Remote Capture Flashcards

1
Q

Considerations for Field Anesthesia with Weather

A

Timing chosen for appropriate time of year when hazards minimized

ex: Ungulates may be captured in late winter
* Decreased risk of hyperthermia
* Snow helps with tracking

Snow and rain–> hypothermia, esp if wind (convective heat)

Summer months: plan for cooler hours of day

Safe helicopter generally not possible in high winds or foggy conditions

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2
Q

Hypoxemia in Wildlife Ax

A

common complication of wildlife anesthesia (particularly with ruminants)

Oxygen = fundamental supportive care during field anesthesia
* Aluminum E, D cylinder + sturdy regulator, flowmeter
* Portable oxygen concentrators

Nasal insufflation often adequate to resolve hypoxemia

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3
Q

Emergency Kit for Wildlife Field Anesthesia

A

Basic kit: epinephrine, atropine, lidocaine, reversal agent

Lac Repair Kit

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4
Q

Environmental Hazards

A

Beware of surrounding environment: other animals may approach
 Esp true/important with social carnivores, bears
 Need to have a lookout posted to protect the team
Firearm back up with more dangerous species

All capture team members should receive firearm safety training
* Similar training advisable for people using dart
* Rifles or pistols; pepper spray = alternative as a non-lethal firearm

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5
Q

Basic Safety Features of High Potency Opioids

A

Carfentanil, etorphine, thiafentanil = risk of lethal toxicity in people

Use protective clothing (disposable gloves and face shields when using)

Pharmacological antagonist available to treat human exposure

Everyone on team trained in human first aid
 Equipment available to provide respiratory and airway support

Wildlife anesthesia: NEVER be performed by a single person
* Minimum two people available when potent drugs being used/handled, esp during dart loading

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6
Q

Helicopter Capture Techniques

A

significant hazard, requires very skilled pilot for wildlife capture

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7
Q

Communication with Local Officials

A

Advised to meet with local medical personal prior to capture to discuss evacuation and treatment plan in case of inadvertent human exposure

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8
Q

Injuries Assoc with Dart Placement

A

dart impact trauma

high-velocity injection of dart contents

inaccurate dart placement

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9
Q

Dart Impact Trauma

A

dispersion of energy on dart impact
o Impact kinetic energy = 1/2M x V2 where M = mass of dart, V = velocity
o Use lowest velocity provides accurate trajectory at a given distance

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10
Q

Inaccurate dart placement

A

Abdominal, thoracic, or other vital structures of head, neck

Aim for well-muscles area away from viscera

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11
Q

High-velocity injection of dart contents

A

systems that expel drug via explosive charge disrupt tissue, produce trauma
o Used only on large, well-muscled animals
o Minimize volume of injectate to decrease tissue trauma (<3mL)

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12
Q

Two Mechanisms of Dart Discharge

A
  1. Explosive Discharge
  2. Air Activated
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13
Q

Explosive discharge mechanisms

A

Reserved for large, well-muscled animals

Darts = aluminum or plastic body, small explosive cap between plunger, tail

On impact, firing pin inside cap forced forward against resistance of spring –> detonation, expanding gas pushes plunger forward

Short duration of injection (0.001 s)

Needle should be barbed so stays in animal during injection

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14
Q

Air Activated Discharge Mechanisms

A

Aluminum or plastic body into which compressed air introduced through one way valve in tail piece

On impact, silicone seal is displaced exposing a port on side of needle –> plunger pushed forward by air pressure

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15
Q

Opioids in Capture

A

particularly effective in ungulates, produce analgesia and sedation

Lack muscle relaxation, often cause excitement - hyperthermia, exhaustion, lost animals, death, regurgitation

Can be used alone or with a neuroleptic agent

Predictable, relatively fast, can be reversed

Other AEs: hypoxemia, severe resp depression

Risk of renarcanization

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16
Q

Carfentanil

A

Particularly useful in ungulates, also used in large carnivores

Advantages: high potency, rapid onset, reliability, reversal with appropriate antagonist

Muscle rigidity when used alone

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17
Q

Disadvantages of Carfentanil

A

Moose: increased chance of aspiration pneumonia

Long effect: should be antagonized
o If antagonists has shorter half life, re-narcotization

