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Vett 115 WK 2&3
Anesthesia WK2&3 COURSEWORK
| Question | Answer |
|---|---|
| What is anesthesia ? | Absence of sensation, administration of two or more drugs. (tranquilization, muscle relaxation, sedation, analgesia, neuroleptanalgesial. |
| What information should you gather? | Fasting, current condition, changes in condition since scheduling, current on preventive care, scheduled procedure, medications? |
| What do you do during their physical assessment? | levels of consciousness, vitals/respiratory sounds, palpate pulse, body condition. |
| What kind of abnormalities should you treat during evaluation? | dehydration, anemia, cardiac arrhythmia, respiratory compromise, major organ failure, electrolyte imbalances. |
| What does ASA stand for? | the American society of anesthesiologists. places patients in one of three classes. |
| How are anesthetic agents classified? | route of delivery, primary use, drug class. |
| What is an agonists agent? | Stimulant, binds to receptors, exert 1 + effect (most common) |
| What is an antagonist agent? | blocks or reverses effect of agonist. |
| what is a partial agonist? | bind to receptors, exert partial/mild effect |
| what is a mixed agonist? | reverse effect of pure agonists (block too) |
| What are anticholinergic agents? | parasympathetic nervous system blockade. helps with bradycardia and hypersalivation. has many potential adverse effects |
| what are the most common anticholinergic agents? | atropine and glycopyrrolate |
| What are tranquillizers/ sedatives? | Used for patient restraint for minor procedures. |
| What are phenothiazine (major) tranquillizers? | calm and sedate before general anesthesia. Acepromazine most common, not good for very young or very old or very sick. |
| what are benzodiazepine (minor) tranquilizers? | use in combination with other agents, wide range of effects. (diazepam, midazolam, zolazepam.) good sick animal drugs. |
| what are alpha2 adrenergic drugs? | sedatives used alone or in combination with opioids, dissociatives and other agents. Potential complications (geriatric, pediatric, sick patents) Xylazine, dexmedetomidine, detomidine, romifidine. |
| What are alpha 2 adrenergic antagonists? | Wake up patients and reverse alpha 2 adrenergic agonists effects. Yohimbine (rev xylazine) atipamezole (rev dexmedetomidine, rev detomidine) tolazoline. |
| what are opioids? (narcotics) | related to morphine, stimulate opioids receptors, numerous indications, numerous adverse effects. |
| agonists opioids | stimulate the mu-receptors. mostly analgesic, class II controlled substance. Morphine, fentanyl, oxymorphone, hydromorphone. |
| partial agonists opioids | partial activity at mu-receptors. buprenorphine. |
| mixed agonists-antagonists | exert agonist activity at kappa-receptors and antagonists activity at mu-receptors. Butorphanol. |
| antagonists opioids | wake patients after opioid sedation. Naloxone. |
| what is a Propofol | short acting IV anesthetic. Induce/ maintain anesthesia, not controlled substance, cloudy liquid for iv, supports bacterial growth, use aseptic technique |
| What are dissociates? (cycloheximides) | injectable anesthetic used alone. Immobilize patients for minor or brief procedure, unusual effects on vitals, ketamine and tiletamine. controlled substance. give with tranq/sed to reduce adverse effects. |
| what are barbiturates? | gen anesthesia, treat of seizures, and euthanasian. controlled substance. ult short acting (thiopental sodium, methohexital).intermediate acting (pentobarbital sodium) |
| etomidate | imidazole-derivative sedative hypnotic. short acting injectable, not controlled substance. drug of choice for heart and head problems. |
| guaifenesin (GG, glyceryl guaiacolate) | muscle relaxant/ sedative, injectable, for larger animals. |
| what are inhalant anesthetics? | liquid agents vaporized in oxygen administered via breathing system. vapor pressure, blood-gas partition coefficient, minimum alveolar concentration MAC. |
| Halogenated agents | induce and maintained general anesthesia, isoflurane and sevoflurane most common. induce dose-dependent hypotension. |
| nitrous oxide (laughing gas) | deep blue canister, gas at room temp. speed uptake of other agents, potential hypoxemia. |
| Endotracheal Tubes | Maintain open airway, minimize risk of pulmonary aspiration of blood, stomach contents. Ease supplemental oxygen flow. Allows ventilate patient. Murphy tubes and cole tubes. |
| What parts are in a endotracheal tube? | Connector, cuff, pilot balloon, valve (internal diameter) |
| laryngoscopes | visualize larynx, handle and blade, blade size ranges |
| anesthetic masks | administer oxygen, anesthetic gases to nonincubated patients. choose smallest size possible. |
| anesthetic chambers | solid box to induce general anesthesia, used for small patients: feral, vicious, intractable. two ports, fresh and exit waste gas. |
| anesthesia machines | deliver inhalant anesthetics and oxygen, used during general anesthesia. Carrier gas supply, anesth. vaporizer, breathing circuit, scavenging system. |
| anesthesia machine prep | machine assembly, check for leaks (non and re breathing system) |
| carrier gas supply | gases into which liquid inhalants anesthetic evaporates and that carry vapor to patients: oxygen. Yoke, outlet valve, valve stem. |
| Compressed gas cylinders | color coded (oxygen is green, nitrous oxide is blue). E tank is small, H tank is large. |
