Quiz 4 - Anesthesia

What are some of the common reasons for complications?

human error

equipment related issues

general anesthesia

_________ anesthesia is safer.

multi-drug

Drugs all have unwanted side effects, and most are ?

dose dependent

What makes up human error?

inadequate training

lack of familiarity with the anesthetic equipment/agents

failure to appropriately prepare patient for anesthesia

drug calculation and administration errors

errors caused by fatigue, rushing, or inattention

The task of running anesthesia should be reserved for ___________ only.

trained personnel

What are components of drug calculation and administration errors?

math errors

using the wrong medication

using the wrong concentration

administration by wrong route

confusion between syringes drawn

Sodasorb should be replaced after ?

5 hours

What happens if the vaporizer isn't refilled?

the patient won't stay asleep

What are the components of general anesthesia complications?

inappropriate anesthetic depth

hypotension

hypothermia

bradycardia

hypoventilation

regurgitation

How do you check depth?

check palpebral, jaw tone, eye position

What does an absent palpebral and jaw tone and ventral eye position indicate?

adequate depth

What does an absent palpebral and jaw tone and central eye position indicate?

too deep

What are the risks of being too deep?

bradycardia

hypotension

hypercapnia

hypoventilation

What does a slight to moderate jaw tone, slight palpebral, and central eye position indicate?

too light

What are the risks of being too light?

patient responding to noxious stimuli

patient waking up intra-op

What is a normal anesthetized blood pressure?

MAP: 60-100 (80 is ideal)

What does MAP mean?

mean arterial pressure

<60 MAP = ?

hypotension

What can lead to decreased tissue perfusion and cardiac output?

hypotension

What is a way to correct hypotension if the depth is ok?

decrease inhalant

What is a way to correct hypotension if you decrease the inhalant and hypotension is still low?

give fluids

What is a way to correct hypotension if the heart rate is low too?

increase heart rate

What should be done to correct hypotension if nothing else is working?

vasopressors

What is considered hypothermia?

<95F

What is the best way to treat hypothermia?

prevent it

At what temperature do drugs stop working?

93 F

What are examples of heat support?

bair huggers

hotdog blankets

water blankets

warm towels

fluid bags

What is a heart rate that is lower than expected for a given species and the situation its in?

sinus bradycardia

Large breed dogs have ______ heart rates and small breed dogs have _________ heart rates.

lower, higher

What dogs have abnormally low heart rates for their size?

dachshunds

What is a way to correct bradycardia if the depth is ok?

decrease inhalant

How can bradycardia and hypotension be corrected?

increase heart rate

What is a slow or shallow ventilation?

hypoventilation

Hypoventilations will result in a __________ ETCO2.

higher

What is a measure of air moving in and out of the alveoli?

ventilation

What is the process of delivering O2 from the alveoli to the tissues?

oxygenation

What is a condition in which blood flow and oxygen is restricted or reduced in part of the body?

ischemia

What requires active abdominal effort; a forceful expulsion of stomach contents followed by retching?

vomiting

What is the flow of stomach contents into the esophagus and mouth unaccompanied by retching?

regurgitation

What breeds are more disposed to regurgitation?

brachycephalic

How can you treat regurgitation?

preventative anti-acids

suctioning out esophagus and mouth after

Maropitant does not prevent _____________, only emesis.

regurgitation

What is the minimum bloodwork for anesthetic purposes called the big 4?

PCV, TS, Bun, glucose

What is important to note about c-sections?

almost all drugs with cross the placenta

What types of drugs do not cross the placenta?

neuromuscular blocking agents and local anesthetics

What should be done due to a decreased lung capacity due to the diaphragm being pushed cranially from a distended uterus?

pre-oxygentation

There is an ____________ demand in oxygen in a patient that is about to give birth.

increased

Clipping and prepping should be done _________ induction.

before

With C-sections, how should awake or anesthetized patients be clipped and why?

in left lateral recumbency rather than dorsal

in dorsal, the heavy uterus could compress the vena cava

How is analgesia given with a C section?

