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Flashcards in Unit 3 notes Deck (80):
1

Define induction period

taking an animal from a conscious level to an unconscious level
should be the shortest component of GA

2

2 types of induction agents used

Injectable (preferred)
Inhalant

3

Route of injectable induction agents

IV (followed by inhalant, give slowly and titrate to effect)
IM (2-3 times IV dose, cannot titrate to effect, fractious animals only)

4

Injectable drugs used

Barbituate
Cyclohexamine
Propofol

5

What is the "blast em technique"

setting a high O2 flow rate, and a high vaporizer setting

6

Disadvantages of inhalant drugs

Waste gas exposure
Less patient cooperation
Dramatic vasodilation

7

2 Types of inhalant drugs

Isoflurane
Sevoflurane

8

Bast em technique

setting a high O2 flow and vaporizer setting to quickly induct patient

9

Nice way technique

setting a high O2 flow rate and gradually increasing the vaporizer settings by 1/2% every minute

10

Who should the Nice way and Blast em techniques NOT be used on?

Brachycephalics

11

2 Types of ET tubes

Murphy-eye tube: inflatable cuff
Cole

12

5 Indications for intubating

Provide airway
Prevent aspiration
Provide efficient gas delivery
Decrease dead space
Provide controlled ventilations

13

Disadvantages of ET tube use

Stimulation of vagus nerve
Some species have difficulties
Risk of bronchi insertion
Risk of obstructed ET tube
Can contribute to hypothermia

14

How to measure length of ET tube

Tip of nose to thoracic inlet

15

3 causes of difficult intubatioin

Poor patient positioning
Laryngospasms
Inadequate plane of anesthesia

16

Define maintenance period

Period of time following induction in which a STABLE level of anesthesia is reached

17

Stage I

PA period
Voluntary excitement phase
-Conscious
-All protective reflexes present
-Normal heart and RR
-Disoriented
-Slight decreased sensitivity to pain

18

Stage II

Induction period
Involuntary excitement phase
-goes to conscious to unconscious level
-all protective reflexes present
-normal heart and RR
-patient may be struggling

19

Stage III Plane I

Light Anesthetic Plane
-Animal can be intubated
-Sluggish reflexes
-Jaw tone relaxed
-Unable to withstand sx

20

Stage III Plane II

Medium Anesthetic Plane
-Most sx procedures are done at this plane
-Most reflexes absent
-Slight increase in heart and RR due to sx stimulation

21

Stage III Plane III

Deep Anesthetic plane
-Most reflexes absent
-Muscle tone slightly more relaxed
-No response to sx stimulation
Requires very close monitoring!!

22

Stage III Plane IV

Overdose of anesthetic
-Patient in danger of cardiac arrest
-Significant depression of body systems
-Change planes immediately!!

23

Stage IV

CPR necessary for life!!
Crash cart
no longer GA--- headed towards death

24

Palpebral reflex

"blink" reflex
gently touch medial canthis of the eye
lost at surgical plane

25

Pedal reflex

"toe pinch" reflex
pinch webbing of toes
lost at surgical plane

26

Nystagmus

Happens during middle of plane change

27

Eye rotation

Will rotate medial and ventral at stage III plane II

28

Ear flick

Only works with cats and equine

29

Jaw tone

Best reflex to watch
will never be completely gone
pull to 45 degree angle and feel for tone

30

BP normals

Systolic= 100-160mmHg
Diastolic= 60-100mmHg
Mean= 80-120mmHg

31

Hypotensive values

Systolic= <60mmHg

32

3 Things that contribute to BP

Blood volume
Cardiac output
Vascular resistance

33

Causes of hypotension

Hypovolemia
Overdose of anesthetic drugs
Decrease in cardiac output

34

Managing hypotension

Bolus IV fluids (20ml/kg/hr.)
+/- decrease anesthetic %
Give + inotropic drugs

35

3 ways to measure BP

Doppler machine
Oscillometric
Direct arterial BP

36

2 Parts to place with DOPPLER & how to hook up

Cuff- should be 40% the circumference of leg, placed proximal to the crystal and attached to sphygmomanometer

Crystal- placed on artery, concaved side down

37

Technique for using DOPPLER

Inflate cuff until you cannot hear pulse
gradually release pressure until you hear the pulse again

38

Pulse Oximeter values & normals

Values=
Amount of Hgb saturated with O2 reported out as SpO2 or PaO2
Pulse Rate

Normals=
>95% (under anesthesia)
>90% when awake
60-160bpm canine
110-220bpm feline
30-40 equine

39

How to place Pulse Ox

Must be placed onto a moist, non-pigmented area such as:
tongue, webbing of toes, vulva, prepuce

40

Causes for desaturation (Pulse Ox)

V/Q mismatch
Disconnected from breathing system
Blocked airway
Inadequate flow rate
Erroneous readings (most common)
Hypovolemia

41

4 ways to monitor respiratory system

Capnograph
Res. Bag
Esophageal Stethascope, flutter valves, ET tub fog... etc
Rate and character

42

Capnograph gives you what 3 things?

