Term
| What is included in a state of general anesthesia? |
|
Definition
| relaxation of skeletal muscles, reduction of protective reflexes, unconsciousness |
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Term
| If a patient is on a light plane on anesthesia and a painful stimulation is applied, what will you see? |
|
Definition
| increased respiratory rate |
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Term
| How many stages of general anesthesia are there? |
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Definition
|
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Term
| What happens in the first stage (State 1) of general anesthesia? |
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Definition
| exaggerated response to all stimuli; CNS excitement |
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Term
| What happens in the second stage (State 2) of general anesthesia? |
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Definition
| delirium or struggling may occur; excess epinephrine levels may occur |
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Term
| What happens in the third stage (State 3) of general anesthesia? |
|
Definition
| sleep or surgical state of anesthesia |
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Term
| What are the planes that stage 3 gets divided into? |
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Definition
|
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Term
| What happens during plane 1 of general anesthesia? |
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Definition
| light plane of anesthesia; RR 12-20, HR 90-120; eyes are rotated medially and the 3rd eyelid is prolapsed; all reflexes present; muscle tone still evident; usually can intubate |
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Term
| What happens during plane 2 of general anesthesia? |
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Definition
| considered the normal surgical plane; increased RR may be seen as surgery is finishing; mild decrease in HR and BP; slight medial rotation of the eyeball with the 3rd eyelid still prolapsed; pupil constricted or moderately dilated; palpebral reflex is absent; toe pinch reflex is also absent; muscle tone is generally absent but degree of relaxation will depend on the anesthetic agent used |
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Term
| What happens during plane 3 of general anesthesia? |
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Definition
| very deep plane and only desireable for very manipulative surgical procedures; shallow and irregular breathing, less than 8 per minute; decease in HR and lowering of blood pressure; CRT will extend beyond 2 sec; eyeball is centrally fixed and the 3rd eyelid is not as prolapsed |
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Term
| What happens during plane 4 of general anesthesia? |
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Definition
| considered an overdose plane of anesthesia with the respiratory system and the cardiovascular system in danger of failing; respiration is shallow and irregular; HR and BP decreased; prolonged CRT; eyeball is centrally fixed; pupil is widely dilated and does not respond to light; reflexes are absent (loss of anal tone is a crude indicator of excessive anesthetic depth); |
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Term
| What happens in the fourth stage (State 4) of general anesthesia? |
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Definition
| terminal stage; cardiac muscle and brain tissue are in danger of failing; immediate resuscitative measures are needed |
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Term
| What are the main signs used to monitor anesthesia? |
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Definition
| HR and rhythm, RR and rhythm, arterial pulse and blood pressure, temperature, MM color, CRT, pupil size, reflexes |
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Term
| What happens to the heart rate during anesthesia? |
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Definition
|
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Term
| What happens to the heart rate during induction? |
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Definition
| may increase due to epinephrine release |
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Term
|
Definition
| slow/decreased heart rate |
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Term
| When is a heart rate considered too slow in a dog/cat? |
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Definition
| dog, less than 70; cat, less than 80 |
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Term
| What ways can you monitor a HR? |
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Definition
| digital palpation; Audio Patient Monitor (APM); ECG/EKG; Oscilloscope; Doppler flow detector |
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|
Term
| How does the Audio Patient Monitor work? |
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Definition
| it is connected to an esophageal stethoscope and amplifies the heart and lungs sounds |
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Term
| How does the Doppler flow detector work? |
|
Definition
| monitors arterial pulses through vessels |
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Term
| Which arteries are used for monitoring? |
|
Definition
| superior palmar metacarpal and plantar metatarsal |
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|
Term
| What happens to the tidal volume of air under general anesthesia? |
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Definition
|
|
Term
| How can you calculate the amount of tidal air? |
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Definition
|
|
Term
| What is the minute volume? |
|
Definition
| air exchanged with each minute |
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|
Term
| How can you calculate the minute volume? |
|
Definition
|
|
Term
| What happens to the RR under general anesthesia? |
|
Definition
| may decrease to 10-16 BPM |
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|
Term
| What ways can you monitor the RR? |
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Definition
| esophegal stethoscope, grossly watching |
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|
Term
| What is the measurement of blood co2? |
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Definition
|
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Term
| What do you look for when checking arterial pulse and blood pressure? |
|
Definition
| check for the character of the pulse wave and to check the heart rate |
|
|
Term
| When do pulse deficits occur? |
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Definition
| when the heart rate exceeds the pulse rate |
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Term
| What arterial vessels are used for monitoring? |
|
Definition
