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Anesthesia Test 2
| Question | Answer |
|---|---|
| what are the 4 main causes of anesthetic deaths in animals | human error, anesthetic agent, anesthetic machine, patient-related problems |
| what type of anesthetist makes the most errors | more experienced, they have more experience and become over confident |
| what is the most common reason for human error | failure to do a complete physical exam and to take a complete history |
| Xylazine shouldn't be used in what patients | pregnant, geriatric, neonates |
| In many cases using multiple drugs may be __________ for the patient than one drug alone. | safer |
| If you are using a premix of multiple drugs, what do you do to the individual doses | lower them |
| you must ensure oxygen tank is always __________. | full |
| make sure carbon dioxide is not __________, endotracheal tube is _________ and in the ________. Vaporizer must contain the right __________ | exhausted, patent, trachea, anesthetic |
| why should the pop-off valve not be inadvertently left closed | rapidly compromise the animals breathing |
| what classes of patients are at high risk during anesthesia | class III and class IV |
| what are the patients that are commonly considered to be at greater risk for anesthesia | -geriatrics, neonates, brachycephalics, sighthounds, obese animals, trauma patients, c-sections, cardio/resp/hepatic/renal diseases. |
| the bacteria in the mouth or bad dental health can cause problems in which organ system | circulatory system |
| what patients would halothane not be appropriate for | patients with hepatic disease |
| ________ access should be established __________ surgery. | IV, before |
| IV fluids should be provided _______ the course of surgery to support the __________. | during, circulation |
| True or false: an ET tube is more ideal than a mask? | true |
| how often should the patient be monitored | ideally continually but at least every 5 minutes |
| what does CPCR stand for | Cardiopulmonary Cerebral Resuscitation |
| what is CPCR defined as | cessation of both the heart beats and respirations |
| when does clinical death occur | when the brain is dead which normally happens 4 mins after CPA |
| _____________ arrest always precedes __________ arrest | respiratory, cardiac |
| what are the signs seen prior to resp and cardiac arrest | -weak irregular pulse -decreased resp rate -cyanotic MM -prolonged CRT -central, dilated pupils |
| 7 steps anesthetist should take is cardiopulmonary arrest appears imminent | 1. vaporizer turned off 2. airway is assessed to ensure ET tube is patent 3. pure oxygen should be available 4. animal bagged every 6 seconds 5. give reversal agent if there is one 6. IV fluids and drugs given 7. continue monitoring during this time |
| acronym to help represent steps to carry out in an emergency | CABD (circulation, airway, breathing, drugs) |
| what do you carry out in step C (circulation) when assessing an emergency | -check if heart is still beating and that animal has a pulse. otherwise start compresions |
| what do you carry out in step A (airway) when assessing an emergency | ensure a patent airway is present by making sure is chest is rising |
| what do you carry out in step B (breathing) when assessing an emergency | bag animal every 6 seconds with pure oxygen until it is no longer cyanotic |
| what do you carry out in step D (drugs) when assessing an emergency | admin IV fluids at shock rate unless animal is euvolemic |
| what does euvolemic mean | animal has a normal amount of fluids in their body |
| cardiac massage can be ________ or ________. | open, closed |
| what does closed cardiac massage entail | compressing the chest without opening the chest wall |
| what does open cardiac massage entail | involves squeezing the heart through an open chest |
| why is open cardiac massage not the first open | very invasive, recovery is very critical, expensive |
| how should an animal be placed for cardiac massage | right lateral |
| how much of the chest do you compress during cardiac arrest | approx. 1/3 to 1/2 of the chest diameter |
| what is the appropriate rate of compressions for a dog and cat | 100/min for medium large dog 120/min for small dog or cat |
| what are the 2 ways to check the effectiveness of CPCR | -assess ETCO2 (10-15 mmHg is normal) -doppler probe on eyeball |
| where do you cut for internal cardiac massage | through the side between the ribs, through the sternum, or up through the diaphragm |
| you should keep compressions going and check every ________ minutes | 2 |
| if resps are not seen they should be provided every _________ seconds. | 15 |
| what are the 3 common emergency drug routes | IV, IT, IC |
| what kind of drug is epinephrine and when should it be given | Cardiac stimulant, only when heart stops |
