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Questions and Answers
An anesthetized patient is showing signs of being too deeply anesthetized. Of the following, what is the MOST immediate action a veterinary technician should take?
An anesthetized patient is showing signs of being too deeply anesthetized. Of the following, what is the MOST immediate action a veterinary technician should take?
- Administer a reversal agent for the anesthetic drug.
- Start chest compressions.
- Increase the oxygen flow rate to flush the anesthetic gas.
- Immediately decrease the vaporizer setting. (correct)
During anesthesia, a patient's oxygen flow rate is set below 0.5 L/min. What complication is MOST likely to arise from this?
During anesthesia, a patient's oxygen flow rate is set below 0.5 L/min. What complication is MOST likely to arise from this?
- Improper functioning of the vaporizer. (correct)
- Reduced anesthetic agent vaporization, leading to inadequate anesthesia.
- Increased risk of hyperthermia due to inadequate gas exchange.
- Inaccurate readings on the capnograph.
An anesthetized patient shows signs of anesthetic overdose and cardiopulmonary arrest. After turning off the vaporizer and initiating IPPV with pure oxygen, what is the NEXT crucial step?
An anesthetized patient shows signs of anesthetic overdose and cardiopulmonary arrest. After turning off the vaporizer and initiating IPPV with pure oxygen, what is the NEXT crucial step?
- Begin IV fluid administration at a rapid rate.
- Flush the anesthetic system to remove residual inhalant. (correct)
- Administer reversal drugs immediately.
- Apply external heat to combat hypothermia.
An anesthetized patient exhibits a sudden increase in breathing system pressure during IPPV. What is THE MOST likely cause?
An anesthetized patient exhibits a sudden increase in breathing system pressure during IPPV. What is THE MOST likely cause?
During anesthesia, a patient develops pale mucous membranes. After confirming the oxygen supply and ventilation are adequate, which factor should be ruled out LAST?
During anesthesia, a patient develops pale mucous membranes. After confirming the oxygen supply and ventilation are adequate, which factor should be ruled out LAST?
Which of the following is NOT an indicator that a patient is too deeply anesthetized?
Which of the following is NOT an indicator that a patient is too deeply anesthetized?
What is the MOST appropriate initial intervention for a patient under anesthesia exhibiting a prolonged capillary refill time (CRT)?
What is the MOST appropriate initial intervention for a patient under anesthesia exhibiting a prolonged capillary refill time (CRT)?
What problem is MOST likely to result from tipping a vaporizer?
What problem is MOST likely to result from tipping a vaporizer?
An anesthetized canine patient has pale mucous membranes. After ensuring 100% oxygen delivery and proper IPPV, which of the following is the MOST likely cause to investigate FIRST?
An anesthetized canine patient has pale mucous membranes. After ensuring 100% oxygen delivery and proper IPPV, which of the following is the MOST likely cause to investigate FIRST?
During a surgical procedure, the anesthetized patient begins to exhibit a rapid, shallow breathing pattern (tachypnea). What is the most likely underlying cause of this?
During a surgical procedure, the anesthetized patient begins to exhibit a rapid, shallow breathing pattern (tachypnea). What is the most likely underlying cause of this?
You are using IPPV on an anesthetized patient but are getting poor lung compliance. You check the pressure manometer and it reads normal. Which cause of poor lung compliance is MOST likely?
You are using IPPV on an anesthetized patient but are getting poor lung compliance. You check the pressure manometer and it reads normal. Which cause of poor lung compliance is MOST likely?
Following a surgical procedure, a patient is recovering from anesthesia and exhibiting hypoventilation while breathing room air. What is the MOST appropriate immediate action?
Following a surgical procedure, a patient is recovering from anesthesia and exhibiting hypoventilation while breathing room air. What is the MOST appropriate immediate action?
What is the underlying physiological principle that makes hypoventilation during recovery from anesthesia a significant concern?
What is the underlying physiological principle that makes hypoventilation during recovery from anesthesia a significant concern?
An anesthetized patient is breathing shallowly and has pale mucous membranes. Which of the following is the MOST appropriate INITIAL response?
An anesthetized patient is breathing shallowly and has pale mucous membranes. Which of the following is the MOST appropriate INITIAL response?
