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Emergencies in anesthesia can be due to multiple problems. What are the most common problems?
- Human error
- Equipment failure
- Adverse anesthetic effects
- Patient related issues
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Human errors are typically caused by what?
Inattention to detail
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List some common problems associated with human error
- Failure to maintain a thorough history
- Failure to perform a pre-anesthetic physical exam
- Lack of experience w/ the anesthesia machine & anesthetic agents
- Incorrect administration of drugs
- Inattention to patients
- Fatigue
- Failure to respond early to signs of change in the patient
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How are anesthetic emergencies avoided?
- Be compentent with:
- Drugs
- Body physiology
- Normal & abnormal vital signs & what they mean
- Anesthetic equipment
- Specialty techniques
- Patient, lab work & anesthetic depth
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How are equipment failures avoided?
Checking equipment prior to their use
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Dexmedetomidine is an alpha-2 drug that may have what adverse effects?
- Vasocontriction (hypertension)
- Bradycardia
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Why is Atropine only given before Dexmedetomidine and never after?
It can cause fatal arrhythmias if given after Dexmedetomidine
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How is BP calculated?
CO x HR
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What is the lowest acceptable systolic BP?
90 mmHg
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What is the lowest acceptable MAC? What can be done to correct MAC if it becomes a problem?
- 60 mmHg
- Give a fluid bolus, decrease the anesthetic
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What is a side effect commonly associated with opioid use?
Respiratory depression
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How many patient classes are there? What does each class mean?
- 5 classes
- Class 1: minimal risk, healthy animal, routine procedures
- Class 2: slight risk, minor dz present; geriatrics, neonates, obese animals
- Class 3: moderate risk; severe compensated systemic dz
- Class 4: high risk, severe systemic dz that is life threatening; hemorrhage, pyometra, pneumothorax
- Class 5: extreme risk; moribund patient that is nor expected to survive w/o sx; end stage of organ failure, major trauma, shock
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