Veterinary Anesthesia Concepts
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Questions and Answers

What does an increased ETCO2 level generally indicate?

  • Hypoventilation (correct)
  • Hyperventilation
  • Normal ventilation
  • Airway obstruction
  • Hypothermia is indicated by an increased ETCO2 level.

    False (B)

    What is the golden standard for direct blood pressure analysis?

    Sterile catheter injected into peripheral artery

    In dogs, a systolic blood pressure greater than ______ mmHg is considered normal.

    <p>90</p> Signup and view all the answers

    Match the following terms with their definitions:

    <p>Doppler = Predicts MAP better for blood pressure readings Oscillometric BP = Reads systolic, diastolic, and MAP ETCO2 = Measures inspired and expired CO2 Capnography = Non-invasive monitoring of ventilation</p> Signup and view all the answers

    Which of the following conditions may cause falsely high CO readings?

    <p>Cyanide poisoning (A)</p> Signup and view all the answers

    What is the normal range for mean arterial pressure (MAP) in dogs?

    <p>60-100 mmHg</p> Signup and view all the answers

    Which type of oxygen cylinder is commonly used?

    <p>E cylinder (D)</p> Signup and view all the answers

    A closed pop-off valve can cause a patient's alveoli to burst.

    <p>True (A)</p> Signup and view all the answers

    What is the primary function of an oxygen concentrator?

    <p>To absorb nitrogen and increase oxygen concentration.</p> Signup and view all the answers

    The vaporizer setting should not be set too _____ to ensure patient safety.

    <p>high</p> Signup and view all the answers

    Which color represents Isoflurane in vaporizers?

    <p>Purple (B)</p> Signup and view all the answers

    Cryogenic liquid oxygen containers are less expensive and commonly used in smaller clinics.

    <p>False (B)</p> Signup and view all the answers

    What is the first step in performing a machine leak test on an anesthesia machine?

    <p>Turn off O2 flow.</p> Signup and view all the answers

    What is the primary difference between local anesthesia and general anesthesia?

    <p>Local anesthesia causes loss of sensation in a specific area. (A)</p> Signup and view all the answers

    The fresh gas inlet delivers a mixture of gases and _____ from the anesthesia machine.

    <p>vapors</p> Signup and view all the answers

    Match the following anesthetic agents with their corresponding colors in vaporizers:

    <p>Isoflurane = Purple Sevoflurane = Yellow</p> Signup and view all the answers

    Sedation involves the patient being fully unconscious.

    <p>False (B)</p> Signup and view all the answers

    What does pharmacokinetics study?

    <p>The study of what the body does to drugs.</p> Signup and view all the answers

    What is the maximum oxygen titration if a leak is detected during the machine leak test?

    <p>300 ml/min</p> Signup and view all the answers

    The combination of a sedative/tranquilizer with an opioid is referred to as __________.

    <p>neuroleptanalgesia</p> Signup and view all the answers

    Match the type of drug with its appropriate description:

    <p>Local Anesthesia = Loss of sensation in a specific area Analgesia = Absence of sensitivity to pain Sedation = Depression of the CNS while awake Tranquilization = Relaxation while aware of surroundings</p> Signup and view all the answers

    What factors are included in a patient evaluation prior to anesthesia?

    <p>Signalment, history, labwork, temperament (B)</p> Signup and view all the answers

    The veterinarian should document the entire conversation with the client after the patient evaluation.

    <p>True (A)</p> Signup and view all the answers

    Converting a percentage to mg/ml involves moving the decimal place to the __________.

    <p>right</p> Signup and view all the answers

    What is the main purpose of the Murphy design in an endotracheal (ET) tube?

    <p>To prevent accidental occlusion (D)</p> Signup and view all the answers

    Cuff inflation should allow for some escape of gas during manual breaths.

    <p>False (B)</p> Signup and view all the answers

    What is the recommended oxygen flow rate during anesthesia maintenance?

    <p>22 ml/kg/min</p> Signup and view all the answers

    The _____ is a light source used for airway visualization placed under the epiglottis.

