Vet Tech Anesthesia & Surgical Procedures – Flashcards
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Anesthesia
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Loss of sensation & sensitivity to pain
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Anesthesia provides?
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Sedation, tranquilization, immobility, muscle relaxation, unconsciousness, & pain control
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Anesthesia indications?
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Surgery, dentistry, grooming, diagnostic imaging, & wound care
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General Anesthesia
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Reversible state of unconsciousness, immobility, muscle relaxation, & loss of sensation
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Surgical Anesthesia
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Specific stage of general anesthesia
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Analgesia
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Loss of sensitivity to pain
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Sedation
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Drug-induced, CNS depression, drowsiness, various intensity, minimally aware or unaware of surroundings, aroused by noxious stimulation, indications (minor procedures, imaging, grooming, wound treatment)
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Tranquilization
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Drug-induced state of calm, reluctant to move, aware of surroundings but not concerned
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Hypnosis
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Drug-induced sleeplike state, impaired ability to respond to stimuli, aroused w/sufficient stimulation
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Narcosis
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Drug-induced sleep, not easily aroused, associated w/narcotic drugs
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Local Anesthesia
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Loss of sensation in a small specific area of the body
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Topical Anesthesia
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Loss of sensation of a localized area
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Regional Anesthesia
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Loss of sensation to a larger but limited area of the body (epidural)
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Balanced Anesthesia
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Administration of multiple drugs in smaller quantities, maximizes benefits, & minimizes ASE
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Signalment
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Species, Breed, age, sex, reproductive status
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What species are more sensitive to opioids than Dogs & Ruminants?
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Horses & Cats
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What specie has a rougher recovery from inhalants?
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Horses
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Anticholinergics can make saliva thick & ropy, causing airway occlusion in what specie?
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Ruminants
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Ruminants are more sensitive to what medication than Horses?
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Xylazine
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What is prone to respiratory depression & dependent atelectasis, requiring more ventilatory support?
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Large animals
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What specie can tolerate dissociative agents used alone?
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Cats
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What specie may experience seizure-like activity?
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Dogs
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What may experience pressure necrosis of tissues lying over pressure points & require padding when laterally recumbent?
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Large animals
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What species are prone to excess airway secretions that may result in airway blockage?
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Cats & Ruminants
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Horses may what during recovery?
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Fracture limbs
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What species are prone to hypoxemia & hypercarbia caused by ? mechanical dead space?
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Cats, small Dogs, small pediatric patients
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What specie are prone to bloat?
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Ruminants
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What breeds are sensitive to barbiturates?
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Sighthounds
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What breeds are more sensitive to Acepromazine?
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Boxers & Giant breeds
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What breeds are more resistant to Acepromazine?
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Terriers
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What breeds are difficult to intubate?
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Brachycephalic
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What breeds are sensitive to sedatives?
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Draft Horses
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Acepromazine is contraindicated in what & why?
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Stallions, may cause penile prolapse
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Xylazine causes what in pregnant Cows & Ewes?
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Uterine contractions in the 3rd trimester
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Epinephrine (sympathomimetic) combined with what can cause cardiac arrhythmias?
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Cyclohexamines, Xylazine, Barbiturates, & Halothane
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Tricyclic Antidepressants (Amitriptyline & Clomipramine) can cause?
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Cardiac arrhythmias
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Antibiotics (Chloramphenicol) can cause?
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? biotransformation of Barbiturate Anesthetics & lead to prolonged recovery
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Monoamine Oxidase Inhibitors (Amitraz & Selegeline) can?
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? effects of Morphine & other opioids, & lead to additive effects w/Anticholinergics or CNS depressants
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Antihistamines can cause?
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CNS & respiratory depression w/Opioids
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Hydration assessment can be seen by?
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Skin turgor, placement of eye in the orbit, MM color, CRT, moisture level, HR, & pulse strength
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What are recommended tests for Dogs/Cats w/ class P1 to P2 & < 5 yrs old?
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PCV & TP
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What are recommended tests for Dogs/Cats w/ class P1 to P2 & > 5 yrs old?
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CBC / Chemistry
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What are recommended tests for Dogs/Cats w/Class P3-P5 & any age?
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As ordered by VIC
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What are recommended tests for Ruminants w/Class P1 to P2 @ any age?
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PCV & TP
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What are recommended tests for Ruminants w/Class P3-P5 @ any age?
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As ordered by VIC
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What are recommended tests for Horses w/Class P1 to P2 @ any age?
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CBC & TP
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What are recommended tests for Horses w/Class P3-P5 @ any age?
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As ordered by VIC
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ASA Physical Status 1?
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Normal healthy, minimal risk, elective procedures
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ASA Physical Status 2?
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W/mild systemic disease, low risk, neonatal, geriatric, obese, mild dehydration, &/or skin tumor
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ASA Physical Status 3?
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W/severe systemic disease, moderate risk, anemia, moderate dehydration, compensated major organ disease
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ASA Physical Status 4?
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W/severe systemic disease that is constant threat to life, high risk, ruptured bladder, internal hemorrhage, pneumothorax, &/or pyothorax
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ASA Physical Status 5?
