Anesthetic complications

A healthy canine patient has anesthetic complication rate of ___ and cats have ___

12%, 10.5%

Emergency have a ___ anesthetic complication rate

increased

Mortality rates of anesthesia: ___-___ increasing with ___ disease

0.1%-0.4%, systemic

complications increases with breeds like ___, ___ ___, and ___

brachycephalic, Jack Russell, Weimaraner

Risk variables include: ___/___, patient ___, ___ ___, ___ procedure, ___ ___

species/breed, personnel skills, surgical, anesthesia cirumstances

The diffrences in risk for anesthetic circumstances is ___ vs. ___ Sx

elective, emergency

causes of anesthesia problems: ___ ___, ___ ___, ___ ___ ___, and patient ___

human error, equipment failure, adverse drug reaction, factors

Causes of human error: during ___ ___, inadequate ___, and insufficient ___

preoperative period, experience, attention

human error during preoperative period includes inadequate ___ or ___

Hx, PE

Human error occurs with inadequate experience with ___/___ or ___

machine/equipment, drugs

Human error with drugs occurs due to lack of ___, or ___ with the ___ ___

understanding, administration, 6 rights

insufficient attention causing human error could be due to being ___/___, ___ or failure to recognize ___

hurried/preoccupied, fatigue, problems

parameters monitored: ___, ___, ___ ___, ___, ___ ___ and ___ ___

respiration, MM, cardiac, reflex activity, temperature, O2 status, IV catheter

Reflex activity used for anesthesia includes: ___ ___, ___ ___ or ___ ___

jaw tone, eye position, palpebral reflex

Equipment failure is uncommon when a ___ ___ is performed

preanesthesia check

Possible equipment issue with CO2 absorber: ___

exhaustion

Signs of CO2 absorber exhausion: ___, ___, ___, ___ ___ ___, and ___

tachypnea, tachycardia, arrhythmia, brick red MM, sweat

When a CO2 absorber is exhausted a decrease in oxygen in non-rebreathing, may lead to ___, increasing ___

rebreathing, CO2

equipment failure due to decreased O2 flow could be due to a ___ tank, the valves are ___, the flowmeter ___ is lodged, ___ or ___

empty, jammed, float, disconnected, leak

Reponse to decrease O2 flow: if on a non-rebreathing ___, or if on rebreathing ___ ___

disconnect, replace tank

Equipment failure die to improper assembly can be prevented by ___ the ___, from the ___ to ___

follow the circuit, source to scavenger

Equipment failure in the ET tube could be due to ___, ___ or ___

kinking, secretion, placement

prevent ET tube failures by having a ___ ___. This should include ___ while watching the chest, and ___ and feeling for airflow

checklist, bag, airflow

Remedy for ET tube failure include: ___, ___ or ___

repositioning, replacing, suction

Equipment failure due to the vaporizer is ___. It could be due to insuffcient ___, improper ___, ___ or ___

rare, incompensated, agent, tipping, overfilling

Equipment failure due to the pop-off valve if it ___ ___, which increase ___, cause ___in the ___ and decreased ___ ___

left closed, pressure, barotrauma, lungs, cardiac output

adverse drug response is generally ___. It can be prevented with specific ___ considering the patient status and MDB, ___ knowledge knowing effects and contraindications, ___ ___ with multiple anesthetia

uncommon, protocols, pharmocology, balanced anesthesia

Geriatric patient have reached ___ of life expectancy

75%

Geriatric patient factors have have lower ___ ___, decreased ___, ___, decreased ___ ___, ___ response, tend to become ___, and are finicking with ___ ___

organ function, hydration, disease, drug requirements, slower, hypothermia, IV fluids

