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What is the motto of the anesthetist?
"The anesthetist's job is either too boring or too exciting"
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What are some causes for anesthetic problems?
- human error
- equipment failure
- anesthetic agents
- patient variation factors
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Every anesthetic episode has the potential to _____ the patient.
kill
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What could cause human error?
- slightly experienced
- incomplete preliminaries
- unfamiliar
- incorrect administration of drugs
- inattentiveness
- preoccupied or in a hurry
- fatigue
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What does it mean to be slightly experienced?
overconfident beyond their ability
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What could a tech fail to complete in the preliminaries?
- obtain an adequate history - lack of details
- perform an adequate PE - miss dyspnea, anemia, dehydration
- lack of access to owner (owner drops off pet)
- owner not questioned properly
- information obtained by not recorded or passed on
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How can someone be unfamiliar with protocol or equipment?
- clueless about drugs, dosages, anesthesia machine
- untrained, unlicensed
- performing duties beyond training and ability
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How can a tech administer the drugs incorrectly?
- wrong patient weight
- wrong math
- wrong drug
- wrong concentration
- wrong route
- wrong patient
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How can a tech be inattentive?
distracted, bored, tired
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When should procedures be scheduled in order to cut down on fatigue of the staff?
early in the day when everyone is fresh
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Equipment failure is really what? Why?
- human failure
- bc equipment was not checked before use or not maintained properly
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What parts of the equipment could fail?
- CO2 absorber
- O2 tank
- misassembly
- endotracheal tube
- vaporizer
- pop-off valve
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What problems could we have with the CO2 absorber?
used up
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How can a CO2 absorber that is not working correctly affect the patient?
- hypercarbia
- hypercapnia
- respiratory acidosis
- arrhythmias
- increased RR, HR
- CNS damage
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What could go wrong with the O2 tank and what can we do to fix this?
- could be empty
- check before procedure
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What needs to be on in order for the patient to breathe?
O2 tank AND flowmeter
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What do we need to check during the procedure for the O2 tank?
check flowmeter, O2 tank, and reservoir bag every 5 minutes
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How do we check to make sure the anesthesia is assembled correctly?
trace path of O2 flow
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What are some problems we could have iwht the endotracheal tube?
- blockage
- kinks
- FB
- cuff not inflated
- too small
- in esophagus
- endobronchial
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What problems could we have with the vaporizer?
- wrong anesthetic liquid
- inaccurate, stick dial
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What problems could we have with the pop-off valve?
- left closed after bagging
- results in high pressure in breathing circuit
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High pressure in breathing circuit could result in...
- harder to breathe
- pressure on great vessels which impairs blood flow to heart
- possible ruptured alveoli
- can be fatal
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How do we prevent too much pressure in the breathing circuit?
keep bag no more than 2/3 full
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