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Moribund patient who is not expected to survive w/o the operation, extreme risk, severe head trauma, GDV (Gastric Dilation Volvulus), &/or pulmonary embolism
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Total Body of Water?
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Intracellular & Extracellular fluid
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Intracellular fluid is?
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In cells & is 2/3 of TBW
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Extracellular Fluid is?
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Not in cells & is 1/3 of TBW
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Intravascular Fluid is?
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1/4 of ECF, & is outside the cells but inside the vessels
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Interstitial Fluid is?
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3/4 of ECF & is in between the cells
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Plasma is what % of BW?
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5%
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Blood volume is what % of BW in Dogs & large animals?
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8-9%
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Blood volume is what % of BW in Cats?
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6-7%
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Calculating Blood volume for Dogs & large animals is?
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90mL/Kg. lean BW
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Calculating Blood volume for Cats is?
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60mL/Kg. lean BW
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Intrcellular cocentration solutes are?
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K?, Mg²?, Protein, & Phosphate
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Extracellular concentration solutes are?
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Na?, Cl?, & HCO??
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1/3 of IV fluids administered will?
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Stay in the intravascular space
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2/3 of IV fluids administered will?
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Diffuse into the interstitial space
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What doesnt pass freely through the vascular endothelium?
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Colloids
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Colloids in the intravascular space draw?
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Water into the space, creating osmotic or oncotic pressure
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Dehydration, Anorexia, & General disease condition
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Depletes ECF, administer fluids w/solute profile similar to ECF
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Perioperative hemorrhage
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Loss from intravascular space, administer fluids w/solute profile similar to ECF (Hypertonic Saline or Colloid solutions)
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Significant Perioperative hemorrhage
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Loss of blood constituents, water, & electrolytes, administer blood products
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Low Albumin
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Administer blood plasma or colloid solutions
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Replacement fluid is?
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? concentrations of Na? & Cl? designed to replace fluid losses
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Maintenance of IV fluids?
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Lower Na? & Cl? but more K? designed to maintain fluid balance over a longer period
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Crystalloids
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Pass freely through vascular endothelium, & may have dextrose &/or buffers, starts in intravascular space but 2/3 will go into interstitial space
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Isotonic, polyionic replacement solutions are?
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Lactated Ringer's Solution, Normosol-R, Plasma-Lyte A ; R (PA ; PR), ; Isolyte
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LRS ; PR contain what?
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Calcium ; cannot be administered w/blood products
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LRS does not contain?
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Mg²?
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Normal Saline (NS) contains only?
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Sodium ; Chloride dissolved in water, preferred fluid for Addison's disease & administering blood transfusions
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What type of colloid solution is used often?
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Hetastarch
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Sterilization
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Destruction of ALL microorganisms on an item
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Disinfection
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Destruction of MOST pathogenic microorganisms on inanimate objects
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Antisepsis
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Destruction of MOST pathogenic microorganisms on animate objects
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Antiseptics
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Kills microorganisms during patient skin preparation & surgical scrubbing
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Cleaning
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Physical removal of surface contaminants
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Sanitize
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Reduce number of microbes to a safe level
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Ideal disinfectant
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Broad spectrum, nonirritating, nontoxic, noncorrosive, & inexpensive
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Components of an Anesthesia Machine (order that they occur in circuit)
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Oxygen source, Pressure-reducing Valve, Flowmeter, Fast flush valve, Vaporizer, Unidirectional inspiratory valve, Negative pressure relief valve, Corrugated breathing tube & Y-piece, Unidirectional expiratory valve, "Pop-off" valve, Manometer, Reservoir bag, Carbon dioxide absorber, & Scavenging system
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Oxygen source
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Carrier for vaporized anesthetic gas & delivers to patient, ? concentration compensates for ? tidal volume, 20 to 22%, pressure reading of 2200 lbs psi when full
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Color coding on oxygen source
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Oxygen- Green, Nitrous Oxide- Blue, Medical air- Yellow, & Carbon Dioxide- Gray
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Pressure-Reducing valve
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Reduces pressure leaving the tank from 2200 to 40-45 psi
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Flowmeter
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Further reduces pressure of gas to 15 psi, regulates O? entering the system, graduations may be in 100-mL increments until 1-L level & then 500-mL increments after
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Fast Flush valve
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Allows quick infusion of O? into breathing circuit, used in recovery phase to dilute residual anesthetic gases remaining in system & hasten patient recovery, NEVER use w/Non-rebreathing systems, & NEVER use if pressure-relief "pop-off" valve is closed
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Vaporizer
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Inlet- O? enters vaporizer to carry anesthetic gas molecules to patient, outlet- O? & anesthetic gas leave to enter circuit, Holds liquid anesthetic & vaporizes that liquid into a gas form that can be delivered to patient in a controlled manner
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Factors that effect Vaporizer?