    <p>laryngoscope</p> Signup and view all the answers

    Match the stages of anesthesia with their characteristics:

    <p>Stage I = Voluntary movement post drug administration Stage II = Delirium with involuntary movement Stage III Plane I = Light anesthesia with some eye movement Stage IV = Extreme CNS depression and risk of death</p> Signup and view all the answers

    Which of the following are factors that may affect patient monitoring depth during anesthesia? (Select all that apply)

    <p>Physical status of the patient (B), Ketamine use (D)</p> Signup and view all the answers

    The palpebral reflex is commonly used to assess anesthesia depth, as it does not risk injury to the eye.

    <p>True (A)</p> Signup and view all the answers

    What is considered the 'danger zone' of anesthesia?

    <p>Stage IV</p> Signup and view all the answers

    In the case where there is air but no gas exchange, it is referred to as _____ space.

    <p>dead</p> Signup and view all the answers

    Which type of ET tube is commonly used and has a safety feature to prevent occlusion?

    <p>Murphy tube (A)</p> Signup and view all the answers

    At what pressure should an oxygen cylinder be changed?

    <p>500 psi (D)</p> Signup and view all the answers

    The non-rebreathing system is preferred for larger pets.

    <p>False (B)</p> Signup and view all the answers

    What is the formula to calculate the reservoir bag volume based on body weight (BW)?

    <p>BW (kg) x tidal volume (mL/kg) x 5</p> Signup and view all the answers

    The _____ system uses a CO2 absorption canister to prevent rebreathing.

    <p>Rebreathing</p> Signup and view all the answers

    Which of the following is a disadvantage of the rebreathing system?

    <p>More resistance for smaller patients (D)</p> Signup and view all the answers

    Match the scavenging systems with their characteristics:

    <p>Passive = Replaced after 50g in weight Active = Utilizes central vacuum collection Both = Keeps anesthetic agents below 2ppm</p> Signup and view all the answers

    Chemical absorption in the rebreathing system prevents the rebreathing of oxygen.

    <p>False (B)</p> Signup and view all the answers

    What are the two types of breathing systems in anesthesia?

    <p>Rebreathing and Non-rebreathing</p> Signup and view all the answers

    Manual ventilation is performed by squeezing the reservoir bag and temporarily occluding the _____ valve.

    <p>APL</p> Signup and view all the answers

    What is the primary concern if the anesthesia machine and breathing system are not checked properly?

    <p>Environmental pollution (A)</p> Signup and view all the answers

    A closed pop-off valve can lead to lung collapse by preventing oxygen from being removed from the alveoli.

    <p>True (A)</p> Signup and view all the answers

    The ______ is a safety feature that prevents the pop-off valve from closing completely, ensuring oxygen can always flow out of the system.

    <p>pop-off occlusion valve</p> Signup and view all the answers

    What is the main concern if the anesthesia machine and the breathing system are not properly checked?

    <p>Both A and B (C)</p> Signup and view all the answers

    The rebreathing system is preferred for smaller pets.

    <p>False (B)</p> Signup and view all the answers

    Which of the following is NOT a factor that could lead to patient death if used improperly on an anesthesia machine?

    <p>Excessive fresh gas flow (C)</p> Signup and view all the answers

    What is the maximum oxygen flow rate you should titrate to if a leak is detected during the machine leak test?

    <p>300 ml/min</p> Signup and view all the answers

    During the machine leak test, the pressure gauge should be observed for ______ seconds to check for any pressure drop indicating a leak.

    <p>30</p> Signup and view all the answers

    What is the purpose of the vaporizer?

    <p>To change liquid anesthetic agent into vapor in a controlled manner.</p> Signup and view all the answers

    Which of the following is NOT a sign of adequate anesthetic depth?

    <p>Strong palpebral reflex (C)</p> Signup and view all the answers

    The Bispectral Index (BI) is primarily used in veterinary medicine to assess anesthetic depth.

    <p>False (B)</p> Signup and view all the answers

    What are two reasons why monitoring anesthetized patients is crucial?

    <p>To ensure adequate blood flow and ventilation, and to create a legal record of the patient's condition during anesthesia.</p> Signup and view all the answers

    A ______ stethoscope is used to listen to the patient's heart and lung sounds during anesthesia.