Geriatic patients may require about ___ to a ___ of drug

half, third

Geriatric patient are more likely to be hypothermic due to decreased ability to ___

regulate

pediatric patient are less than _ __

3 months

Pediatric patient factors: ___ ___ ___, ___, ___, or ___

immature organ function, fasting, anatomy, hypothermia

Pediatric patients have decreased ___ function leading to decreased protein, and metabolism, and ___ function decreasing excretion

hepatic, renal

Pediatric patients have decreased hepatic function leading to a decrease in ___ and ___

protein, metabolism

Pediatric patient have reduced renal function leading to decreased ___

excretion

Fasting a pediatric patients can lead to ___, or ___

dehydration, hypoglycemia

Pediatric patients has lower ___, more ___ ___, and may ___

fat, surface area, shiver

Brachycephalic patient factors: ___ ___, increased ___ ___, ___ ___, and ___

anatomic abnormalities, parasympathetic tone, respiratory compromise, precautions

Brachycephalic anatomic abnormalities include: ___ ___, ___ ___ ___, ___ ___ ___, and ___ ___

stenotic nares, elongated soft palate, everted laryngeal saccules, hypoplastic trachea

brachycephalic increased parasympathetic tone leads to ___

bradycardia

Precautions with brachycephalics includes: ___ for _ min, ___ ___, ___ ___ with a ___, and maintaining the ___

preoxygenate, 5, rapid induction, rapid intubation, laryngoscope, tube

Breeds of sighthounds: ___ ,___ , ___, ___ ___

greyhound, whippet, afghan, russian wolfhound

sighhounds are know to have adverse reactions to the anesthetic agent type: ___

barbituates

Sighthounds have decreased ___ ___

hepatic metabolism

Precautions that can be taken with sightounds: ___, __/___ and ___

propofol, ketamine/valium, isoflurane

Obese animals have poor ___ ___, require less ___, and can have ___ ___

blood supply, drugs, respiratory compromise

obese animals may require about ___ the drug amount between normal and current weight

halfway

An obese animal should be ___ for _ min, and if they take shallow breaths either ___ or ___

preoxygenate, 5, bagging, ventilation

A pregnant female have incerase ___ ___ in dorsal recumbency, ___ or ___ issues due to organ pressure, and increased ___ during Sx

heart workload, respiratory, GI, hemorrhage

In pregnant females caution of ___ ___ into the offspring could cause drug depression

placental transfer

Precautions in pregnant females include: ___, ___, ___, ___ ___, and what to ___

epidural, general, preoxygenate, reversible agents, avoid

When an epidural is given they should be provided __ ___, and ___

IV fluid, O2

Pregnant females should be given the ___ dose

lowest

when pregnant females are given opioids makes sure ___ agents are available

reversible

avoid ___ and ___ in pregnant animals

pentobarbital, valium

Trauma patient factors: ___ ___, and ___ the patient

multiple systems, stabilized

Trauma can mess with systems causing things like ___ ___, ___ and respiratory issues like ___, ___ ___, and ___ ___

cardiac arrhythmia, shock, pnemothorax, pulmonary contusion, diaphragmatic hernia

patients with trauma should be ___ and a ___ should be created and ___ ___ should be taken

stabilized, mdb, chest radiographs

Patient factors due to CNS diseases ___ disorders, which can be altered with ___, or ___

seizures, drugs, hyperventilation

Drugs can alter a seizure ___, and increase ___ pressure

threshold, intracranial

Seizure disorders can also be affected by hyperventilation which decreases ___

CO2

Cardiovascular disease is another patient factor with conditions like: ___, ___, ___, ___, and ___

anemia, shock, cardiomyopathy, CHF, heartworm

Patients with cardiovascular disease should be ___, and be given agents that are _-___, and _-___

stabilized, non-depressive, non-arrhythmogenic

When a patient has cardiovascular disease cautions with ___, as overload can cause ___, ___ ___, and ___ ___

fluids, tachypnea, lung sounds, nasal discharge

Respiratory diseases conditions that is patient factors include: ___, ___ ___, ___, ___, ___ ___ and ___

effusions, diaphragmatic hernia, pneumothorax, tracheal collapse, edema

A patient with a respiratory condition should be ___ first, and avoid using ___ ___

stabilized, nitrous oxide

Patients with respiraory disease should be ventilated _-_ rpm, at ___-___ cm H2O

8-20, 10-20

Another patient factor is hepatic disease as some functions affected includes: ___ ___, ___ ___, ___ ___, and ___ ___

