Anesthesia Study Guide

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Anesthesia Study Guide
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2011-12-03 21:51:48
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Anesthesia study guide final bel rea
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Anesthesia study guide final bel rea
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  1. Surgical fluids
    • 10 mls/kg/hr
    • record every 15 min
  2. Hypotensive fluids
    • 3-5 mls/kg bolus over about 15 minutes OR
    • Double surgical rate (20 mls/kg/hr) and run 15 minutes
  3. animal greater than 7 kg
    • RB system
    • Y tubing
    • reservoir bag
    • scavenge
    • open pop-off
  4. Animal less that 7 kg
    • NRB system
    • Fresh gas to outlet port on vaporizer
    • Scavenge
    • Open Pop-Off
  5. Oxygen flow rates
    • RB - 30 mls/kg/min
    • NRB - 200 mls/kg/min OR 1 L/min
    • Never less than 500 mls/min
  6. Check oxygen supply
    psi X 0.3 = liters of oxygen
  7. Passive charcoal is good for how long?
    12 hours OR weight gain of 50 grams
  8. Pressure check machine
    • Set up re-breathing system
    • cover Y tubing
    • close pop-off
    • Inflate reservoir bag (O2 flush or O2 flow meter)
    • Build pressure up to 20 cm H2O on manometer
    • Should not fall more than 5 cm H2O in 30 seconds
  9. Resrvoir bag
    60 mls/kg (round up to next whole liter)
  10. ET tubes
    • ID (internal diameter in mm
    • Tip of nose to thoracic inlet
    • check cuff, lube with sterile lube or H2O
    • muzzle gauze
    • Lidocaine and stylet for cats
  11. Esophageal stethoscope
    • Measures HR
    • Record every 5 minutes
    • Tip of nose to mid-sternum
    • Lube
    • Can SOMETIMES hear arrhythmias
  12. PA drugs
    • Anticholinergics
    • Tranquilizers
    • Alpha-2 agonists
    • Opiods
    • Neuroleptanalgesics
  13. Induction drugs
    • Barbiturates
    • Cyclohexamiens/dissociatives
    • Propofol
    • Etomidate
    • Neuroleptanalgesics
    • Guaifenesin
  14. Inhalants
    • Halothane
    • Iso
    • Sevo
  15. HR under anesthesia
    60-120 BPM
  16. Tachycardia causes
    • Anesthesia too light
    • pain
    • sx stimulation
    • hypoxia
    • hypotension
    • anemia
    • hypovolemia
    • cardiac disease
    • hyperthyroidism
  17. Tachycardia intervention
    • Increase vaporizer
    • opioids
    • correct underlying problem (ie: blood transfusion)
    • analgesics
    • press on eyeballs
  18. bradycardia rates
    • <60 BPM lg dogs
    • <70 BPM small dog
    • < 100 BPM cats
  19. Bradycardia causes
    • Too deep
    • drugs
    • vagal stimulation
    • hypothermia
    • hyperkalemia
  20. Bradycardia intervention
    • Turn down vaporizer
    • reversal of anesthetic drugs
    • anticholinergics (atropine IV)
  21. Pale MM, prolonged CRT causes
    • Peripheral vasoconstriction
    • Decreased tissue perfusion
  22. Peripheral vasoconstriction causes
    • alpha-2
    • hypothermia
    • pain
  23. Decreased tissue perfusion causes
    • too deep
    • hypotension
    • heart failure
    • anemia/blood loss
    • bradycardia
    • arrhythmias
  24. Intervention for prolonged CRT/pale mm
    • turn down vaporizer
    • IV fluids for shock/hypotension
    • blood transfusions
    • warm patient
  25. Cyanosis
    • Hypoxemia
    • Check respiratory rate
    • check ET tube
    • Check O2 supply
    • increase ventilation +/- flow rate
  26. Respiratory rates under anesthesia
    8-30 BPM
  27. Hypoventilation
    Decreased RR and tidal volume
  28. Hypoventilation causes
    • excessive depth of anesthesia
    • Obese pt
    • tilted table
  29. Hypoventilation intervention
    increase ventilations (MAY need to decrease gas)
  30. Hyperventilation causes
    • too light
    • surgical stimulation
    • pain
    • hypercapnia (check ET CO2, Soda lime)
    • metabolic acidosis
    • pulmonary disease
  31. Hyperventilation intervention
    • Increase depth
    • analgesics
  32. Doppler BP
    • Measures systolic BP and pulse
    • Not very accurate in cats, add 14 mmHg
    • Cuff size - width = 40% the circumference of the limb or tail
  33. Oscillometric BP
    Measures systolic and diastolic BP and MAP
  34. Normal systolic BP
    100-160 mmHg
  35. Normal diastolic
    60-100 mmHg
  36. normal MAP
    80-120 mmHg
  37. Hypotenstion
    • systolic < 80 mmHg
    • MAP < 60 mmHg
  38. Hypotension causes
    • too deep (vasodilation, decreased CO)
    • drugs (vasodilation)
    • Blood loss (hypovolemia)
  39. Hypotension intervention
    • Decrease vaporizer
    • increase IV fluids
    • drugs (dopamine, dobutamine, ephedrine)
  40. Capnograph
    • end tidal CO2, insp CO2, and RR
    • ET CO2 should range between 35-45 mmHg, insp CO2 close to 0
  41. Decreased ET COS (hypocapnia) causes
    • Hyperventilation (too light, pain)
    • tube in esophagus
    • cardiopulmonary/respiratory distress
  42. Hypocapnia intervention
    • increase vaporizer
    • ventilate/CPR
  43. Increased ET CO2 (Hypercapnia) causes
    usually due to respiratory depression causing hypoventilation
  44. Hypercapnia intervention
    Increase ventilations (may need to turn down gas)
  45. Increase IN CO2
    • expired soda lime granules
    • increase O2 flow
  46. Causes of decreased O2 sats
    • probe problems
    • peripheral vasoconstriction (alpha-2s, hypothermia)
    • ET tube
    • Empty O2 tank
    • O2 flow rate too low
    • Lung disease
    • Apnea
    • Cardiac arrest
    • bradycardia
    • sever arrhythmias
    • PDA/VSD
    • V/Q mismatch
  47. Decrease O2 sat interventions
    • Get O2 to patient
    • Increase ventilations
  48. Maintenance settings (1.5 X MAC)
    • Iso = 1.5-2.5%
    • Sevo = 2.5-4%
  49. Signs pt might be too light
    • Increased HR
    • Increased RR
    • Increased BP
    • PT movement
    • Palpebral
    • Eyes central
    • Tight jaw tone
  50. Intervention of a pt too light
    • Turn up vaporizer and ventilate
    • Give rest of/more of induction drug
  51. Signs pt is too deep
    • Shallow resp
    • <8 breaths per minute
    • increased CRT
    • bradyardia
    • weak or absent pulse
    • hypotension
    • cardia arrhythmias
    • hypothermia
    • all reflexes absent
    • myscle tone slack
    • eyes central
    • pupils dilated
  52. Intervention of a pt too deep
    • turn vaporizer down or off
    • support ventilations
  53. Pulse dissapears when systolic BP = ________
    <60 mmHg

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