Term
| Why is pre-anaesthtetic assessment important? |
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Definition
| Many anaes. deaths can be prevented by careful and thorough preparation |
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Term
| Anaesthesia specific history questions |
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Definition
-age?
-previous anaesthetics? if so, unusual responses / adverse effects?
-history of other dz? esp cardiac / resp
-coughing / resp abnormalities?
-any concurrent medication? last given?
-exercise tolerance? gives idea if out of breath easily
-V/D/eating/drinking? i.e. fluid status
-last meal? |
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Term
| In a pre-anaes. clinical exam, what should you roughly look at? |
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Definition
-species
-breed
-animal morphology
-age
-'distant' examination |
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Term
| Examples of breeds w. higher anaesthetic risk |
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Definition
remember anaest. is more than just the drug - consider practical aspects too
-brachiocephalic, esp. bulldogs - airway problems
-breeds w. protuberant eyes e.g. pekingnese - risk of globe proptosis - protect the eye (practical)
-sighthounds e.g. greyhounds - slow recovery from thiopental, plus need extra care re. temp regulation
-chondrodysplastic breeds - difficult venous access due to leg morhology |
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Term
| Examples of how animal morphology is relevant to anaes. |
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Definition
-very thin: incr. heat loss, altered drug distribution,
-obese:impaired ventilation during anaesthesia
Animal may be able to compensate when conscious but suppressed during anaes. |
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Term
| What needs to be considered in neonates in anaesthesia? |
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Definition
-may have dec. thermoreg. ability
-CO is rate dependent
-higher percentage water content in body c.f. older animals
-poorly developed renal / hepatic function
-high met rate so risk of hypoglyceamia |
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Term
| What needs to be considered in geriatrics in anaesthesia? |
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Definition
-dec. CV and resp reserve
-incr. risk of co-existing dz.
-incr. change of poor renal/hepatic function
-dec. thoracic compliance i.e. thorax stiff and dec. expansion
-incr fat content affects drug distrubution |
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Term
| What "distant" examinations should be carried out in the initial pre-anaesthetic assessment? |
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Definition
-LOOK at resp. pattern: rapid /slow / deep / shallow
-mobility
-catheters present? swelling in limbs? |
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Term
| Briefly describe a pre-anaesthetic examination of an animal and organ systems |
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Definition
-eyes -obvious abnormalities?
-mucous membranes - colour / CFT / hydration?
-skin tenting? peripheral oedema?
-LNs/swellings in retropharyngeal or neck areas
-jugular vv. - filling time / distension / check patency if require catheterisation
-auscultate both sides of thorax, all over - HR / rhythm / mumurs or abnormal sounds? / assess pulse simultaneously - any deficits? / lung sounds
-abdomen palpation if relevant - distension / pain
-rectal T (last!) |
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Term
| Which lab tests might be useful preanaesthesia? |
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Definition
NB: no evidence to support "blanket" testing pre-anaest, but may be useful if suspicion is raised in history / clin. exam:
-biochem
-haematology - PCV / full blood count / clotted if concerned about coagulopathy
-radiography e.g. concerneed about pneumothorax / cardiac enlargement / lung dz.
-ultrasound
-ECG - distinguish types of irregularity |
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Term
| Describe the ASA Classification of Patient Physical Status |
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Definition
ASA I - normal healthy animal
ASA II - mild systemic dz or impairment e.g. elderly but otherwise healthy
ASA III - more severe sys. dz which is well compensated / controlled by tx
e.g. some animals w. mitral regurgitation murmurs are BAR
ASA IV - severe systemic dz. not compensated for
e.g. dog w. mitral regurgitation murmur w. clin. signs
ASA V - moribund, unlikely to survive 24 hours w. or w/o surgery
E - added to any classification if an emergency |
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Term
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Definition
-dec. risk of V and regurgitation and so aspiration, esp in D+C
-dec. abdominal pressure |
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Term
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Definition
-6hrs food withdrawal (time to completely empty stomach)
-Allow water until pre-med |
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Term
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Definition
-6-12hrs food withdrawal (want to dec. vol and P but not stop motility)
-Allow water until pre-med |
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Term
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Definition
-18-24hrs food withdrawal
-12-18hrs water withdrawal - cattle may drink to fill rumen |
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Term
Any other preparatiopn pre-anaesthesia?
i.e. not history, exam, lab test, starvation |
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Definition
-check anaesthetic equipment
-ensure suitable fluids, catheters, endotracheal tubes, drugs for emergency etc to hand
-make sure all info gathered - plan for anaesthesia / if complcations arise etc |
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