epidural with local anesthetic (doesn't cross the placenta)

What is given for intra-operative care after delivery of babies?

full-mu opioid

A new mother can have a _______________ because their plasma volume is increased without an increase in the number of RBCs, and this gets worse with more fetuses.

physiological anemia

Ideally, there should be at least __________ per baby.

one person

How should neonates' airways be cleaned?

bulb syringes

What are examples of common respiratory distress issues?

pneumonia

anything pushing on the diaphragm like C-sections

hemothorax

pneumothorax

diaphragmatic hernias

What can be done if respiratory distress becomes too compromised?

thoracentesis

What is needed if the respiratory distress is caused by something in the upper respiratory tract like a mass around the larynx?

emergency tracheostomy

What should not be done with diaphragmatic hernias?

do not tilt head down

What is the most common post-op complication with diaphragmatic hernias?

pneumothorax

What shows the oxygen saturation in the hemoglobin and the tissues?

SpO2

What is considered a low SpO2?

below 96-95

What monitors ETCO2 and gives us a waveform for each breath, providing information about ventilation?

capnograph

What is considered a too high ETCO2 volume?

>60

What monitors how much CO2 is currently in the blood?

blood gas

___________ cases of diaphragmatic hernias tend to do better than traumatic ones.

chronic

An ___________ should be established if possible to monitor invasive BP and arterial blood gases.

arterial line

What is done if possible in the pre-op period with a GDV?

decompress the stomach with an orogastric tube or percutaneous trocharization with a large bore catheter

What arrhythmias are seen with GDV?

PVCs and occasionally v-tach

With GDV, you should place _____ catheters for CRIs and possibly blood.

two

What CRIs are typically run with a GDV?

fentanyl and lidocaine

What makes up the intra-operative care for GDVs?

fluid therapy

CRIs

vasopressors

orogastric tube

Septic patients should be treated ?

immediately

What are the two parts of sepsis?

infection

the body's response to the infection

We like to use ______ inhalant with sepsis cases.

less

What intra-op drugs are used for a sepsis case?

lidocaine CRI

full mu of choice

vasopressor

What should be given post op for a sepsis case?

analgesia

lactate and electrolytes

What is a severe complication because there is blood coming from somewhere in the abdomen, and it can lead to severe anemia and death if not corrected?

hemoabdomen

Hemoabdomens are ?

emergencies

What is the pre-op workup for a hemoabdomen?

PCV/TP

BP

MM

PCV increase is most commonly due to ?

dehydration

PCV decrease is most commonly due to ?

anemia

TP increase is most commonly due to ?

dehydration

TP decrease is most commonly due to ?

hemorrhage

You should use a _______ dose of premeds with a hemoabdomen.

lower

Code 0/Code red = ?

DNR, red collar

A Code 1/Code green = ?

full CPR, green collar

Compressions should be __________ and ventilations should be ______________.

100-120/min, 10/min

Avoid ____________ of the horse prior to and during induction/sedation.

excitement

What can decrease pressure on the major abdominal vessels with less cranial displacement of the diaphragm?

fasting

Fasting is recommended for ?

8-12 hours

What should be done before anesthesia to reduce the chance of aspiration pneumonia from foreign material in the mouth?

rinse the mouth

What should be done before anesthesia to reduce the chance of foreign material entering the OR?

clean out hooves

What standing sedative has the longest onset in horses?

acepromazine

Which standing sedatives have the shortest onset in horses?

xylazine

butorphanol

What tranquilizer is used for young/excited or uncooperative horses?

acepromazine

What should acepromazine be avoided in?

hypotensive

low hematocrit

liver disease

Acepromazine is given to horses ____________ before a procedure.

30 min - 1 hr

______________________is the opioid of choice because it does not cause the same intestinal ileus as full mu opioids do, this is a huge concern in horses as they are prone to colic.

butorphanol

What are the signs the horse is sedated

lower of head

drooping of the lip

shifting weight

not listening to surroundings

What induction drug needs appropriate sedation prior to administration?

ketamine