| what kind of drug is dopamine and when can it be given | cardiac stimulant, when heart is still beating |
| what drug is a longer acting corticosteroid that helps reverse shock and reduce inflammation | Dexamethasone |
| what drug is an anticholinergic useful for prevention and treatment of bradycardia that also causes dilation of the pupils | Atropine |
| what does furosemide do and what is its product name | "lasix", treats pulmonary edema, stimulate kidneys, treat over-hydration |
| what drug is useful to give after Cardiac arrest | Sodium Bicarbonate |
| what cardiac stimulant has fallen into disfavour but used to treat eclampsia | Calcium Gluconate |
| what drug is sometimes used instead of epinephrine and why | Vasopressin, less likely to cause arrhythmias |
| what is the most common arrhythmia is dogs and cats | asystole, and PEA (pulseless, electrical activity) is the next |
| what position should the patient be place din for EKG | dorsal or lateral recumbency |
| what is the initial EKG shock and what do you increase too is there is no response | 3-5 joules/kg, 50% |
| most major surgeries on equines are done under _______ anesthesia rather than _____________. | inhalant, injectables |
| ruminant surgery is performed using...... | local analgesics |
| True or False: intubation in large animals is normally done blindly with head and neck extended | True |
| what are the common ET tubes used in large animals | 15,20,15,30mm |
| in what areas of anesthesia differs from small and large animals | induction, maintenance, recovery |
| how to restrain a horse for induction | -in clinic with a wall with rings and ropes available to stabilize horse. -in the field the head is held with a halter and separate handler hold the tail to help steady the horse |
| why should the horse be walked in in a circle when being induced | to dissuade rearing |
| once the horse is induced what does the handler do to prevent it from standing up | sit on its neck |
| why should the surgery table be well-padded for large animals during surgery | large muscles puts pressure on nerves which can result in paralysis after surgery |
| where is it preferable for a large animal to recover | unbothered, quiet, dimmed, padded stall |
| how long is food and water withheld from in a horse before surgery | food: 8-12 hours water: 2 hours prior |
| what is different about horse preanesthetic prep | -shoes are taken off and thoroughly cleaned. -mouth is rinsed out |
| what 2 drugs are tranquilizers and can cause prolapse of penis in males which can be permanent in horses | acepromazine, promazine |
| which drug is not normally given to horses as a pre-med and why | Atropine, may decrease intestinal peristalsis which could result in ileus and colic |
| what are the common drug "cocktails" used in horses | -xylazine/ketamine -detomidine/ketamine -diazepam/ketamine |
| when giving a horse a cocktail. It is important to give the ____________. IV first and wait __________ minutes until animal is sedated. Then you can give __________ IV. | tranquilizer, 3-5 mins, ketamine |
| what drug are barbiturates usually paired with foe induction | Glyceryl gluconate (Guaifenesin) |
| what are the approx ET tube sizes for neonates and one month old foal | neonate: 7-9mm foals: 9-11mm |
| what is the inducing agent that WAS commonly used in horses for standing castrations | Succinyl Choline |
| why is Succinyl Choline deemed inhumane now | it is a muscle paralyzing agent. Therefore the animal is not able to move but can feel everything |
| how are horses positioned in a clinic setting for surgery | -on a large foam rubber pad or water bed |
| what is the most common used inhalation agent for horses and what is the flow rate | -ISO -4-6 L/min |
| what should a horses resp rate be maintained at under anesthesia | 7-10 rpm |
| what should a horses heart rate be maintained at under anesthesia | greater or equal to 28 bpm |
| how can you find a heart rate on a horse | facial artery, dorsal metatarsal artery, or from the chest with a stethoscope |
| what reflexes should you look monitor during horse anesthesia | -palpebral and corneal reflexes |
| where is the doppler or oscillometer placed on the horse | tail |
| why is it ESSENTIAL to monitor horses frequently to ensure they do not get too deep | horses experience slow responses to changes in anesthetic concentrations and it can take up to 20 mins to see a change in depth |
| what are the 5 common post-op complications in horses | -myositis, phlebitis, eye trauma, neurological injury, excitement |
| what is myosostitis and what breed of horses is it common in | inflammation of the muscles, heavy draft horses |
| how can you prevent eye injury after anesthesia in horses | -remove halters and provide padding for eyes and head |