During recovery from anesthesia, a patient's SpO2 drops below 90%. Besides increasing oxygen supplementation, what should be assessed NEXT?
During recovery from anesthesia, a patient's SpO2 drops below 90%. Besides increasing oxygen supplementation, what should be assessed NEXT?
Of the following options, which is NOT a step taken when responding to inadequate anesthetic depth?
Of the following options, which is NOT a step taken when responding to inadequate anesthetic depth?
What should be done to ensure accurate anesthetic delivery when using a vaporizer?
What should be done to ensure accurate anesthetic delivery when using a vaporizer?
An anesthetized patient experiences a sudden drop in blood pressure. The veterinarian asks you to help determine the cause. Which of the following is least likely to be the cause?
An anesthetized patient experiences a sudden drop in blood pressure. The veterinarian asks you to help determine the cause. Which of the following is least likely to be the cause?
In managing a patient with pale mucous membranes under anesthesia, when is consulting with the veterinarian MOST crucial?
In managing a patient with pale mucous membranes under anesthesia, when is consulting with the veterinarian MOST crucial?
An anesthetized patient develops bradycardia and prolonged CRT. After checking pulse strength and blood pressure, which of the following is the MOST appropriate next step?
An anesthetized patient develops bradycardia and prolonged CRT. After checking pulse strength and blood pressure, which of the following is the MOST appropriate next step?
What is the MOST crucial first step a veterinary technician should take when faced with an anesthetic emergency?
What is the MOST crucial first step a veterinary technician should take when faced with an anesthetic emergency?
Which of the following actions would BEST help in preventing anesthetic medical errors during a surgical procedure?
Which of the following actions would BEST help in preventing anesthetic medical errors during a surgical procedure?
During anesthesia, a patient's blood pressure suddenly drops. After ensuring the equipment is functioning correctly, which of the following '4 H's & 1 P' should the technician FIRST consider as a potential cause?
During anesthesia, a patient's blood pressure suddenly drops. After ensuring the equipment is functioning correctly, which of the following '4 H's & 1 P' should the technician FIRST consider as a potential cause?
What is the MOST appropriate action if an anesthetized patient begins to exhibit signs of cyanosis?
What is the MOST appropriate action if an anesthetized patient begins to exhibit signs of cyanosis?
What is the MOST important reason for maintaining a current and well-stocked crash cart in the surgical suite?
What is the MOST important reason for maintaining a current and well-stocked crash cart in the surgical suite?
While performing a leak test on an anesthesia machine, you notice that the system does not hold pressure even after closing the pop-off valve. What is the MOST likely cause?
While performing a leak test on an anesthesia machine, you notice that the system does not hold pressure even after closing the pop-off valve. What is the MOST likely cause?
During an anesthetic procedure, the technician notices the patient's SpO2 is gradually decreasing despite being on oxygen. What INITIAL action should the technician take?
During an anesthetic procedure, the technician notices the patient's SpO2 is gradually decreasing despite being on oxygen. What INITIAL action should the technician take?
What is the PRIMARY reason for using 'balanced anesthesia' with multiple drugs during a procedure?
What is the PRIMARY reason for using 'balanced anesthesia' with multiple drugs during a procedure?
What should a technician do if the APL valve is stuck in a closed or semi-closed position during a procedure using a rebreathing circuit?
What should a technician do if the APL valve is stuck in a closed or semi-closed position during a procedure using a rebreathing circuit?
What is the MOST appropriate way a veterinary technician can ensure effective closed-loop communication during an anesthetic emergency?
What is the MOST appropriate way a veterinary technician can ensure effective closed-loop communication during an anesthetic emergency?
Flashcards
Vaporizer Tipping
Vaporizer Tipping
Overdosing a patient due to anesthetic liquid splashing around inside the vaporizer
Vaporizer Problems
Vaporizer Problems
Results may include delivering too much anesthetic and overdosing the patient.
Animal waking up during Anesthesia
Animal waking up during Anesthesia
Setting is too low, leaks around ETT cuff, apnea, rapid shallow breathing or blocked/misplaced ETT.