    <p>esophageal</p> Signup and view all the answers

    Match the following monitoring techniques with their corresponding descriptions:

    <p>Doppler = Measures systolic, diastolic, and mean arterial pressure Oscillometric = Measures only systolic arterial pressure Pulse Oximetry = Indirect measurement of % O2 saturation of hemoglobin + HR Esophageal Stethoscope = Passed to the level of the heart to auscultate heart and lung sounds Rectal Thermometer = Used to measure body temperature</p> Signup and view all the answers

    Which monitoring parameters can be affected by cuff size?

    <p>Noninvasive blood pressure (D)</p> Signup and view all the answers

    White tape should be used to secure the cuff for noninvasive blood pressure measurements.

    <p>False (B)</p> Signup and view all the answers

    What are two factors that can affect the accuracy of pulse oximetry readings?

    <p>The placement of the probe, and the presence of excessive hair or movement.</p> Signup and view all the answers

    A BI value of 60 indicates ______ under anesthesia.

    <p>adequate depth</p> Signup and view all the answers

    Which of the following is a common complication associated with anesthesia?

    <p>Hypothermia (B)</p> Signup and view all the answers

    A decreased ETCO2 level can indicate hyperventilation.

    <p>True (A)</p> Signup and view all the answers

    Which of the following conditions can lead to a falsely high ETCO2 reading?

    <p>Cyanide poisoning (A)</p> Signup and view all the answers

    The normal systolic blood pressure range for dogs is ______ mmHg.

    <p>90-120</p> Signup and view all the answers

    Which of the following factors can affect the accuracy of oscillometric blood pressure readings?

    <p>All of the above (F)</p> Signup and view all the answers

    Doppler blood pressure readings provide a more accurate estimation of MAP compared to systolic readings.

    <p>True (A)</p> Signup and view all the answers

    Hypoventilation is associated with an ______ ETCO2 level.

    <p>increased</p> Signup and view all the answers

    What are some potential causes of decreased ETCO2 levels?

    <p>Hyperventilation, hypothermia, and airway obstruction</p> Signup and view all the answers

    Which of the following is NOT a common reason for an inaccurate oscillometric BP reading in a patient?

    <p>Recent consumption of a large meal (B)</p> Signup and view all the answers

    The electrical activity of the heart can be measured using an electrocardiogram (ECG), even if the animal is dead.

    <p>True (A)</p> Signup and view all the answers

    Which of the following is NOT a common complication during anesthesia?

    <p>Hypertension (D)</p> Signup and view all the answers

    The four most common issues with anesthesia are often referred to as the four ______.

    <p>H's</p> Signup and view all the answers

    Match the following vital signs with their normal ranges under anesthesia.

    <p>PaO2 = &gt; 95% ETCO2 = 35-45 mmHg MAP (dogs) = 60-100 mmHg SAP = 90-120 mmHg RR = 10-20 bpm Temp = 98-102.5 °F HR (dogs) = 50-160 bpm</p> Signup and view all the answers

    What are the four mechanisms of heat loss?

    <p>Radiation, Convection, Conduction, and Evaporation</p> Signup and view all the answers

    Which two mechanisms of heat loss contribute the most to overall heat loss?

    <p>Radiation and Convection (C)</p> Signup and view all the answers

    Hyperthermia is always caused by a failure of thermoregulation.

    <p>False (B)</p> Signup and view all the answers

    Flashcards

    Anesthesia

    Insensibility; loss of sensation in a body part or the whole body.

    Analgesia

    Absence of sensitivity to pain; not feeling pain anymore.

    Sedation

    Depression of the CNS; the patient is calm but not fully unconscious.

    Tranquilization

    Relaxing the patient while they remain aware of surroundings.

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    Neuroleptanalgesia

    Combination of a sedative/tranquilizer and an opioid for pre-medication.

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    Pharmacokinetics

    Study of what the body does to drugs; includes metabolism and half-lives.

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    Pharmacodynamics

    Study of what drugs do to the body; important for anesthesiologists.

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    Patient Evaluation

    Assessment prior to anesthesia; includes history, exams, and diagnostics.