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Temperature, Gas flow rate, & Back pressure
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Precision Vaporizer
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Used w/high-vapor-pressure anesthetics, always found out-of-circle, compensates for all 3 factors (Temp, GFR, & BP)
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Nonprecision Vaporizer
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Glass canister that allows liquid anesthetic to vaporize at uncontrolled rate, Use w/anesthetics w/low vapor pressure liquid that vaporize slowly, does not compensate for the 3 factors, less acurate delivery & ? risk for patient
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Vaporizer-Out-Of-Circuit (VOC)
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Not localized in breathing circuit, oxygen from flowmeter enters vaporizer prior to entering breathing circuit, precision vaporizers, & ? resistance gas flow
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Vaporizer-In-Circuit (VIC)
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Oxygen enters breathing circuit from flowmeter, exhaled gases pass through the vaporizer, Nonprecision vaporizers, & ? resistance gas flow
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Specific-Use vaporizers color codes?
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Isoflurane- Purple, Sevoflurane- Yellow, Halothane- Red, & Desflurane- Blue
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Isoflurane induction Rate & maintenance is?
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3-5% induction & 1.5-2.5% maintenance
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Unidirectional Inspiratory Valve
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Letter A on figure, Allows movement of gas in one direction only, during inspiration
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Negative Pressure Relief Valve
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Letter B on figure, Safety device if negative pressure results from empty oxygen source is detected in the system, this valve allows room air to enter the system
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Unidirectional Expiratory Valve
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Letter C on figure, Same as inspiratory valve except w/ expired gases, allows movement of gas in one direction during expiration
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Pop-off Valve
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Letter D on figure, Acts as a vent, prevents pressure & build up in the system when completely open, used to determine flow rate techniques, only closed when bagging an a patient squeeze bag then open valve
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Manometer
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Letter E on figure, Pressure gauge of anesthesia machine, measures but not regulates, normal resting pressure when pop-off valve is open- 0
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Reservoir Bag
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Rubber bag, allows patient to rebreathe some exhaled gases stored in the bag, deflates -inspiration, inflates- expiration, in any circuit it allows manual ventilation of the patient
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Tidal Volume
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Volume of air inhaled during a normal breath at rest, 10mL/Kg bodyweight, then multiply TV by 5
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Carbon Dioxide Absorber
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During exhalation, waste gases pass to CO? absorber or scavenging system, canister containing barium hydroxide lime or sodium hydroxide lime, crystals absorb exhaled CO? resulting in production of heat, water, & a color change, depleted crystals are hard, 6 to 8 hours of use time to a whole canister then change crystals
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Scavenging System
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Evacuates waste gases from anesthesia machine out of surgery suite, active system- mechanical device attached to machine & a building source that produce a vacuum to remove gases, Passive system- relies on gravity, tubing attached to pop-off valve carries waste gases to activated charcoal container, weigh canister before use & reweigh after each use, when gained 50g from initial weight-discard
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Leak Testing
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Before every use, perform w/rebreathing circuit only, check pop-off valve 1st (must be closed), check rebreathing bag & corrugated hose, check Y-piece, check metal rings on inspiratory & expiratory valves, check CO? absorber, & check tubing
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Rebreathing Circuit
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Allows recirculation of some expired anesthetic gases, permits use of lower oxygen flow, some gases are rebreathed, use in patients >7 Kg
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Universal F circuit rebreathing
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Design of inspiratory tube inside expiratory tube allows warming of inspired gases, single-tube design is less congested at head & mouth
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Traditional Circuit Rebreathing
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2- Corrugated hoses connected at one end w/Y-piece
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Non-rebreathing Circuit
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No gases are rebreathed, for patients <7 Kg, low resistance for breathing for the patient, ? expense because of the amount of oxygen used
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Oxygen Flow Rates
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Rebreathing- ? OFR for induction & recovery, w/large-volume delivery of gas, maintenance flow is ? than induction & recovery Non-rebreathing- ? OFR continuously
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Pulse oximeter is to ______ _______ as a capnograph is to ________ ________ ________?
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Oxygen saturation, carbon dioxide levels
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Internal organ that is most vulnerable to over oxygenation?
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Lung
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When oxygen is administered through a nasal catheter into the trachea, what % of reduction in oxygen flow should there be?
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50%
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CO? measurement can only be performed in what situation?
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Intubated anesthetized animals
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The Gold Standard test when monitoring for overall oxygenation ability of a patient is?
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PaO?
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Oxygen delivery to the body depends on what 3 things?
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Heart output, arterial oxygen content, & blood flow
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Normal animals should have an SpO? in what range?
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98-100
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An animal that is taking prolonged inspirations may have what kind of obstruction?
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Foreign body in upper airway
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A normal CO? range is?
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35-45 mmHg
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PaO? is measured on what kind of blood sample?
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Arterial
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When an animal is in respiratory distress the best position for them to be in physically is in sternal recumbency. True or False?
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False, lateral recumbency
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Elizabethan collars may be used to administer oxygen. True or False?
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True
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An animal may acquire oxygen toxicity by administering too much oxygen to them. True or False?
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True
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Four signs of respiratory distress in a Dog or Cat
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SpO? ?, cyanosis, prolonged inspirations, & RR ?
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Five things a Technician can do to assess an animal in respiratory distress
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Check character of animal (positioning, awareness, etc), PE, Radiographs, check MM, get RR