IPPV
IPPV
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Inadequate Anesthetic Depth
Inadequate Anesthetic Depth
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Too Deeply Anesthetized - Breathing
Too Deeply Anesthetized - Breathing
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Too Deeply Anesthetized - MM Color
Too Deeply Anesthetized - MM Color
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Too Deeply Anesthetized - CRT
Too Deeply Anesthetized - CRT
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Too Deeply Anesthetized - HR
Too Deeply Anesthetized - HR
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Too Deeply Anesthetized - Hypotension
Too Deeply Anesthetized - Hypotension
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Anesthetic Overdose Action
Anesthetic Overdose Action
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Flush Anesthetic System
Flush Anesthetic System
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If Vet Unavailable...
If Vet Unavailable...
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Treating Pale Mucous Membranes
Treating Pale Mucous Membranes
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Prolonged CRT Definition
Prolonged CRT Definition
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Prolonged CRT First Action
Prolonged CRT First Action
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Pale Mucous Membranes - Check Depth
Pale Mucous Membranes - Check Depth
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Hypoventilation and Hypoxia
Hypoventilation and Hypoxia
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Prevent Hypoventilation
Prevent Hypoventilation
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Flow-by Oxygen
Flow-by Oxygen
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Technician's Role
Technician's Role
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The 4 H's & 1 P
The 4 H's & 1 P
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Prevent Medical Errors
Prevent Medical Errors
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Responding to Emergency
Responding to Emergency
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Causes of Problems
Causes of Problems
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Human Error Examples
Human Error Examples
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Reduce Adverse Effects
Reduce Adverse Effects
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ADS Issues
ADS Issues
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APL Valve Problems
APL Valve Problems
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Balanced Anesthesia
Balanced Anesthesia
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Study Notes
- Veterinary technicians play an active role in preventing and identifying common anesthetic problems
- Technicians must be knowledgeable about their skill set, available supplies, equipment, drugs, and patient status
- When unsure, ask for help or seek a second opinion
- Practice emergency scenarios with staff through role-playing
- Vet technicians are highly active in resuscitation efforts
- Maintain sufficient supplies to account for equipment failures or high consumption
Possible Anesthetic Problems
- Cardiac or respiratory arrest requires immediate intervention
- Tachycardia or tachypnea signals a potential issue
- Movement during anesthesia can compromise the procedure
- Overdose leads to dangerous physiological depression
- MM Cyanosis indicates inadequate oxygenation
- Adverse drug effects require careful monitoring and potential intervention
- Excitatory phase may occur during induction or recovery from anesthesia
The 4 H's and 1 P
- Hypothermia can prolong recovery and increase complications
- Hypoventilation impairs oxygenation and CO2 elimination
- Hypotension reduces tissue perfusion
- Hemorrhage requires rapid control to prevent shock
- Pain can cause stress and physiological instability
Equipment Complications
- BP cuff errors can lead to inaccurate readings
- Doppler cuff incompatibilities may hinder accurate blood pressure measurement
- ECG red dots not sticking can interfere with cardiac monitoring
- Patient positioning with tangled cords can pose risks
- Loose SpO2 Y-clip affects pulse oximetry readings
- Cuff or ETT deflation can compromise the airway
Preventing Medical Errors
- Proper preparation and organization
- Triple-checking math calculations
- Correct MOV cuff inflation
- Leak prevention in the Anesthesia Delivery System (ADS) reduces WAG exposure
- Regular vaporizer testing to ensure accurate drug delivery
Responding to Emergencies
- Think and triage before acting
- Know the location of supplies
- Ensure the crash cart is stocked and ready
- Keep drug lists and supplies updated
- Practice closed-loop communication
- Maintain calm and clarity
- Post emergency follow-up discussions
Causes of Anesthetic Problems
- Human error contributes to complications
- Equipment failure leads to anesthetic problems
- Adverse effects of drugs can cause anesthetic problems
- Increased patient risk may increase anesthetic problems
Human Error