| since the rumen is so large in cattle, they should have roughage withheld _________ hours, gran withheld _________ hours and water withheld _____ hours prior to major anesthesia and surgery | 48, 24, 12 |
| what could happen if a cattle rumen is too large before surgery | regurgitation may occur which could lead to aspiration pneumonia particularly in lateral recumbency |
| why is atropine not given to cattle | it may cause bloat |
| what drug is so potent in can be used as an induction agent in cattle | xylazine |
| what iso can cattle be maintaned on | 1-3% and flow of 4-5 L/min |
| what reflexes should you monitor in cattle | eye rotation and corneal and palpebral reflexes |
| where should the eye be positioned in cattle for anesthesia | ventromedially rotated |
| which is the most common pre-anesthetic used in ovine and caprine | xylazine |
| what makes IV induction a challenge in swine | they have hard to access superficial veins |
| what 2 species are prone to laryngospasm | cats, pigs |
| what is a pigs idiosyncratic reaction to halothane | hyperthermia (greater than 41 degrees), blotchy skin, muscle rigidity and tachycardia |
| what tranquilizer is approved for pigs and it quite effective | Azaparone (stresnil) |
| what is the difference between local analgesia and local anesthesia | local analgesia (affects peripheral nerves) local anesthesia (affects brain) |
| 3 common situations when local analgesics are used | 1. spray larynx before intubation in cats 2. epidural analgesia 3. lubrication of urinary catheters |
| what is one disadvantage to local analgesics | cannot reach deep tissues properly |
| what can happen if a local anesthetic is injected into a nerve | may be permanent loss of function |
| small animal epidurals are inserted into the....... | intervertebral space just cranial to the sacrum between L7 and S1 |
| minor skin surgeries are usually in what shapes | L shape or a fan shape |
| If the nerve is palpable for the minor skin surgery the lidocaine should be deposited _________ to the nerve not in it | adjacent |
| what is the paravertebral blocks used for | used in cattle to block the nerves supplying the paralumbar fossa |
| what is the site used to repair the left displaced abomasum and c-sections | paralumbar fossa |
| where is lidocaine injected during a paravertebral block | transverse process of T13 and L1 |
| how long does it take for a paravertebral block to kick in | 10 mins |
| what is an alternative technique to the paravertebral block | inverted "L" block |
| how does an L block work | insert a need SQ and approx 10-15 ml of lidocaine is infiltrated as the needle is withdrawn |
| what is the ring block used for | teat surgery |
| how does the basic ring block work | teat and area above are cleaned, multiple sites around the base pf the teat are injected with lidocaine |
| in the case that the actual teat needs to be frozen for a ring block, what needs to happen | a tourniquet is placed at the base of the teat, and 10ml of 2% lidocaine is infused into the teat |
| what nerve block is used to dehorn cattle | cornual nerve block |
| where is the cornual nerve palpated | frontal crest between the eye and the ear |
| how do perform the cornual nerve block | approx 5-10ml of 2% lidocaine is injected using a 18g 1-1.5 inch needle |
| where does the epidural block provide analgesia too | the tail, birth canal, and perineum |
| what block can also treat vaginal and rectal prolapses | epidural block |
| how do you find where to insert the needle for an epidural block | tail is lifted up and down, the space between the 1st and 2nd coccygeal vertebrae is then felt to be an indentation |
| how to insert the needle for an epidural block | along the midline, pushed through the ligamentum flavum until a pop is felt |
| what is the IV block used for and what is it also known as | amputation of a digit also known as "bier block" |
| what do you place above the site for amputation | tourniquet |
| what are the 3 most common uses of local analgesics in equines | 1. intra-articular blocks 2. lameness exams 3. line blocks |
| what are equine Intra-articular blocks used for | diagnosis of lameness within a joint |
| how does the intra-articular block work | it removes the sensation to the site and if the joint was the source of the lameness the horse will appear sound |
| how does a lameness exam work | a serious of blocks are performed starting distally. in between each block the horse is walked to see if the lameness is alleviated |
| how is the limb help to inject for a lameness exam | in flexion |
| what block is used to detect lameness of the fetlock | high palmer block |
| what is the line block used for | used to repair lacerations |
Created by:
jscott41
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