Respiratory depression, hypoxemia, hypertension, CNS excitation

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18
Q

Reversal of Carfentanil

A

Reverse with naltrexone
* Naloxone, diprenorphine, nalmefene  re-narcotization

100mg naltrexone:1mg carfentanil

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19
Q

Etorphine

A

Particularly effective in ungulates, rhino, and elephants

3000-6000x more potent than morphine

Used alone or in combo with a suitable neuroleptic agent

Underdosing = excitement; optimum dose, first effect 3-8 min post IM
* Full effect 20-30 min

Slow recovery (up to 7-8 hr) without antagonist
* Antagonist IV 1-3min, IM = 5-10 min

Most serious adverse effect = respiratory depression

Other SEs: normal opioid things

Reversal: diprenorphine

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20
Q

Thiafentnail

A

rapid induction, greater therapeutic index, shorter half-life, lower incidence of renarcotization, less respiratory and cardiac depression vs etorphine, carfentnail

Only commercially avail in South Africa

3000-6000x more potent than morph

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20
Q

Thiafentnail

A

rapid induction, greater therapeutic index, shorter half-life, lower incidence of renarcotization, less respiratory and cardiac depression vs etorphine, carfentnail

Only commercially avail in South Africa

Reversal: naltrexone 30-50mg:1mg TF

Used alone or in combo with a2 +/- ketamine

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21
Q

Butorphanol

A

Combination with etorphine = improved ventilatory function

Commercially available at 30, 50 mg/ml: high concentration formulations greatly increase utilization for remote delivery

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22
Q

Naltrexone

A

most versatile, lowest chance of narcotization

Rapid antagonism of mu-opioid receptor antagonism

Reliable antagonism of longer-acting opioids (carfentanil), IM or IV
* Dose of 100 mg:1 mg of carfentanil
* 10-30 mg of naltrexone: 1 mg thiafentanil