| femoral, lingual, metacarpal, metatarsal |
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|
Term
| What causes a decrease in body temperature? |
|
Definition
|
|
Term
| Which patients lose heat faster and why? |
|
Definition
| small animals will lose body heat faster because of a higher surface area to body mass ratio |
|
|
Term
| What measures can you take to preserve body temperature? |
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Definition
| do not place animal directly on a stainless steel table; avoid drafts; cover with blanket or towels during recovery; use warm water circulating pads; styrofoam positioning pads on surgery table; heating pads |
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|
Term
| What can happen when a patient becomes hypothermic? |
|
Definition
| hypothermia may slow the rate that the anesthetic is metabolized which results in a prolonged anesthetic time |
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|
Term
| What happens to MM when animals are breathing 100% o2 when on inhalation anesthetics? |
|
Definition
| membranes will appear more pink |
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|
Term
| If you do a CRT and blood pressure is low, what will you see? |
|
Definition
| an abnormally long time will be needed for the color to return |
|
|
Term
| What happens to the pupils under general anesthesia? |
|
Definition
| a pupil that is widely dilated indicates a deep level of anesthesia |
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|
Term
| What is the palpebral reflex and when is it seen? |
|
Definition
| When touching near the corner of the eye, the animal will blink; it is present in the awake or lightly anesthetized animal |
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|
Term
| What is the pedal reflex and when is it seen? |
|
Definition
| assessed by pinching the middle toe and observing for contraction of the limb; present in the awake or lightly anesthetized animal |
|
|
Term
| What is the jaw tone reflex? |
|
Definition
| should be diminished during induction in order to pass an endotracheal tube |
|
|
Term
| What is the anal tone reflex? |
|
Definition
| loss of anal tone is considered a crude indicator of excessive anesthetic depth |
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|
Term
| What does a pulse oximetery unit do? |
|
Definition
| measurement of hemoglobin saturation with oxygen |
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|
Term
| What is NOT detected by the pulse ox? |
|
Definition
| tachycardia (fast heart rate) |
|
|
Term
| Where can a pulse ox probe be placed? |
|
Definition
| tongue, vulvar mucosa, shaved ear, toe webbing, rectal probe |
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|
Term
| What can interfere with a pulse ox reading? |
|
Definition
| patient motion, poor positioning of probe, skin pigment, hair, poor peripheral vasoconstriction, pigmentation of the tissues |
|
|
Term
| What is a desired oxygen saturation reading on a pulse ox? |
|
Definition
|
|
Term
| When do CO2 levels increase? |
|
Definition
| respiratory function is depressed; hypoventilation occurs |
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|
Term
| For the respiratory system, what are signs of anesthetic emergencies? |
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Definition
| decreased rate of ventilation (<8/min); decreased depth; apnea (absence of respirations); cyanosis |
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|
Term
| What medication is used in case of respiratory arrest as a respiratory stimulant? |
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Definition
|
|
Term
| For the circulatory system, what are signs of anesthetic emergencies? |
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Definition
| decreased heart rate (<70 BPM for the dog and <80 for the cat); decreased pulse pressure leading to shock; prolonged capillary refill time (CRT); hypothermia (cold to touch) |
|
|
Term
| What fluid is good for shock therapy? |
|
Definition
|
|
Term
| What is the IV fluid shock rate for dogs? |
|
Definition
|
|
Term
| What is the IV fluid shock rate for dogs? |
|
Definition
|
|
Term
| What drug is used in case of cardiac arrest? |
|
Definition
|
|
Term
| What is another sign when dealing with an anesthetic emergency? |
|
Definition
|
|
Term
| What are the signs of cardiopulmonary arrest? |
|
Definition
| mucous membrane color becoming pale or capillary refill time increasing beyond 2 seconds; reduction of the heart rate; changes in the parameters of the respiratory or cardiovascular system |
|
|
Term
| When should cardiopulmonary resuscitation be performed? |
|
Definition
| when sudden apnea occurs and the heart action in not sufficient to adequate circulation |
|
|
Term
| What are 3 anesthetic emergencies? |
|
Definition
| anesthetic overdose and cardiopulmonary arrest; aspiration; airway obstruction |
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|
Term
| What are signs of aspiration pneumonitis? |
|
Definition
| wheezing; harsh RR; cyanosis; dyspnea; can occur in induction as well as recovery |
|
|
Term
| What are treatments for aspirations? |
|
Definition
| 100% O2 therapy with O2 cage or nasal catheter; broad spectrum antibiotics; corticosteroids; bronchodilating drugs; may need tracheostomy |
|
|
Term
| What are signs of airway obstructions? |
|
Definition
| accumulation of secretions; soft tissue obstruction (soft palate, more in brachycephalic breeds); collapsing trachea; space occupying tumors in the mouth; inflamed tonsils; laryngospasm |
|
|
Term
| What are mechanical signs of airway obstructions? |
|
Definition
| dislodged endotracheal tube; occluded breathing tubes; sticky inhalation or exhalation valves; overinflated rebreathing bag; kinking of the endotracheal tube; occlusion of the endotracheal tube |
|
|
Term
| What can be used to assist in respiration? |
|
Definition
|
|
Term
| What are the ABCD's of CPR? |
|
Definition
A= Airway. Establish an airway via trach tube
B= Breathe/ventilate patient at 5 breaths per minute
C= Cardiac compressions at 80 to 100/minute
D= Drug therapy |
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|
Term
| What are the key factors in drug metabolism? |
|
Definition
| liver function, body temperature, kidney function |
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|
Term
| What is the Jorvet Vetalarm? How does it work? |
|
Definition
| respiratory monitor or apnea monitor that connects between endotracheal tube and anesthesia hoses; will detect changes in the temperature of the expired gases; alarm will sound if animal does not breath within pre-set interval |
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|
Term
| What does the Ocsilloscope do? |
|
Definition
| provides the ECG tracing on a TV type screen |
|
|
Term
| What is a Doppler pressure monitoring device? |
|
Definition
| will measure the blood pressure by the indirect method; a sensor is placed over a peripheral artery |
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