| anesthetic vaporizers | holds liquid inhalant anesthetic, adds vaporized anesthetic to carrier gas. Precision: high vapor pressure, isoflurane and sevoflurane. Non precisions: low vapor pressure, methoxyflurane Inlet, outlet, fresh gas inlet. |
| breathing circuits | circulates fresh gases to the patients. conveys waste gases to scavenging system. closed/total rebreathing system. semi closed/partial rebreathing system. non rebreathing systems. |
| re breathing circuit parts | unidirectional flow valves. reservoir (re breathing) bag, pop-off (pressure relieve) bag, CO2 absorbent canister, pressure manometer, neg pressure relief valve, corrugated breathing tubes. |
| scavenging system | transfers waste gas outside building, periodic checking ensures proper flow. |
| what equipment do you need for endotracheal intubation? | right size tubes, hard roll gauze/IV tubing, guaze sponge, syringe, exam ight, laryngoscope, stylet, selecting a tube, right diameter and length. Diameter: prep three sizes, length: tip of nose to thoracic inlet. Hypoventilation, hypoxia, dead space. |
| endotracheal intubation for horses | extent head, speculum. Advance over tongue. Inspirations, wait for breath. If feeling resistance, pull back 10 to 15 cm. tube rotation 90 degrees, check for air passing out on expiration. apnea, pressure eon thorax. |
| endotracheal intubation for cattle | speculum, extension, insert arm, reflect epiglottis forward, remove arm, beveled end in palm, guide tube with the hand that is in the mouth. |
| checking proper placement for endotracheal intubation. | check for bag expansion/contraction, air movement on exhalation, motion of unidirectional valves, palpation: single firm structure, vocalization, normal waveforms |
| cuff inflation | seal between trachea and cuff essential, check for leaks, avoid over inflation. |
| laryngospasm | glottis closes during intubation. cats, swine, small ruminants most common. hypoxia and cyanosis possible. prevention is key. |
| anesthetic monitoring | subtle warning signs require quick action, complications develop quickly, maintain balance by monitoring frequently, checking multiple parameters, don't leave it to instrumentation, don't judge by dose or setting |
| stages an planes of anesthesia | stage one: voluntary movement. stage 2: involuntary movement stage 3: surgical anesthesia. stage 4: anesthetic overdose (three Ds: down deep dying) |
| Principles of monitoring | careful observation to determine stage. Should be between plane I and III. (reflexes, eye position, jaw tone) factors influence stage: IV agents, inhalants, premedication. anesthetic protocol. |
| monitoring parameters | Is the patient in danger or safe? is anesthetic depth adequate, excessive, appropriate for this procedure. Vital signs: indicators of circulation, oxygenation, ventilation. reflexes: palpebral, swallowing, pedal, corneal reflexes |
| monitoring parameters | muscle tone, eye position, response to simulation. |
| monitoring equipment | in conjunction with visual monitoring, early warning, precise assessment. |
| mechanical indicators of circulation | esophageal stethoscope (esophageal catheres, sensor, base unit.) Electrocardiographic monitor ( electrodes on patients skin) |
| mechanical indicator of circulation | ultrasonic |
| oscillometric blood pressure monitor | measures BP, HR, blood pressure cuff, computerized base unit. |
| indicators of oxygenation | pulse oximeter, measures blood pressure and heart rate |
| indicators of ventilation | apnea monitors, warn anesthetist of apnea, base unit and sensor. capnograph: measures CO2 in inspired/expired air, quickest, computerized base unit. |
| small animal anesthesia | selecting protocol (pre meds and anesthetics, right route, dose and order). Signalment (pre existing problems, physical status class, procedure.) equip prep (gathered, checked before procedure). preanesthetic period (physical asses, patient history, lab r |
| what is pre oxygenation? | a tightly fitting mask can increase the oxygen concentration in the lungs to close to 100%. increases body oxygen storage and tolerance to apnea. |
| induction of anesthesia | IV induction (check vitals, remove restrains) IM induction ( two to three times corresponding IV dosage) mask induction (fast inhalant) chamber induction (small aggressive patients, high risk) |
| anesthetic recovery | prep ( transfer, extubate, stop inhalants, continue oxygen, remove unnecessary equipment, keep warm) watch mucous membranes, respirations. |
| anesthetic recovery | prevent self trauma, extubate, remove when swallowing reflex returns. postanesthetic period ( restrict food, reintroduce water gradually) |
| equine anesthesia | challenges with temperament, physical size, effects of inhalant anesthetics, management of recovery. Preparation, hoists hydraulics tables |
| equine anesthesia pre period | place IV usually in jugular, some must be sedated first, rinse mouth, clean feet, remove or wrap shoes, sedate and position. |
| equine anesthesia induction | IV induction, induction stall, lateral recumbency (protect muscles and nerves) prevent myopathy, pull forelimb closest to table forward. |
| maintenance of equine anesthesia | biggest challenge, hypoventilation very common, IV maint usually for procedures less than 1 hour |
| equine prep for recovery | standing instincts make it dangerous, nasopharyngeal tube first for nasal edema, halter, recovery stall, ropes |
| monitoring recovery for equine | signs of recovery ( nystagmus common) Paddling of limbs, rough recovery, extubating (nasal passage unobstructed, postanesthetic period: muzzled free access to water. |
Created by:
jennjenn1
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