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    Boyle's Law

    The relationship P1/V1 = P2/V2 in gases, describing pressure and volume changes.

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    Oxygen Cylinder Replacement Pressure

    Change oxygen cylinder when pressure drops below 500 psi.

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    Manual Ventilation Process

    Using a reservoir bag, squeeze and occlude APL valve for ventilation.

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    Tidal Volume Calculation

    BW (kg) x tidal volume (mL/kg) x 5 for ventilation needs.

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    Rebreathing System

    Circle system preventing CO2 rebreathing with chemical absorption canisters.

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    Non-rebreathing System

    Preferred for small pets, less resistance, but higher oxygen flow rates.

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    Mapleson D and F

    Types of breathing systems; Mapleson D is common with bain circuits.

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    Passive Scavenging System

    Uses charcoal to absorb anesthetic gases, effective but limited in flow rates.

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    Active Scavenging System

    Central vacuum collects waste gases, more effective but costly.

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    Environmental Safety in Anesthesia

    Improper checks may cause environmental pollution and patient hypoxemia.

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    Oxygen Cylinder (E cylinder)

    A commonly used cylinder for storing oxygen, made of steel or aluminum.

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    Cryogenic Liquid Oxygen Containers

    Large containers used for consistent O2 supply at facilities, resembling a big thermos.

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    Oxygen Concentrator

    A device that increases oxygen concentration by absorbing nitrogen from the air.

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    Modern Vaporizers

    Devices that convert liquid anesthetic into vapor; have varying colors for different agents.

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    Closed Pop-off Valve

    A valve that should always be kept open to allow excess oxygen to escape during usage.

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    Machine Leak Test Steps

    A process to perform a pressure check on anesthesia machines to ensure no leaks.

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    APL Valve

    A valve that must be closed during leak tests, otherwise remains open for normal operation.

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    Vaporizer Setting Importance

    Setting that controls the amount of anesthetic vapor; too high can be harmful.

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    Oxygen Remaining Calculation

    Calculating the remaining oxygen in a cylinder, based on psi and flow rate.

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    Pressure Gauge Observation

    Monitoring pressure gauge during a leak test to check for drops in pressure.

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    End tidal CO2 (ETCO2)

    A measurement of CO2 levels in exhaled air, indicating ventilation status.

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    Hypoventilation

    Reduced breathing rate leading to increased ETCO2 levels.

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    Hyperventilation

    Increased breathing rate resulting in decreased ETCO2 levels.

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    MAP in dogs

    Mean Arterial Pressure (MAP) should exceed 60 mmHg for adequate blood flow.

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    Doppler BP

    A method to measure blood pressure, particularly predicting MAP.

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    Direct BP analysis

    The gold standard for measuring blood pressure via a catheter in an artery.

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    Capnography

    The monitoring of the concentration of CO2 in exhaled air.

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    Endotracheal Tube (ETT)

    A tube inserted into the trachea to maintain an open airway and deliver anesthetic gases.

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    Murphy's Eye

    An oval hole in the Murphy endotracheal tube to prevent occlusion.

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    Dead Space

    Areas in the respiratory system where gas exchange does not occur.

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    Cuff Inflation Technique

    Method to inflate the ETT cuff to prevent gas escape during ventilation.

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    Oxygen Flow Rate for Anesthesia

    Beginning flow rate is 44 ml/kg/min, then 22 ml/kg/min during maintenance.

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    Palpebral Reflex

    A reflex test used during anesthesia to assess consciousness; gentle touch near eye.

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    Stages of Anesthesia

    Progression from light sedation (Stage I) to overdose (Stage IV).

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    Surgical Plane of Anesthesia

    Stage III of anesthesia where surgeries are performed, with controlled reflexes.

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    Factors Affecting Anesthesia Monitoring

    Medications like Ketamine or Propofol affect responsiveness and pain perception.

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    Oxygen Cylinder Explosion Hazard

    Open oxygen cylinder valves slowly to prevent explosions.

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    Large Cryogenic Oxygen Containers

    Big containers for liquid oxygen; used in larger facilities.

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    Oxygen Concentrator Function

    Increases oxygen concentration by absorbing nitrogen from air.