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23
Q

Drug Choices in Human Overdoses

A

Naloxone, naltrexone

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24
Naloxone
Pure narcotic antagonist, may reverse all opioids listed above Reverse in 1-3 min IV Short half life, renarcotization seen with carfentail Dose given to elk of 2 ucg for every 1 ucg of carfentanil given
25
Diprenorphine
Antagonist used to reverse **etorphine**, **agonistic properties on own** * Acts as antagonist when given after etorphine Rapid reversal Adverse effects = rare * Overdosing: continued immobilization DT partial agonist activity Human accidently gets etorphine, no diprenorphine (DT agonist effects)
26
Cyclohexamines
Adverse effects: hyperthermia, excessive salivation, catecholamine release, convulsions Act fast, relatively wide margin of safety, cardiorespiratory depression only moderate  Laryngeal function somewhat preserved Combined with a benzo or alpha-2 agonist= additive or synergistic Particularly effective in carnivores, primates, birds; no known antagonist
27
Ketamine in Wildlife
Never used as a sole immobilizing agent, co-administer with tranquilizer-sedative Optimum dose, first effects = 2-5 min post IM, full effects 5-10 min - duration 45min-2hr **Ketamine based combos = unreliable in bears, do not use in vultures**
28
Telazol
First effect = 1-2 min, full effects 15-30 min Onset usually smooth with good muscle relaxation, somatic analgesia Duration of effect, quality of emergence, duration of recovery vary with species: tiletamine, zolazepam metabolized at different rates Recovery in 3-8 hours, may be prolonged in some species If reconstitute with a2 agonist – decrease volume injected, enhance analgesia, decrease recovery times following antagonism of a2 agonist
29
No Telazol in...
Tigers, other big cats (debated) Rough recoveries in ungulates - ruminants, swine NZWR
30
Alpha 2 Agonists
Alone = unreliable immobilization in most species hypoxia in ungulates, hypertension +/- bradycardia  Contribute to ruminal tympany, regurgitation in ungulates Also alters thermoregulation Very excited animals --> not predictable level of immobilization
31
Xylazine, Detomidine Reverals
1 mg of atipamezole : 10 mg xylazine (IM) 5 mg atipamezole : 1 mg detomidine (IM)
32
Medetomidine
 Produce sedation, analgesia, and muscle relaxation  Unreliable alone: medetomidine + low dose ketamine or Telazol  Antagonism with atipamezole = 3-5x medetomidine dose
33
a2 Reversals
Atipamezole = most selective, can be used in all species Species-dependent differences in response to yohimbine, tolazoline but less with atipamezole  Yohimbine not particularly effective in wild bovids IM unless emergency: CNS excitation, tachycardia, hypotension followed by hypertension with IV ---Animals may arouse rapidly without warning following IV ---Potentially dangerous species = may not give you time to escape
34
ACP, Droperidol (neuroleptic agents)
-typically paired with opioids (etorphine) -long-acting tranquilizer to facilitate translocation -overall stress reduction -effects = days to weeks
35
Perphanazine enanthate
 Slow-onset, long-acting PTZ derivative formulated in sesame oil vehicle  Onset 12-16 h, effects last up to 10 days
36
Zuclopenthixol acetate
Thioxanthene derivative, lasts up to 3-4 days – 1mg/kg IM in most studies Occasionally, extrapyramidal signs
37
Azaperone
 Butyrophenone drug, used as a tranquilizer in pigs  +/- alpha 2, +/- opioids for ax, immobilization of wild/farmed ungulates  Pigs = DOA of 6 h
38
Anticipated Drug Needs
 Budget for at least 50% more drug than is actually needed  Help offset drug wasted from lost darts or poor dart placement
39
Dart Loading Once Target Located
Metal darts not loaded for >12hr: possible corrosive action of drugs may impair injection mechanism Preloaded darts with air-activated discharge should not be pressurized; have tendency to lose pressure if armed for extended period
40
How far does the animal need to be for accurate dart delivery?
within 30-40m Animals may be stalked, baited, approached in a vehicle or helicopter, or trapped or snared prior to approach Trapped animals advantage of limiting movement during capture * May be more stressful than helicopter capture, esp for bears
41
How long should capture take?
2-5min
42
What is the most important determinant of induction time?
**Dart placement** = most important determinant of induction time
43
Location of Dart Placement
Facilitate fast drug absorption --> muscle mass of **neck, shoulder, or hindquarters** must be injected
44
How Dart Placement Changes During Time of Year
Brown bears: **dart in hindquarter** when they emerge from **spring** dens In **fall** due to large fat stores, **dart in shoulder or neck** Use hindquarters to spring Hair falls on neck and shoulders
45
Drug Selection and Movement of Immobilized Wildlife
 When a2 used, animals head or limbs should not move prior to approach  Telazol alone or with narcotics, may be some involuntary movement
46
Carnivore Positioning
lateral or sternal
47
Management of Ruminal Tympany
in sternal – help prevent tympany * If problem, rock animal back and forth to stimulate eructation * Pass tube orally/nasally if needed: may predispose to regurgitation, aspiration * Tympany severe: finish procedure, antagonize agents * Alpha2 antagonist will increase ruminal activity to help
48
Timing of Procedures during Wildlife
Painful procedures first after initial sedation when in deepest plane of anesthesia
