Recovery Flashcards Preview

Anesthesiology > Recovery > Flashcards

Flashcards in Recovery Deck (30):
1

Small animal extubation

1. Sternal recumbancy
2. Ensure clean airway
3. Deflate cuff and remove after cough or swallow

2

What should be done if regurge has occurred?

1. Position the head lower
2. Swab the pharynx
3. Remove ET tube with cuff inflated (deflate a small amount if needed)

3

Small animal recovery monitor

Continue physiologic monitoring until sternal and upright

4

Small animal supportive care

Continue to use warming to maintain body temp and stimulate as needed to increase level of consciousness

5

Common recovery complications

-Pain
-Dysphoria
- Hypo-hyperthermia
-Hypoventilation
-Hypoxemia
- Prolonged recovery

6

Recognizing pain

1 TPR changes
2. Vocalization
3. Posture/gait
4. Interaction with caregivers
5. Guarding of painful site
6. behavior change

7

Consequences of pain

1. Increased cardiac work load
2. Hypo or hyper ventilation, hypoxemia
3. Ileus
4. Oliguria
5. Risk of thromboembolism
6. Impaired immune function
7. Anxiety or fear

8

Should pain level be anticipated and treated based on procedure?

Yes

9

What will a dysphoric patient become with additional opioids?

More distressed

10

What will a painful patient become with additional opioids?

Quiet

11

What are some considerations when differentiating pain from dysphoria?

1. What analgesics have been administered?
2. What kind of procedure??
3. Patient temperament and breed
4. Surgical site pain

12

Strategies to differentiate pain from dysphoria?

1. Short acting opioids (worse or better?)
2. Alpha-2 agonists
3. Acepromazine
4. Benzodiazepine
5. Opioid antagonist (butorphenol good)

13

Consequences of short term hypothermia

Increased O2 demand
Prolonged recovery
Discomfort

14

Consequences of long term hypothermia

Delayed healing
Infections

15

Hyperthermia causes

Opioid use in cats, MRI with obese furry dogs

Can reverse if severe

16

Treatment of hypoventilation

delay extubation and continue IPPV as needed
Clear airway
Reverse drugs

17

Treatment of hypoxemia

1. Address underlying cause
2. Position properly
3. Warming
4. O2 support (increased FiO2)

18

Causes of prolonged recovery

1. Hypothermia
2. Hypotension
3. Hypoglycemia
4. Electrolyte derangement
5. Anemia
6. Hypoventilation.hypoxemia
7. Drugs
8. Neurologic disease

19

Treatments of prolonged recovery

Address underlying cause before reversing analgesic drugs

20

Equine recovery

Most dangerous time for equine anesthesia

Potential for injury of horse or personnel

21

Types of recovery

Free recovery- short procedures or dangerous horses

Assisted recovery- long procedures or unstable patients, orthopedic disease

22

Types of assisted recovery

Personnel on hand, ropes inside/outside recovery stall, Sling recovery, pool recovery

23

Equine sedatives

Recovery from triple drip usually uneventful

Need sedative to recovery from gas anesthesia- Alpha-2 agonist +/- acepromazine

24

What should be used to control pain in equines?

NSAIDS
Alpha-2 agonists
Butorphanol (visceral)
Morphine/meperidine (somatic pain)

25

Equine hypothermia

Maintain body temp through procedure so that there is no nead to warm during recovery

26

Is hypoxemia common during equine recovery?

Yes, supplemental O2 recommended to required for all equine patients via tube or nasal flow by

27

Airway obstruction in equine recovery

Check for nasal edema before recovery, apply intranasal phenylephrine

28

Equine weakness recovery

Hypocalcemia, hypokalemia, hypoglycemia, anemia- can lead to fatal injury

Check bloodwork prior to recovery and correct disturbances

29

Rhabdomyolysis myopathy

Horses muscle injury secondary to hypoperfusion- hard muscles, sweating, tembling, myoglobinuria, pain

Tx: fluids analgesics

30

Ruminant recovery

Do not try to stand prior to ready
Regurg +/- aspiration and bloat are common complications
Maintain sternal recumbency
Delayed extubation and keep cuff inflated
Pass stomach tube to relieve gas bloat