Unit 3 notes Flashcards
(80 cards)
1
Q
Define induction period
A
taking an animal from a conscious level to an unconscious level
should be the shortest component of GA
2
Q
2 types of induction agents used
A
Injectable (preferred)
Inhalant
3
Q
Route of injectable induction agents
A
IV (followed by inhalant, give slowly and titrate to effect)
IM (2-3 times IV dose, cannot titrate to effect, fractious animals only)
4
Q
Injectable drugs used
A
Barbituate
Cyclohexamine
Propofol
5
Q
What is the “blast em technique”
A
setting a high O2 flow rate, and a high vaporizer setting
6
Q
Disadvantages of inhalant drugs
A
Waste gas exposure
Less patient cooperation
Dramatic vasodilation
7
Q
2 Types of inhalant drugs
A
Isoflurane
Sevoflurane
8
Q
Bast em technique
A
setting a high O2 flow and vaporizer setting to quickly induct patient
9
Q
Nice way technique
A
setting a high O2 flow rate and gradually increasing the vaporizer settings by 1/2% every minute
10
Q
Who should the Nice way and Blast em techniques NOT be used on?
A
Brachycephalics
11
Q
2 Types of ET tubes
A
Murphy-eye tube: inflatable cuff
Cole
12
Q
5 Indications for intubating
A
Provide airway Prevent aspiration Provide efficient gas delivery Decrease dead space Provide controlled ventilations
13
Q
Disadvantages of ET tube use
A
Stimulation of vagus nerve Some species have difficulties Risk of bronchi insertion Risk of obstructed ET tube Can contribute to hypothermia
14
Q
How to measure length of ET tube
A
Tip of nose to thoracic inlet
15
Q
3 causes of difficult intubatioin
A
Poor patient positioning
Laryngospasms
Inadequate plane of anesthesia
16
Q
Define maintenance period
A
Period of time following induction in which a STABLE level of anesthesia is reached
17
Q
Stage I
A
PA period Voluntary excitement phase -Conscious -All protective reflexes present -Normal heart and RR -Disoriented -Slight decreased sensitivity to pain
18
Q
Stage II
A
Induction period Involuntary excitement phase -goes to conscious to unconscious level -all protective reflexes present -normal heart and RR -patient may be struggling
19
Q
Stage III Plane I
A
Light Anesthetic Plane
- Animal can be intubated
- Sluggish reflexes
- Jaw tone relaxed
- Unable to withstand sx
20
Q
Stage III Plane II
A
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
Q
Stage III Plane III
A
Deep Anesthetic plane -Most reflexes absent -Muscle tone slightly more relaxed -No response to sx stimulation Requires very close monitoring!!
22
Q
Stage III Plane IV
A
Overdose of anesthetic
- Patient in danger of cardiac arrest
- Significant depression of body systems
- Change planes immediately!!
23
Q
Stage IV
A
CPR necessary for life!!
Crash cart
no longer GA— headed towards death
24
Q
Palpebral reflex
A
“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
