Flashcards in Chpt. 12 - Key Points Deck (25):
Although they are uncommon, the tech must be able to anticipate and respond to emergencies in an efficient and knowledgeable fashion.
Human errors resulting in anesthetic problems
- Failure to obtain an adequate history
- Failure to perform a PE
- Lack of familiarity with the anesthetic machine or drugs used
- Incorrect administration of drugs
- Errors related to fatigue, inattentiveness, distraction
Examples of equipment failure or operator carelessness
- Carbon dioxide absorber exhaustion
- Failure to deliver sufficient oxygen to patient
- Misassembly of the anesthetic machine
- Failure of the vaporizer or pop-off valve
- ET tube problems
Anesthetic agents may cause problems during anesthesia, and the anesthetic protocol must be chosen to reflect the special needs of each patient.
The anesthetist must be familiar with the adverse side effects associated with the used of each agent in the anesthetic protocol.
Preexisting factors increasing the risk for anesthetic complications
Geriatric and pediatric patients
- less reserve than younger patients
- have reduced anesthesia requirements
- require reduced doses of injectable agents
- prone to hypothermia and hypoglycemia
- have anatomic characteristics that make respiration difficult, particularly during recovery
- preoxygenate before induction
- rapid induction and intubation needed
- closely monitor during recovery
Thiobarbiturates should be used with extreme care
Alternative agents are preferable in most situations
Should receive anesthetic doses according to their ideal body weight
Pregnant animals presented for c-section
- at increased anesthetic risk
- alternatives to inhalation anesthesia: epidural anesthesia, balanced anesthesia, neuroleptanalgesia
- almost all anesthetic agents may cause depression of fetal respiration and/or circulation
- use of reversing agents may be advisable
Patients having undergone recent trauma
Stabilize and thoroughly evaluate before anesthesia!
Animals with cardiovascular or respiratory disease
May require special anesthetic techniques such as preoxygenation and manual control of ventilation.
Hepatic and renal disease
May delay excretion of injectable agents, and prolonged recovery times may be seen.
Is ideally a team effort involving all hospital personnel.
It is helpful to have preauthorized emergency protocols and periodic "dress rehearsals".
Maintaining adequate anesthetic depth
May be difficult in some patients.
Factors contributing to this problem:
- incorrect placement of ET tube
- incorrect vaporizer setting
- inadequate ET tube size
- many other factors
Excessive anesthetic depth
May result from excessive administration of anesthetic agents or from preexisting patient problems.
It may be necessary to bag the patient with 100% oxygen to achieve a lighter plane of anesthesia.
Pale MMs and prolonged CRT
- poor perfusion
- if severe, shock
- critical emergency
- insufficient delivery of oxygen to tissues
- may be result of: machine problem, airway or ET tube blockage, respiratory difficulties resulting from excessive depth, pneumothorax, or respiratory disease.
- oxygen delivery must be reestablished through masking, intubation, or tracheostomy
Abnormalities in cardiac rate and rhythm
May result from:
- administration of anesthetic agents
- electrolyte abnormalities
- many other factors
Respiratory arrest accompanied by cyanosis and/or bradycardia
Must be treated by ventilation with 100% oxygen!
Cardiac arrest should be treated according to the principles of ABCD:
- establish a patent airway
- bag the patient with 100% oxygen
- initiate internal or external cardiac massage
- administer epinephrine and other drugs
!!Current trend for an intubated patient is to start with cardiac massage, thus following a CABD approach!!
Regurgitation and/or vomiting
May be dangerous in the anesthetized animal because of the danger of airway obstruction and aspiration pneumonia.
May be treated by eliminating external stimuli and administering diazepam.
Dyspnea caused by laryngospasm or brachycephalic airway obstruction
May be treated by:
- administration of oxygen by mask
- reintubation of the patient