Veterinary Medicine - Anesthesiology Flashcards
(57 cards)
Capnography - Rebreathing CO2 - Possible Causes
Tachypnea, Low oxygen flow relative to respiratory rate, Soda lime exhaustion, Stuck one-way valve, Patient too small for rebreathing circuit, Increased resistance in circuit
Capnography - Rebreathing CO2 - Management
Increase flow rate until inspiratory CO2 goes down to zero, Check inspiratory valves, Check soda lime color, Check source of resistance, Ventilate
Capnography - High ETCO2 - Possible Causes
Deep-plane anesthesia, Lung disease, Atelectasis, Obesity, Body position, Induction apnea
Capnography - High ETCO2 - Management
Decrease anesthesia gas, Mechanical ventilation
Capnography - Tachypnea - Possible Causes
Low plane anesthesia, Pain, Hyperthermia
Capnography - Tachypnea - Management
Increase anesthesia, Analgesia, Cooling, Ventilate
Capnography - Leak in the circuit - How does it look?
Slowly tapering of ETCO2 after normal initial expiration and plateau
Capnography - Leak in the System - Management
Inflate ET cuff, Replace circuit
Capnography - “Shark Fins” - Possible Causes (2)
Partial obstruction of the circuit, Bronchoconstriction
Capnography - “Shark Fins” - Management
Clear obstruction, Administer Bronchodilators
Capnography - “Additional Peaks” - Cause
Flow rate is lower than required - Patient is breathing in his own
Capnography - “Additional Peaks” - Management
Increase ventilation, Administer OpiatesKetamine to cause respiratory depression + increase ventilation
You’re experiencing Capnography abnormalities - Describe the management algorithm
1) Check Patient (Pulse / Breathing / Reflexes) 2) Check O2 Flow + Ventilate 3) Check Soda Lime Valves Circuit 4) Check Capnograph
Oscillometric Pressure Devices - Best placed on which artery?
Coccygeal A.
Doppler Pressure Devices - Best placed on which artery?
Metatarsal A.
Doppler Pressure Devices - Measures…?
Systolic Arterial Pressure (SAP)
Oscillometric Pressure Devices - Measures…?
Mean Arterial Pressure (Measured directly). *SAP (Calculated). *DAP (Calculated)
Oscillometric Pressure Devices - Originally created for human patients with human sized arteries - Therefore the use of them is less recommended in which animals?
Cats, Small breed dogs
Invasive blood pressure measurement - Contraindications
Thrombocytopenia, Thrombocytopathy, Decrease in clotting factors
Invasive blood pressure measurement - Indications
Sepsis, GDV, Suspected Expected reperfusion injury , Active Expected hemorrhage , Cardiac failure, Shock of any kind, Unstable BP of any kind
a2 Agonists - What are our 2 reversal drugs and when to use them?
1) Vasoconstriction (Peripheral effect) -> Reflex bradycardia. 2) Vasodilatation (Central Effect) + Bradycardia
Hypertension - Causes
Situational (e.g. Stress, Excitement). Secondary: -Renal disease (e.g. AKI, CKD). -Endocrinopathies (e.g. Cushing’s disease, Hyperaldosteronism, Diabetes Mellitus, Hyperthyroidism, Hyperestrogenism). -Pheochromocytoma. -2nd to high Intracranial pressure
Screening for Hypertension - What is the best organ to assess?
Retina
Anesthesia in Brachycephalic Syndrome - Sedation / Analgesia / Pre Induction / Induction / Post-anesthesia important notes
Sedation - Midazolam (Preferably no hard sedatives). Analgesia - Light opiates (due to GI signs). Pre Induction - O2 for a few minutes. Induction - Propofol. Post Op: Late extubation | O2 for a couple of hours Cooling Steroids if airway inflammation is present
