clin pro 2
Card Set Information
clin pro 2
Anesthetic problems emergencies
What are some causes why animals won't stay anesthetized?
What causes the vaporizer to keep the patient awake?
setting too low or turned off
Check anesthetic level in fill window
Malfunction-does iso vaporizer need to maintained at 3-4% for surgical plane
What can go wrong with the endotracheal tube that would cause the patient to wake up?
the placement of the tube
not in esophagus
Cuff blow by
How can oxygen cause problems under anesthesia?
Flow rate too low
: not getting enough anesthetic
Excessive use of flush valve (dilution of anesthetic)
What are the causes of that a patient would be too deeply anesthetized?
Vaporizer setting too high for the patient
Dose of injectable too high (induced)
What are some signs of patient being too deep?
Resp<8/min may be shallow or dyspneic
Mucous membranes pale, may be cyanotic
Pulse weak, hypotension(<80mmHg)
Cold extremities ears hypothermia
: PLR, Corneal reflexes
Muscle tone flaccid
How would you treat a patient who is too deeply anesthezied?
Decrease vaporizer setting (possibly turn off)
Bag with 100% O
every 5 sec. until signs of recovery
Increased heart rate
improved color and crt
consider iv fluids, external heat, drugs, reversal agents
What are the causes of pale mucous membranes?
Intraoperative blood loss
Drugs causing vasodilation and hypotension
What are the preexisting anemias?
Feline leukemia virus
Chronic Renal failure
What are the drugs that cause vasodilation and hypotension?
Inhalation agents (halothane)
Treatment for pale mucous membrane?
Determine anesthetic depth lighten if too deep
Monitor vital signs- heart/ rep. rate pulse CRT
Consider fluid therapy, transfusion (on DVM's orders)
What causes prolonged CRT?
Excessive anesthetic depth
What drugs cause Hypotension?
How would you treat hypotension?
Immediately check pulse and blood pressure, absence of femoral pulse indicates pressure <40mmHg
IV fluids- crystalloids, Colloids
Reduce anesthetic depth if possible
Administer 100% O
What drugs would you use for hypotension?
cardiac inotropes(increase force of contraction)
What causes dyspnea and/ or cyanosis?
Unable to obtain oxygen
Unable to breathe normally
Anesthetic too deep
Why is the patient unable to obtain oxygen?
No oxygen in tank
Endotracheal tube blocked
What are some reasons why the airway might be obstructed?
ET tube blocked
Excessive flexion of neck
: especially on untubating patient
aspiration (if not intubated)
What are some respiratory pathology?
What would you see when a patient is in dyspnea and or cyanosis?
Exaggerated chest or abdominal movements on inspiration
Blue purple mucous membranes
How would you treat dyspnea and cyanosis?
Determine oxygen source adequate
Bag with 100% Oxygen (vaporizer off) and observe chest wall for movement.continue until pulse oximeter is 90-95% or mucous membrane color improves
If unable to intubate consider tracheostomy or 14 g IV cath into cricothyroid ligament w/3cc syringe attached to Y piece.
IV fluids drugs (doxapram)
Monitor closely cardiac arrest may follow
Post operative supplemental oxygen may be necessary
What causes tachypnea?
Inadequate anesthetic depth
Opiod (panting)esp. oxymorphone
Paradoxical response to hypoxia and hpercapnia in excessively deep anesthesia
How do you treat tachypnea?
If normal anesthetic depth, temp, and vital signs dont change vaporizer setting usually self corrects within 1-2min
Consider analgesia if pain induced
Tend to see i obese and toy breeds. May need to assist or control ventilation.
What causes Tachycardia?
What drugs cause tachycardia?
What are the preexisitng condition that causes tachycardia?
congestive heart failure
When do you see tachycardia?
In stage III of anesthesia
Heart rate>160 (large dog)
Heart rate >180 (small dog)
Heart rate >240 (cat)
How can you treat tachycardia?
Checkdepth may need to increase if heart
If cause is shock treat hypotension
What causes bradycardia?
stimulation of vagus nerve
What drugs cause bradycardia?
xylazine or medetomidine
What causes stimulation of vagus nerve?
Handling of viscera
In what rate is consider bradycardia?
<100 in cats
How to treat bradycardia?
Not all require treatment, check anesthetic depth
Decrease vaporizer setting if needed
100% oxygen (bag)
If caused by drugs or excess vagal stimulation- atropine or glycopyrrolate IV consider the use of epinephrine
What causes cardiac arrhytmia?
Preexisting heart disease
Gastric dilation and volvulus
Myocardial contusion (bruse heart cause by trauma)
PVC barbiturate, halothane hypoxia, cardiac disease trauma, acid base electrolyte abnormality epinephrine.
What do you see during cardiac arrhythmias?
Dropped beats on auscultation
Treatment for cardiac arrythmias
R/O inadequate oxygen flow or CO2 accumulation
Ventilate with oxygen 100% oxygen
drugs lidocaine (local anesthesia)
If injected IV corrects arrhytmias
What drugs cause respiratory arrest?
True or false: Prolonged bagging with oxygen cause respiratory arrest?
What are causes of respiratory arrest?
prolonged bagging with O2
lack of oxygen flow
preexisting respiratory disease
How do you treat respiratory arrest?
If from drugs or bagging- give 1 breath every 30 sec while continuing to monitor
Otherwise inform DVM, Intubate (if not already) administer 100% oxygen
Check heart to r/o cardiac arrest
Turn off vaporizer
Ensure oxygen flow
R/O airway obstruction
Bag every 3-5sec until vital signs improve
IV cath, fluids at shock rates
: doxapram: respiratory stimulant, reversing agents
discontinue bagging for 15-30 seconds, observe for breathing
What do you do during cardiac arrest?
Check for airway, breathing, start compression, give drugs
Intubate administer 100% oxygen
Make sure no obstruction of airway (chest movement)
One breath per 2 compressions
One breath every 3-5 sec
Alternate 2 breaths with 10 compression if solo
1-2 compressions per second
Cardiac pump-small animals
: manually compressing the heart
Thoracic pump-large animals:changing the in the thorax
Palpable femoral pulse should occur with each compression
Defibrillate for ventricular fibrillation
IT a 2x dose for atropine, epinephrine, Lidocaine
IV central line if possible
IC lest preferable
: can cause more damage if needle is in wrong chamber