Exam 1 Flashcards
what is the bare minimum bloodwork you would want to do before anesthesia
what if its an older, compromised patient?
PCV
TP
BUN
+/- glucose
CBC, chem, UA
physical status class:
normally, healthy (elective) (e.g. spay/neuter)
class I
physical status class:
mild systemic dz (e.g. mild mitral valve disease)
class II
physical status class:
moderate systemic dz (e.g. chronic renal disease, pneumonia)
class III
physical status class:
moribund (likely to die whether you anesthetize or not)
class V
physical status class:
severe dz (life threatening) (e.g. hemoabdomen, colic, septic)
class IV
what size patients would you use a rebreathing system
large patients > 5 kg
physical status class:
e.g. colic
emergent
pressure of a full oxygen tank
2000 psi
what size patients would you use a non-rebreathing system
small patients < 5 kg
what size patients do you not want to use the O2 flush valve on
small patients due to risk of damage
should the oxygen flow rate be higher in a rebreathing or non-rebreathing circuit
non-rebreathing to prevent rebreathing of CO2
5 ways to minimize anesthetic gas waste in the workplace
lower O2 flow rate
scavenge waste gas effectively
ensure leak-free
use good work practices with inhalants (e.g. fill vaporizer at end of day)
well ventilated rooms
mild hypoxemia
< 80 mmHg
< 95% SaO2
severe hypoxemia
< 60 mmHg
< 90% SaO2
differentials for hypoxemia
low inspired O2
low partial pressure (altitude or low PAO2)
hypoventilation (high CO2)
V/Q mismatch
anatomic shunt
diffusion impairment
most common cause of hypoxemia in horses
V/Q mismatch
4 methods to monitor oxygenation
- pulse oximeter
- blood gas or arterial O2 partial pressure
- cyanosis
- lactate (indirect)
what sample is required for a blood gas to measure oxygenation
arterial blood sample
when does cyanosis occur
PaO2 < 40 mmHg
3 methods to monitor ventilation
- capnography/capnometry
- blood gas or CO2 partial pressure
- acid-base balance (indirect)
what sample is required for a blood gas to measure ventilation (CO2)
arterial or venous blood sample
horse respiratory differences under anesthesia
high PCO2
affected by position
severe V/Q mismatch
cluster breathing
cat respiratory differences under anesthesia
low PCO2
mucus plug airway obstruction
difficult intubation
reactive airway
dog respiratory differences under anesthesia
depressed by opioids
brachycephalic syndrome
aspiration pneumonia
lab animal respiratory differences under anesthesia
difficult intubation
affected by position
difficult monitoring
mucus plug airway obstruction
marine animal respiratory differences under anesthesia
diving reflex
may drown
difficult intubation
amphibians respiratory differences under anesthesia
breathe through skin
difficult intubation and monitoring
bird respiratory differences under anesthesia
no alveoli or diaphragm
air sacs
no FRC
affected by position
mucus plug airway obstruction
inhalant sensitivity
complete tracheal rings
difficult to monitor
ruminant respiratory differences under anesthesia
difficult intubation
regurg/aspiration
affected by position
abdominal compression
bloat
salivation
high resp rate
smaller tidal volume
sheep hypoxic from alpha-2 agonists
camelid respiratory differences under anesthesia
difficult intubation
good oxygenation
regurg/aspiration
porcine respiratory differences under anesthesia
difficult intubation, easy to go into bronchi
small airway
unknown underlying diseases