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    Vaporizer Function

    Changes liquid anesthetics to vapor for controlled delivery.

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    Closed Pop-off Valve Risk

    Closing this valve can cause lung damage due to pressure buildup.

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    Vaporizer Color Codes

    Different anesthetics are identified by specific colors: iso = purple, sevo = yellow.

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    Oxygen Calculation Basics

    Calculate remaining oxygen by using psi and flow rate figures.

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    Pressure Check Requirement

    Always check O2 cylinder pressure, replace < 500 psi.

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    Reservoir Bag Calculation

    Formula: BW (kg) x tidal volume (mL/kg) x 5.

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    Manual Ventilation Technique

    Squeeze reservoir bag and occlude APL valve for ventilation.

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    Rebreathing System Pros

    Lower O2 flow rates and easier setup with CO2 absorption.

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    Non-Rebreathing System Pros

    Less resistance, little dead space, fewer components for smaller pets.

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    Types of Scavenging Systems

    Passive (charcoal absorption) or Active (vacuum collection) systems.

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    Advantages of Active Systems

    More effective in removing anesthetic gases but expensive.

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    Passive Scavenging Drawbacks

    Low flow rates, environmental impact, replace after 50g.

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    Cylinder Size E

    Cylinder E is 660L and 2200 psi for oxygen storage.

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    Tidal Volume Standard

    Initial tidal volume is 10 mL/kg for manual ventilation.

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    Bispectral Index (BI)

    A scale analyzing EEG values to monitor anesthesia depth, ranging from 0 (flat) to 100 (awake).

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    Monitoring Anesthetized Patients

    Essential for ensuring blood flow, ventilation, and tracking anesthetic events.

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    Eye Position in Anesthesia

    Ventral medial eye position indicates a certain depth of anesthesia and muscle relaxation.

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    Pulse Oximetry (SPO2)

    Noninvasive method to measure oxygen saturation of hemoglobin and heart rate.

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    Noninvasive Blood Pressure (BP)

    Methods like Doppler or oscillometric to measure arterial pressure without invasive techniques.

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    Esophageal Stethoscope

    A device passed to the heart's level to auscultate heart sounds during anesthesia.

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    Temperature Monitoring

    Crucial for tracking body temperature, often measured via the esophagus or rectum.

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    Mean Arterial Pressure (MAP)

    Average arterial pressure in a patient's body, crucial for adequate blood flow.

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    Oscillometric Method

    A technique used to predict systolic arterial pressure through oscillations in the arterial wall.

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    ECG Measurement

    An electrocardiogram measures the electrical activity of the heart, indicating its function.

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    P Wave

    The P wave on ECG represents atrial depolarization, the initial electrical activity of the heart's contraction.

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    Heat Loss Mechanism

    Heat loss occurs through radiation, convection, conduction, and evaporation; radiation and convection are most significant.

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    Hypothermia Symptoms

    Hypothermia during anesthesia can cause decreased respiratory rate, renal dysfunction, and hypokalemia.

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    Common Anesthesia Issues

    The four most common complications during anesthesia are hypothermia, hypoxemia, hypotension, and hypoventilation.

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    Hyperthermia Causes

    Hyperthermia occurs when the body's temperature regulation fails, leading to potentially dangerous conditions.

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    Increased ETCO2

    Indicates hypoventilation, which can occur during conditions like malignant hyperthermia.

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    Decreased ETCO2

    Indicates hyperventilation, possible causes include hypothermia or airway obstruction.

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    Machine Leak Diagnosis

    Often identified by fluctuations in ETCO2 during anesthesia monitoring.

