Exam 2: Lecture 17: Pre-operative Assessment and Preperation - LA Flashcards
(70 cards)
Before taking a LA into surgery, who should we communicate to
referring vet, owner/trainer/agent, and insurance company
before taking a LA into surgery, what should we do for animal prep
Get this history, confirm the need for sx, PE, any additional diagnostics, and prep for anesthesia
What is the role of referring DVM in communication
a liaison, complete referral history, post-op management, and case followup
what should we tell the owner/trainer/agent
risks of sx, risk of anesthesia, intra-operative communication, outcomes, progress of post-op, finances, and insurance
why should we talk to the insurance company before surgery
not all horses are insured so make sure to ask
why should we talk to insurance before euthansia
because sometimes euthanasia can forfeit the insurance policy and they want you to do everything you can to save the animal
what factors increase risk for LA anesthesia
- more time = more risk
- larger horses have more complications
- Age
- a high ASA score
- hypotension
- quality of induction
before we anesthetize any animal, what should we always have the owner do
sign a consent form!!
what are the surgical outcomes we should talk about to the owner
- communicate all possible negative outcomes to client before sx
- talk to the owner about the intended use for the horse and what the problem/sx is
what are some post-op expectations we should mention
is there a proper set up at home?
medications, bandage changes, stall rest, complications
when talking to owner about finances for LA sx, what is important to remember to do
give an accurate estimate and update regularly (esp if there are any changes in procedure/condition)
what are some things we talk about with intra-operative communication
if there is severe disease, if there are complications during sx, or if we need to euthanize during sx
What are inherent risk factors
signalment and medical history
what are some variable risk factors
primary disease (physical and cardiovascular status), elective vs emergent, and extent of procedure
what is important to get in the history for pre-op information
past medical treatments (including any surgeries and anesthesia), nutritional status, vaccination status, and owners perception of the problem
what specific inherent factors increase risk
foals (<1 yr), geriatric (>20 yr), cardiopulmonary status, increased size of patient
what are the specific variable factors that can increase risk
morbidity/mortality status, body system involved, severity of injury, and progression of disease
what surgeries have the greatest variable risk factor
colic and fractures!
T/F: Emergency surgery does not increase morbidity/mortality possibility
false, emergency surgery does increase both of these
what are the categories of ASA risk classification
I, II, III, IV, and V
what is the physical status and clinical example of a category I ASA
physical - normal healthy patient
clin - routine castration, routine arthroscopy
what is the physical status and clinical example of a category II ASA
physical - patient with mild system disease
clin - pregnant, obese, skin tumor removal
what is the physical status and clinical example of a category III ASA
physical - patient with severe systemic disease
clin - dehydration, anemia, fever, hypovolemia
what is the physical status and clinical example of a category IV ASA
physical - patient with severe systemic disease that is a constant treat to life
clin - sepsis, colitis, emaciation, severe dehydration