49
Hypoxemia in Wildlife Capture
common during wildlife immobilization Hypoxemia + hyperthermia is very serious * Increased metabolism, tissue oxygen demand * Increases risk of inducing exertional myopathy Supplemental oxygen with pulse oximetry being measured **Tachycardia followed by severe bradycardia (HR <30 bpm) = warning sign that hypoxemia is very severe**
50
Temperature Monitoring in Wildlife
Ungulates more prone to hyperthermia, especially after long chase Planning immobilization during cooler periods of day or at cooler times Temps >40 Degrees C (104 F)= cause for concern Temp > 41 C = emergency and treated aggressively
51
Other Stimuli in Wildlife Capture
Loud noises increase risk of sudden arousal, especially the **vocalizations of distressed offspring** Changing positions Painful stimuli
52
Signs of CNS Depression
Spontaneous blinking will reappear Carnivores often develop chewing and paw movements * Progresses to head lifting Xyla-ket or medet-ket immobilization, head lifting or limb movement = animal minimally obtunded and should NOT be approached
53
Recovery and Reversal
Reversible drug combination not used: animal should be observed until it can ambulate  Place in a comfortable position  Final set of vitals taken TWO people to administer reversal, typically IM
54
Pulse Monitoring Locations in Wildlife
Femoral a Auricular a Depends on species
55
Hyperthermia
Most immediate sign = critical rise in body temp (>40-41 C) Rapid shallow breathing, panting, and weak, rapid, or irregular heart rate Moving the animal into shade or spraying it with cold water  Also can pack ice/snow around it, cold water enemas
56
Hypothermia
low temps, characterized as temp <35 C Mostly in young animals, animals with low body mass, poor condition Prolonged recovery, acidosis, coagulopathies, and arrhythmias Dry and cover animal + external heat source
57
Capture Myopathy
Most commonly associated with pursuit, capture, restraint, transportation Prey species, particularly ungulates predisposed * Also long legged wading birds * Less common in carnivores but can occur under certain conditions
58
Pathophysiology of Capture Myopathy
**Effects of sympathetic exhaustion + sustained stress + intense muscular exertion** Sustained muscular exertion = production, buildup of lactate in muscle Leads to metabolic acidosis, death of SkM; release of intracellular K+, Ca2+, myoglobin High amounts of myoglobin in plasma, ultrafiltrate in renal tubules = ARF Hyperkalemia, acidosis, acute arrhythmias, circulatory failure
59
Capture Myopathy Tx, Prevent
Difficult to treat PREVENTION IS KEY Chase limited to 2 min Capture efforts not resumed for at least 1 day if failed If several individuals from same herd require capture, advisable to have enough handlers to capture multiple at same time rather than repeatedly stressing herd
60
4 Clinical Capture Myopathy Syndromes
1. Acute Death Syndrome/Capture Shock Syndrome 2. Delayed Peracute Death Syndrome 3. Ataxia-Myoglobinuric Syndrome 4. Muscle Rupture Syndrome
61
Acute Death Syndrome/Capture Shock Sydrome
**during mobilization or within short time after capture**, death usually within 1-6hr post capture Depression, tachypnea, tachycardia, hyperthermia, weak thready pulses, death Elevations in AST, CK, LDH Postmortem lesions: small intestinal, hepatic congestion plus pulmonary congestion and edema Histopath: small areas of necrosis in SkM, brain, liver, heart, adrenals, lymph nodes, spleen, pancreas, renal tubules
62
Delayed Peracute Death Syndrome
RARE, animals in captivity >24hr --Animals appear normal if left undisturbed --If stressed/captured, try to run or escape but stop abruptly and stand/lie still for a few moments o Eyes dilate, death ensues within several minutes * Cause of death: ventricular fibrillation Elevations in AST, CK, LDH No gross or histopathologic lesions post mortem
63
Ataxic Myoglobinuric Syndrome
**Most common, several hours to days post capture** Clinical signs: **mild to severe ataxia, torticollis, myoglobinuria** Elevations in AST, CK, LDH, BUN Post mortem: main lesions in kidney, SkM
64
Muscle Rupture Syndrome
24-48hrs post capture, animals normally appear normal **Clinical signs: marked drop in hindquarters, hyperflexion of hock due to unilateral or bilateral rupture of gastrocnemius muscle** Elevations in AST, CK, LDH Most animals die within few days Postmortem: massive subcutaneous hemorrhage of the rear limbs, muscular lesions similar to ataxic myoglobinuric syndrome but more severe, widespread
65
When do most deaths related to wildlife capture occur?
early phase of large capture project before immobilization protocols have been refined, drug dosages adjusted, team members experienced >2% mortality during trapping = unacceptable
66
Three Categories of Capture Mortality of Free Ranging Mammals
1. Direct effect of immobilizing agents themselves 2. Indirect effects of drug(s) used 3. Secondary Effects caused by capture process itself
67
Three Categories of Capture Mortality of Free Ranging Mammals
1. Direct effect of immobilizing agents themselves 2. Indirect effects of drug(s) used 3. Secondary Effects
68
Indirect Effects of Drugs Used
Drowning, pneumothorax Etorphine often induces hyperthermia --> animal seeks water then drowns
69
Secondary Effects Caused by Capture Process Itself
* Trauma traps * Long term effects form chasing * Have nothing to do with ax risk per se, treated as a separate entity