Term
|
Definition
| a compilation of pertinent info gleaned from the pt hx, PE, and dx tests, which the VIC will use to determine the pt's physical status and anes risk and to select an appropriate anes protocol |
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Term
| minimum pt database consists of |
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Definition
1. Pt hx including the pt signalment
2. complete PE findings
3. results of a preanes dx workup |
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Term
| what to ask when gathering historical info about signs of an illness |
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Definition
1. duration
2. the volume or severity
3. the frequency
4. the character or appearance |
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Term
| Sighthounds are sensitive to ? |
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Definition
| Sighthounds such as greyhounds and salukis are sensitive to barbiturates beacuse of their relative lack of body fat and slow metabolism of these agents compared with other breeds. Consequently these drugs must be used cautiously or not at all in these pts. |
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Term
| Boxers and giant breeds are more sensitive to ? |
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Definition
| acepromazine than other breeds, whereas terriers are resistant |
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Term
| What pts respond to anes procedures differently than other animals and have special needs of which the anes mst be aware? |
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Definition
| pts that are very large, very small, or very old (>75% of the normal lifespan |
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Term
why are neonates and geriatric pts less
able to tolerate some drugs? |
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Definition
| neonates or ped pts are much less capable of metabolizing injectable drugs than are adult animals because the necessary liver metabolic pathways are not fully developed. Geriatric pts may be unable to tolerate normal doses of some drugs because of poor hepatic or renal fxn. The result in either case may be a slow recovery from anes, particularly if doses of inj drugs are not adjusted accordingly |
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Term
| other considerations with young pts? |
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Definition
| more difficult to intubate and catheterize, more subject to dosing errors, more prone to hypothermia and hypoxia, and have a weaker resp dirve. |
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Term
| When obtaining the pre-anesthetic hx, determine... |
|
Definition
the signalment,
current and past illnesses
meds
allergies or drug rxns
status of preventative care |
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Term
| Cats, small dogs and small animal peds are prone to __ |
|
Definition
| hypoxemia and hypercarbia caused by increased mechanical dead space. |
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Term
| a PE finding of dehydration |
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Definition
| increases risk for anes comp incl hypotension, poor tissue perfusion, and kidney damage |
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Term
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Definition
| dcreases the o2-carrying capacity of the blood nad predisposes the pt to hypoxemia |
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Term
| a PE finding of bruising lesions on the skin or mm, in the absence of trauma, |
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Definition
| often indicate a clotting disorder, which will increase the risk of potenially life-threatening intraoperative and postoperative bleeding |
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Term
| a PE finding of respiratory or cardiovascular dz |
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Definition
| increases the risk of anes comp and death |
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Term
| a PE finding of abnormalities of abdominal organs such as an enlarged liver or abnormally small kidneys |
|
Definition
| may be assoc with abnormal organ function and a reduced ability to metabolize or excrete anesthetic agents |
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Term
| When pts are significantly overweight, anesthetics should be dosed __ |
|
Definition
| according to lean body wt (excluding body fat) instead of total body wt. because body fat increases the total body wt but not the volume or wt of the nervous tissue. |
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Term
| Assessing hydration status |
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Definition
| somewhat subjective as parameters are affected by body fat contenet, age, and other factors. Young and obese appear more hydrated, old and chachetic may appear less. Panting may dry mm, appearing less hydrated. |
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Term
| What is an excellent indicator of hydration? |
|
Definition
| careful serial monitoring of body wt - a sudden loss of 1 kg corresponds to 1 L of fluid loss |
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Term
|
Definition
| pts with a mildly decreased LOC that can be aroused with minimal difficulty |
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Term
|
Definition
| pts that are more depressed and can not be fully aroused |
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Term
|
Definition
| a sleeplike state and can be aroused only with a painful stimulus |
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Term
|
Definition
| cannot be aroused and is unresponsive to all stimuli including pain |
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Term
| Normal vital signs in a nonanesthetized dog |
|
Definition
| T 100 - 102.5, HR 60 - 180 (lower for larger, higher for smaller), Heart rhythm NSR or SA, RR 10 - 30 |
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Term
| Normal vital signs in a nonanesthetized cat |
|
Definition
| T 100 - 102.5, HR 120 - 140, heart rhythm NSR only, RR 150 - 30 |
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|
Term
| Normal vital signs in a nonanesthetized horse |
|
Definition
| T 99 - 100.5, HR 30-45, heart rhythm NSR, SA or first or second degree AV block, RR 8-20 |
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Term
| Normal vital signs in a nonanesthetized cow |