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    Study Notes

    Anesthesia Learning Objectives

    • Anesthesia involves loss of sensation (in part or whole body)
    • Local vs general anesthesia
    • Analgesia is absence of pain sensation
    • Sedation is CNS depression without unconsciousness
    • Tranquilization involves relaxation while patient is aware
    • Neuroleptanalgesia combines sedatives/tranquilizers and opioids.
    • Pharmacycokinetics: study of how body affects drugs (metabolism, half-life)
    • Pharmacodynamics: study of how drugs affect the body

    Fluid Drip Rates

    • 10 and 15 drops per mL for macro-drip sets (larger dogs)
    • 60 drops per mL for micro-drip sets (cats, exotics, small dogs)
    • 1 mg = 100 mcg (ug)

    Lecture 2: Pre-anesthesia Patient Evaluation

    • Veterinarian performs pre-anesthesia evaluation
    • Evaluation includes signalment, history, physical exam, blood/urine samples, temperament assessment, pain, stress, and diagnostics.
    • Labwork for healthy pets includes PCV, TS, Glucose, BUN (protein byproduct).
    • Labwork for older/unhealthy pets includes CBC, chemistry, urinalysis.

    When to Perform Pre-anesthesia Evaluation

    • Day before procedure or up to one week before.
    • To assess and analyze the procedure risk.
    • Document all client conversations.

    Pre-anesthesia Preparation

    • Small Ruminants: withhold food (12-18 hours) and water (8-12 hours).
    • Equine: withhold food (4-12 hours) and water (until pre-med).
    • Cattle: withhold food (18-24 hrs) and water (12-18 hours)
    • Rodents, Rabbits, Birds: No fasting.
    • Feeding schedule adjustments depend on species.

    Anesthetic Concerns

    • Hypotension (low blood pressure)
    • Hypoventilation (slow breathing)
    • Hypothermia (low body temp)
    • Hypoxemia (low oxygen levels)
    • Dehydration (less than 5% dehydration = undetectable and could have significant health impact).

    ASA Physical Status Scale

    • Categories of patient surgical risk from very healthy to severe systemic disease.
    • I: Normal, healthy
    • II: Minor skin lesions, tumors, fractures, pregnancies, and obesity.
    • III: Systemic diseases such as fever, anemia, and kidney issues.

    Safety Mechanisms in Anesthesia

    • Prevent use of wrong medical gas during oxygen flow.
    • Oxygen = green, N2O = blue.
    • PISS and DISS connections used to ensure correct gas flow.
    • Safety mechanisms help prevents wrong gas usage.

    Oxygen Sources in Veterinary Medicine

    • Cylinders (E cylinder)
    • Steel or aluminum commonly used
    • Large liquid oxygen containers.
    • Oxygen concentrators

    Steps for Machine Leak Test

    • Turn oxygen flow off
    • Close APL valve (only if needed for machine leak testing).
    • Occlude Y-piece at patient end, using an occlusion valve to pressurize to 30 cmH2O.
    • Observe pressure gauge for 30 seconds.
    • If no drop in pressure, open the APL valve, and remove the occlusion and titrate oxygen if a leak is detected.

    Cylinder Size Calculation:

    • Given psi and oxygen flow rate, calculate remaining oxygen (L) and the time.
    • P1/V1 = P2/V2, Divide liters by psi to get same number.

    Reservoir Bag Calculation

    • Round up when calculating tidal volume.
    • BW (kg) x tidal volume (mL/kg) x 5

    Safety Concerns in Anesthesia Equipment

    • Environmental pollution
    • Patient becoming hypoxic/hypoxemic
    • 2 types of breathing systems: Rebreathing (circle system) and Non-rebreathing systems.

    Scavenging systems

    • 2 types: Active (waste products removed actively) and passive (waste products are absorbed).

    Types of ET Tubes

    • Different sizes and types for different species (e.g., Murphy, Magill)--different features for different species.

    Confirming ETT Placement Methods

    • Capnography readings (CO2 levels)
    • Auscultation of breath sounds bilaterally to ensure correct tube placement.

    Hypothermia Treatment

    • Avoiding antibiotics during Hypothermia as it's not the usual treatment.
    • Active cooling with fluids, fans, covering to decrease body heat.
    • Stopping cooling at 104 degrees to prevent rebound hypothermia.

    IVF Maintenance Rates

    • 40-60 ml/kg/day.

    Anesthesia Planes:

    • Stages to indicate patient levels of sedation through surgery.
    • Specific signs, reactions, and measurements are described for each anesthetic plane.
    • Monitoring patient response to anesthesia is crucial for maintaining patient safety during the surgical procedure.

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