RR
ETCO2
InCO2

43

Normal capnograph readings

RR= 8-20rpm
ETCO2= 35-45mmHg
InCO2= 0-5mmHg

44

2 Types of capnographs

Mainstream: connecter that connects between ET tube and Y tubing. Computer crystal inside tubing reads vitals

Side Stream: Connecter connects between Y and ET tubing. Takes sample of air away from patient and analyzes it inside machine (cheaper)

45

Define controlled ventilation

Controlling the volume of air, rate of respiration, and pressure of air being introduced into the animal

46

How often do you ventilate with controlled ventilation and why?

every 5 min
to prevent:
atelectesis
blow off excess CO2
Prevent hypoxemia
Prevent hypoventilation
Counteract decrease in tidal volume

47

How to completely take over respirations

Res. bag
Mechanical ventilator

48

How to ventilate with Res. Bag

Ventilate 12-16rpm
after 3-5 min patient will stop breating on their own
decrease ventilations (8-12rpm for remaining time)
Wean off ventilator by gradually decreasing ventilations

49

How to ventilate with Mechanical Ventilator

Hook up machine to res bag port
Hook up to scavange

50

3 types of mechanical ventilators

Pressure cycle ventilator- Bird mark 7
Volume cycle ventilator- Ohio Metomatic
Time cycle ventilator- Drager

51

What 2 values does a ECG give you?

Heart rate
Heart rhythms

52

ECG leads

white= right axillary
black= left axillary
red=left inguinal
green= right inguinal

53

Most common artifacts on an ECG

movement
cautery pens
some dental equipment
drying out of electrodes

54

Ventricular means theres an issue with ____

the AV node

55

Sinus means

normal electrical function of heart

56

PVC

Pre ventricular contractions
AV node firing before SA node
wide appearance to QRS complex
consistant R-Rs
missing P wave
QRS for every P
Okay if occasional

57

Uniform PVC

all QRS complexes have the same configuration

58

Multiform PVC

QRS complexes have different configurations

59

Causes of PVCs

Electrolyte imbalance
GDV
Circulating catecholemines
Drugs (barbiturates)
Inhalant anesthetics (Halothane)

60

Treatment of PVCs

(if seeing multiple)
Find underlying cause
Ventilate patient and decrease gas
(if unsuccessful, give lidocaine)

61

Ventricular Tachycardia

3 or more PCVs in a row

62

Causes of V-Tach

Very bad cardiac output
GDV
Electrolyte imbalance
Circulating Catecholemines
Drugs

63

Treatment of V-Tach

lidocaine drip

64

V-Fib

Ventricular fibrillation
Usually a terminal rhythm

65

Treatment of V-fib

Defibrillator paddle

66

Asystole

Animal must be dead for 3-5 minutes before you will even see this
No electrical function (flat line)
Give epinephrine

67

Sinus Tachycardia

Increased heart rate
Regular rhythm
Patient is probably too light
deepen anesthetic plane

68

Sinus Bradycardia

Decreased heart rate
Regular rhythm
Patient is probably too deep
evaluate patient and either decrease gas if too deep or give anticholinergic if at a good plane

69

First degree AV block

Delay in conduction between SA node and AV node
Not a serious problem
everything appears normal, except there is an occasional delay between P and QRS waves

70

Second degree AV block

Some impulses between SA and AV node are blocked
Not life threatening yet (treat if seen!)
some P waves have no QRS complexes
Treat with anticholinergics

71

Third degree AV block

Have more than one lone P-wave in consecutive sessions
Life threatening
Treat with pacemaker

72

Broadened and Heightened T wave

caused by myocardial hypoxia
very wide and broad T wave

73

Spiked T wave

Caused by electrolyte imbalances (hyperkalemia)
Spikey and tall T wave

74

Treatment for abnormal T waves

Ventilate and decrease anesthetic %
Change fluids if consistent spiky T waves

75

Malignant Hyperthermia

a genetic disorder will have increased muscle activity leading to hyperthermia (very uncommon in small animals)

76

Hypothermia causes

Decreased muscle activity
Decreased metabolic rate
Intro of cold gas
Surgical preparation
Open body cavity

77

Ways to prevent Hypothermia

Always keep something between patient and table
Circulating water blanket
Bear Hugger
Monitor the patient
Gauze around feet will keep heat in
Camping blanket

78

Hypothermia @ or above 96 degrees

No physiological effect on patient

79

Hypothermia between 90-94 degrees

decreased anesthetic requirement due to depressed body system

80

Hypothermia between 82-86 degrees

no anesthetic requirement due to significant depression of body systems