubeaze

ET Tube Types

Red rubber (low volume, high pressure)

PVC (transparent, high volume, low pressure)

Silicone (straight)

Murphy eye (hole in bevelled end near cuff)

ET Tube Checks

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

Checking Placement ET Tubes

Palpate within the trachea

Auscultate lung fields

Observe movement of reservoir bag

Check for air movement (using hair)

ET Tube Disadvantages

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

ET tube inserted into oesophagus

Patient light No movement of bag Low sp02)

ET tube lodged in bronchus

Sp02 greatly reduced Unilateral breath sounds Patient wakes up

Laryngospasm in cats

Use one spray of local anaesthetic Wait and oxygenate Use laryngoscope

ET Tube blocked/kinked

Sp02 very low Little movement of reservoir bag Cyanosis

Tracheal rupture

Sub cut emphysema Reduced breath sounds

Extubation

After pharyngeal reflexes have returned Ensure oropharyngeal area is clear of blood/debris Wait until swallow returned (dogs) Extubate before swallowing (cats)

Osophageal Stethoscope

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

Pulse Oximeter

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

E.C.G.

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

Blood Pressure Monitoring

Direct/ Indirect

Direct Blood Pressure Monitoring

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

Indirect Blood Pressure Monitoring

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

Central Venous Pressure

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

Capnography

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)

Apnoea Monitor

Detects gas movement through ET tube