Intro to Anesthesia

define Anesthesia

A loss of sensation.

define Anesthetic agent

Any drug used to induce a loss of sensation with or without unconsciousness.

define Sedation

A drug-induced CNS depression and drowsiness.

define General anesthesia

A reversible state of unconsciousness, immobility, muscle relaxation, and loss of sensation throughout the whole body.

define Anesthetic induction

The process by which an animal loses consciousness and enters general anesthesia.

define Anesthesia maintenance

The process of keeping a patient in a state of general anesthesia during the period between induction and recovery.

define Anesthetic recovery

The period between the time the anesthetic is discontinued and the time the animal is able to stand and walk.

Tranquilization

A drug-induced state of calm where the patient is reluctant to move, and is aware but unconcerned with surroundings.

Hypnosis

A drug-induced sleep-like state that impairs the ability to respond appropriately.

Narcosis

A drug-induced sleep from which the patient is not easily aroused.

what stage is it

awake

what stage is it

light sedation

what stage is it

moderate sedation

what stage is it

deep sedation

what stage is it

hypnosis

what stage is it

narcosis

what stage is it

light surgical anesthesia

what stage is it

moderate surgical anesthesia

what stage is it

deep surgical anesthesia

what stage is it

anesthetic overdose

define local anesthesia

small area

define topical anesthesia

directly to site

define regional anesthetic

larger area via proximal to sensory nerves

define balanced anesthesia

The administration of multiple drugs concurrently

More amount of one drug, means — risks

higher

define Surgical anesthesia (2)

1. a specific stage of general anesthesia

2. a sufficient degree of analgesia (a loss of sensitivity to pain) and muscle relaxation to allow surgery to be performed without patient pain or movement.

define Anxiolysis

the reduction of anxiety

PR stands for (2)

prescribed rate (ml/kg/hr)

dr stands for (3)

delivery rate (drips/ml or gtt/ml)

IR stands for (2)

infusion rate (ml/hr)

DR stands for (3)

drip rate (drips/s or gtt/s)

define gtt

drops

what are two main types of circuits to use on anesthetic machines

1. Rebreathe system

2. Non-rebreathe system

equation for CRI (3ish)

mg = (( dose(mg/kg/hr) )( ml(bag size) )) / ( prescribed fluid rate(ml/kg/hr) )

Olds College Standard Rates for delivery rates for less than 10kg

60 drips/ml

Olds College Standard Rates for delivery rates for more than 10kg

10 drips/ml

Olds College standard Rates for prescription rates for PR dogs

5 ml/kg/hr

Olds College standard Rates for prescription rates for PR cats

3 ml/kg/hr

Olds College standard Rates for minimum 02 flow meter settings

1 L/mins

Olds College standard corrugated tubing for the rebreathe systemm is for patients — 10kg

over

Olds College standard bain tubing for the non-rebreathe system is for patients — 10kg

under

Olds College standard Oxygen flow rates for Chamber induction is? (2ish)

5L/min is recommended regardless of patient size

There are three main elements of preparation (3)

1. a general review of the procedure to determine the equipment, supply, anesthetic agent, and personnel needs,

2. preparation of the patient, equipment, associated supplies,
   and agents that will be administered, and

3. communication with the anesthesia care team prior to
   commencing the procedure.

The minimum patient database consists of the following (3)

1. Patient history

2. Complete PE findings

3. Results of a preanesthetic diagnostic workup

The Pre-Induction Checklist (10)

1. Patient name, owner consent, and procedure confirmed

2. Intravenous (IV) catheter (cannula) placed and patent

3. Airway equipment available and functioning

4. Endotracheal tube cuffs checked

5. Anesthetic machine checked today

6. Adequate oxygen supply for proposed procedure

7. Breathing system connected, leak-free, and adjustable pressure-limiting valve open

8. Person assigned to monitor patient

9. Risks identified and communicated

10. Emergency interventions available

The Pre-Procedure Checklist (3)

1. Patient name and procedure confirmed

2. Depth of anesthesia appropriate

3. Safety concerns communicated

The Recovery Checklist (8)

1. Airway good

2. Breathing good

3. Circulation (fluid balance) good

4. Body temperature good

5. Pain good

6. Assessment and intervention plan confirmed

7. Analgesia plan confirmed

8. Person assigned to monitor patient

Patient History checklist (6)

1. Confirm the procedure to be performed

2. Gather historical information

3. Confirm compliance with fasting instructions

4. Confirm vaccines and other preventive care are current

5. Inquire about drug allergies or reactions

6. Note pertinent medical problems and communicate these to the attending veterinarian

Client Communication checklist (8)

1. Present the standard consent form

2. obtain the client's signature

3. Present a fee estimate and obtain the client's signature

4. Complete any financial transactions (deposits, payments, insurance)

5. Answer the client's questions

6. Inform the client of the nature of the procedure, the expected outcome, and the expected time of completion

7. Communicate the date and time of discharge if known

8. Determine an emergency communication protocol, including client phone number, availability, and schedule

Physical Examination checklist (9)

1. Double-check the patient's identity

2. Weigh the patient

3. Confirm the patient's sex and reproductive status

4. Determine the patient's hydration status

5. Determine the vital signs

6. Perform a physical assessment, focusing on the cardiovascular and pulmonary systems

7. Determine the patient's pain score and physical status class

8. Communicate to the attending veterinarian any pertinent physical abnormalities

9. Note any concurrent conditions that may be best treated while patient is under anesthesia

Direct Patient Preparation checklist (6)

1. If patient is hospitalized, make arrangements for preanesthetic fasting

2. Perform diagnostic tests, convey results to the attending veterinarian, and highlight abnormal data

3. Give medications ordered by the attending veterinarian

4. Place IV catheter and administer fluids if indicated

5. Administer preanesthetic medications

6. Make any necessary preparations for postoperative care

Equipment Preparation checklist (3)

1. Gather all necessary equipment

2. Prepare the anesthetic machine

3. Check that all equipment is in good working order

ASA is known as (not abreaviation really)

American Society of Anesthesiologists Physical Status Classification System

ASA 1 is what kind of patient

A healthy patient

ASA 2 is what kind of patient

A patient with systemic disease that is mild

ASA 3 is what kind of patient

A patient with systemic disease that is severe but not life-threatening

ASA 4 is what kind of patient

A patient with "severe systemic disease that is a constant threat to life”

ASA 5 is what kind of patient

A comatose patient who is "not expected to survive without the operation"

ASA 6 is what kind of patient

A brain-dead patient whose organs are being procured for transplantation into another patient