KEY THINGS TO KNOW TO PREVENT DEATH

Question 1

What is Stage 1 of anaesthesia?

Answer 1

Voluntary excitement; increased HR & RR, excess salivation, voiding of faeces and urine, struggling. PREMED

Question 2

What characterizes Stage 2 of anaesthesia?

Answer 2

Involuntary excitement, cortical depression, narcosis. Some reflex struggling, pupils dilate / nystagmus. VIA INDUCTION

Question 3

What defines Stage 3 of anaesthesia?

Answer 3

Surgical anaesthesia

Question 4

What occurs in Stage 4 of anaesthesia?

Answer 4

Loss of all reflexes, severe respiratory depression/respiratory arrest, cardiac arrest; risk of death

Question 5

What are the four planes of surgical anaesthesia?

Answer 5

Plane 1: Light plane, Some surgical procedures can be carried out
Plane 2: Level required for most patients, most surgical procedures carried out
Plane 3: Too deep for most patients, deeper than required for mot procedures
Plane 4: Very deep, risk of death

Question 6

What is the risk category for a patient who is completely healthy?

Answer 6

ASA 1: Patient is completely healthy, fit

Question 7

What defines a patient with mild systemic disease?

Answer 7

ASA 2

Question 8

What is the classification for a patient with severe systemic disease that is not incapacitating?

Answer 8

ASA 3: Patient has severe systemic disease that is not incapacitating

Question 9

What characterizes a patient with incapacitating disease?

Answer 9

ASA 4: Patient has incapacitating disease that is constant threat to life

Question 10

What is the classification for a moribund patient?

Answer 10

ASA 5: Moribund patient, not expected to live 24hrs with or without surgery

Question 11

What does the ‘E’ represent in the context of emergency surgery?

Answer 11

Emergency surgery – (E placed after the roman numeral)

Question 12

What is the rebreathing flow rate for SA’s?

Answer 12

6ml/kg/min

Question 13

What is the initial flow rate for the Spey clinic for animals over 4kg?

Answer 13

Initial flow rate = 100ml/kg/min or 2L/min (whichever is greater)

Question 14

What is the stable maintenance flow rate on a rebreathing circut?

Answer 14

10mls/kg/min or minimum of 500ml/min

Question 15

What is the non-rebreathing flow rate for animals under 4kg?

Answer 15

500ml/kg/min. Constant

Question 16

What is the formula for calculating ET tubes?

Answer 16

(BW/4)+4

Question 17

What is the formula for fluid rate?

Answer 17

FLUID RATE = MAINTENANCE REQUIREMENT + ONGOING LOSSES + REPLACEMENT DEFICIT

Question 18

What is the maintenance fluid rate?

Answer 18

2-3ml/kg/hr

Question 19

What is the peri-operative fluid therapy rate?

Answer 19

Maintenance + losses = 5ml/kg/hr

Question 20

What is the bolus treatment for hypotension?

Answer 20

5ml/kg/hr +/- fluid bolus

Question 21

What is the recommended bolus amount over 10 minutes?

Answer 21

10ml/kg bolus over 10 min – testing fluid responsiveness

Question 22

What is the traditional fluid rate recommendation?

Answer 22

10ml/kg/hr

Question 23

What should be the fluid rate for large skin deficits or open cavities?

Answer 23

Increased evaporation ± blood loss → 10-20ml/kg/hr

Question 24

What are the three key things to monitor from induction to recovery?

Answer 24

• Breathing
• Heart pumping blood
• Awake or asleep?

Question 25

What is considered 'normal' systolic pressure in dogs and cats?

Answer 25

~90-160

Question 26

What is considered 'normal' diastolic pressure in dogs and cats?

Answer 26

~55-90

Question 27

What is the normal range for MAP?

Answer 27

60-100mmHg

Question 28

When is vital organ perfusion likely to be inadequate?

Answer 28

<60 MAP

Question 29

What temperature indicates severe hypothermia?

Answer 29

<34

Question 30

What is the threshold for MAP intervention?

Answer 30

<60-65mmHg

Question 31

What is the threshold for SAP intervention?

Answer 31

<90mmHg

Question 32

What level of SPO2 indicates hypoxaemia?

Answer 32

<90

Question 33

What is the bradycardia threshold for cats and small dogs?

Answer 33

HR<100

Question 34

What is the bradycardia threshold for medium dogs?

Answer 34

HR<60

Question 35

What is the bradycardia threshold for large dogs?

Answer 35

HR<50

Question 36

What is the tachycardia threshold for cats?

Answer 36

HR>180-200

Question 37

What is the tachycardia threshold for small dogs?

Answer 37

HR>160

Question 38

What is the tachycardia threshold for medium dogs?

Answer 38

HR>100

Question 39

What is the tachycardia threshold for large dogs?

Answer 39

HR>80

Question 40

What are common complications associated with anaesthesia? (respiratory)

Answer 40

hypoventilation hyperventilation hypercapnia (ETCO2 >45mmHg) hypocapnia (ETCO2<35mmHg) hypoxaemia (SPO2 <90)

Question 41

What does the hypotension algorithm address?

Answer 41

What to do in a case of hypotension - drugs required (atropine and dopamine), fluid responsiveness, anaesthetic depth