drug metabolism, protein synthesis, clotting factors, crabohydrates metabolism

Precaution with hepatic disease is drugs will be metabolized in the ___

liver

Renal system is affected by ___, which is why ___ is important to monitor for

perfusion, hypotension

The renal system can be tested for function with ___, ___, ___ or ___

BUN, Creatinine, SG, SDMA

renal disease due to obstruction can cause ___, and ___ ___

hyperkalemia, cardiac effects

Precautions that should be taken with renal disease: ___, decrease ___ ___, and utilize ___

fluids, drug dose, inhalants

Training for an emergency response should go over the ___ ___, have ___ ___, and have ___

team approach, emergency drills, protocols

The team’s approach during a emergency should be lead by a leader like a ___, or ___

DVM, technicians

Emergency protocol should be authorized by the ___, but if unavailable then a ___ ___

DVM, liscensed technicians

Equipment and supplies for an emergency should be found in a ___ ___

crash cart

Being constantly ___ for an emergency is important, “ ___ ___ ___”

ready, primum non nocere

Primum non nocere means

first do no harm

An anesthesia emergency is ___ ___, patient is too ___, ___ ___, ___, ___, ___/___, ___, ___, ___, ___, ___ ___, and ___ ___

waking up, deep, pale MM, hypotension, shock, dyspnea/cyanosis, tachypnea, tachycardia, bradycardia, arrhthmia, respiratory arresst, cardiac arrest

Reasons why a patient could be waking up from anesthesia: ___ ___, ___ ___, ___, ___ ___, ___ ___, and knowing the difference between ___ vs. waking up

vaporizer setting, ET tube, apnea, respiration depth, machine function, agonal

In some cases a patient will wake up either due to the vaporizer ___ or if the ___ is not available

setting, anesthetic

ET tube could lead to the patient wake up due to ___ or ___

placement, leaking

In some case a patient can be apneic occuring ___ ___

post induction

Patient waking up due to an issue with machine function: the ___ ___, ___, ___, or ___ ___

proper pathways, connections, vaporizer, O2 flow

Treatment for a patient waking up includes: ___ ___, check the possible ___, and use ___

pause surgery, causes, drugs

Drugs that can be used to treat the patient waking up includes: ___ ___ agent, ___ of increased gas, and watch ___ ___

IV induction, inhalation, depth change

When a patient is too deep can be observed by with: ___, ___/___, ___ ___, ___ ___ and no ___ activity

RR, HR/rhythm, weak pulse, mucous membranes, reflex

A respiratory rate of a patient that is too deep is less than ___ per min

8

The heart rate of a patient that is too deep would be less than ___ in dogs, and ___ in cats, and there would also be ___ ___

60, 100, pulse deficits

A patient that is too deep with have a weak pulse, the metatarsal is less than ___ mm Hg, and in femoral would be less than ___ mm Hg

60, 40

A patient that is too deep will have MM that is__/__

pale/cyanotic

Causes of a patient being too deep includes: ___ ___, ___ ___, or a ___ ___ increasing sensitivity

vaporizer setting, injection agent, preexisting problem

Treatment of patient extreme depth: turn ___ vaporizer, ___ the reservoir bag, flush with ___, ___ if necessary, and watch the ___ ___

off, empty, O2, bag, depth change

Causes of pale MM includes: ___, ___ ___, ___, and ___ due to ___ or ___

anemia, blood loss, drugs, vasoconstriction, temperature, pain

Treatment of pale mucous membranes: asessing ___, giving ___, or ___ ___, and ___ for pain

depth, fluids, blood products, drugs

Causes for hypotension includes: ___, from either blood loss or vasodilation ___ or being ___ ___

shock, drugs, too deep

Signs of hypotension: ___ ___, ___ ___, ___, or ___

prolonged CRT, weak pulses, hypothermia, tachycardia

treatment of hypotension verify ___, ___ ___, and ___ the patient

pressure, decrease depth, warm