- Inadequate training and unfamiliarity with equipment or agents
- Failure to obtain adequate history impacts patient safety
- Failure to perform adequate physical examination may result in complications
- Drug calculation and administration errors
- Errors caused by fatigue, haste, or inattention increase risks
- Inadequate care and maintenance of supplies and equipment
- Inappropriate operation of equipment
- Equipment-related errors
Adverse Effects
- Adverse effects can be reduced
- Select a protocol tailored to the patient's needs
- Know the disadvantages, adverse effects, and contraindications
- Multi-drug protocols are safer than single drug protocols
- Administer the minimal required amount
- Titrate drugs
- Frequently adjust inhalant concentrations based on depth assessments
Equipment: ADS Issues
- Equipment failure or inaccuracy during operation
- Exhausted carbon dioxide absorbent
- Failed oxygen supply during anesthesia
- Blocked ETTs (Endotracheal Tubes) prevent ventilation
- Disconnected or kinked connections disrupt gas flow
- Blocked parts, stuck flutter valves, or a non-patent scavenge system
APL / Pop-Off Valve Problems
- Leaving the pop-off valve closed risks barotrauma
- Distractions and oversights leaving pop-off valve closed
- Cracks and breaks in the valve compromise its function
- Semi-closed pop-off valves can cause pressure issues
- Faulty components within the APL valve
- If the APL valve decompresses during a leak test that may pose an issue and is not suitable for use
Vaporizer Problems
- Problems often cause overdose
- Avoid using the wrong anesthetic agent by utilizing key fillers
- Tipping or moving the vaporizer can interfere with accurate concentration
- A stuck or jammed vaporizer dial causes serious issues
- Overfilling the vaporizer can cause inaccuracies
- Avoid operating with two vaporizers at once
- Ensure oxygen flow rate is than 0.5L/min for most vaporizers
- Ensure the vaporizer is within delivery specifications or serviced regularly
Common Emergencies During Anesthesia
- Animal Wont Stay Anesthetized
- Inadequate Vaporizer setting
- Leaks around ETT
- Apnea or inadequate tidal volume during ventilation
- Rapid, shallow breathing or tachypnea
- A blocked, misplaced or disconnected ETT during a procedure
- Check that the endotracheal tube not blocked, is in the trachea and that breathing circuit is properly attached
Responding to Adequate Anesthetic Depth
- Be prepared to give injectable anesthetic drugs to keep patient asleep with propofol or MAC sparing agent
- Inadequate oxygen flow during the procedure
- Check ventilator
- A vaporizer inadequately filled with liquid anesthetic
- Re-check the monitoring parameters of the patient
- Consult the team for troubleshooting the situation
- Switch the patient to another machine
Too Deeply Anesthetized
- < rpm, or very swallow or exaggerated breaths
- Pale or cyanotic MM
- CRT >2 seconds
- Bradycardia while under
- Hypotension is occuring
- Weak pulse, systolic blood pressure less than 80mmHG
- Cardiac Arrythmias
- Absent reflexes
- Flaccid muscles & jaw tones
- DIlated pupils, absent PLR, centrally positioned eyes
- Decrease vaporizer setting immediately
- Inform vet
- Turn of vaporizer and begin to ventilate using 100% O2
Pale Mucous Membranes
- Preexisiting conditions may lead to this
- Blood loss during surgery
- Anesthetic agents that cause vasodilation and hypotension, or vasoconstriction
- Hypothermia can lead to pale mucous membranes
- Pain felt during the procedure
- Stress imposed on animal
Treating Pale Mucous Membranes
- Check the depth of the animal
- Check other signs like HR, pulse strength and CRT
- Provide IPPV to rule our problems with 02 delivery
- Rule out possible causes including hypothermia, hypotension, drug reactions
- Vet should then be consulted
Prolonged CRT
- Blood pressure cannot adequately be perfusing superficial tissues
- May secondary to blood loss during surgery
- Immediately check animal's pulse and BP
Hypotension
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Less than 80 systolic
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Less than 50 diastolic
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Less than 60 mean
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Prevention is key, recognize trends in the animal
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Keep Patient Warm
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Reduce Inhalant
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Inhalant detach and detach ADS from ETT and flush system. Only administer 02
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Reverse all agents
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Capnography = or > 15ETC02
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May need to add more air to the cuff
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Description
Veterinary technicians play a crucial role in preventing and identifying common anesthetic problems. Knowledge of skills, equipment, drugs, and patient status is essential. Addressing issues like cardiac arrest, respiratory distress, and adverse drug effects requires immediate intervention.