|
Definition
| T 102 - 104, HR 60-90, heart rhythm NSR or SA, RR 80-20 |
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Term
| Normal vital signs in a nonanesthetized sheep/goat |
|
Definition
| T 102-104. HR 60-90, heart rhythm NSR or SA, RR 16-24 |
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Term
| Where are the heart rate and rhythm most easily evaluated? |
|
Definition
| auscultation of the heart over the left chest wall at the point of maximal intensity |
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Term
| What if the audible intensity os decreased, as in obese pts? |
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Definition
| sometimes palpation for the apical pulse is helpful to locate the optimal area for placement. When teh apical pulse is not palpable, the anesthetist must carefully search in the region of the left axilla for a spot where the heart is most palpable. systematic, small measured chenges in the position of the stethoscope head until the optimal area is located. |
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Term
| A decreased heart sound intensity in a nonobese pt __ |
|
Definition
| may indicate pericardial or pleural effusion |
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Term
|
Definition
| completely regular rhythm with no irregularities or pauses between beats, although the rate may change in response to excitement level |
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Term
|
Definition
| the heart rate cyclically increases during inspiration and decreases during expiration. may be pronounced in young healthy dogs and may cause the inexperienced to to think there are skipped or premature beats. Abnormal rhythms can be differentiated from SA by observing the resp while listening to the heart |
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Term
| first-degree atrioventricular heart blcok |
|
Definition
| caused by a conduction delay through an AV node and is recognized by a prolonged PR interval on an ecg tracing. causes no noticable change in heart sounds and can be detected only by ecg |
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Term
|
Definition
| caused by a periodic block of electrical conduction through the AV node and recognized by missing QRS complex. on auscultation, periodic pauces representing skipped beats are audible. not normal for more than one beat to be skipped in a row. |
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Term
|
Definition
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Term
| pale mm or prolong CRT indicative of __ |
|
Definition
| decreased perfusion from shock, vasoconstriction, hypotension, or a variety of other issues. Pale mm can also be assoc with anemia. cyanotic mm indicate reduced o2 sat |
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Term
|
Definition
| may exhibit mouth breathing, flared nostrils, excessive panting, exaggerated chest or abdo movements on inspiration, wheezing, and reluctance to lie down. in extreme cases a dyspneic animal may exhibit cyanosis |
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Term
| physical status classification |
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Definition
| the most widely accepted is the one adopted by the ASA. rates pt risk from minimal (P1) to extreme (P5) based on pt health. classification of risk is somewhat objective and may change over time |
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Term
|
Definition
| minimal risk, normal healthy pt, pts undergoing electives (OVH, castration, declaw) |
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Term
|
Definition
| Low risk, pt w/ mild systemic dz, neonatal, geriatric, or obese pts. mild dehydration, skin tumor removal |
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Term
|
Definition
| moderate risk, pt w/ severe systemic d, anemia, moderate dehydration, compensated major organ dz |
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Term
|
Definition
| high risk, pt w/ severe systemic dz that is a constant threat to life, ruptured bladder, internal hemorrhage, pneumothorax, pyometra |
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Term
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Definition
| extreme risk, moribund pt that is not expected to survive w/o the operation |
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Term
| What physical exam findings would a patient that is 2% to 3% dehydrated have? |
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Definition
|
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Term
| . What physical exam findings would a patient that is 5% to 6% dehydrated have? |
|
Definition
| Mild loss of skin elasticity |
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Term
| What physical exam findings would a patient that is 6% to 8% dehydrated have? |
|
Definition
| Definite loss of skin elastiticty, may have dry mucus membranes, may have depressed globes within orbits |
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Term
| What physical exam findings would a patient that is 8% to 10% dehydrated have? |
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Definition
| Persistent skin tent with slow return because of loss of skin elasticity |
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Term
| Know the normal fasting times for dogs/cats |
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Definition
| 8-12h (pts under 2 kg shorter), water 2-4 (if at all) |
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Term
| Know the normal fasting times for horses |
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Definition
|
|
Term
| Know the normal fasting times for cattle |
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Definition
| – food 24-48h, water 8-12 |
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Term
| Know the normal fasting times for small ruminants |
|
Definition
| food 12 – 18h, water 8-12h |
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|
Term
| Know the normal fasting times for Neonatal and pediatric (< 8w) |
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Definition
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Term
| which kind of scissors is the most appropriate to cut a small ligament. |
|
Definition
| Mayo dissecting scissors is used when cutting lg muscle masses, cartilage, or any other nondelicate tissue |
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Term
| which kind of scissors in most appropriate to cut a surgical sponge to fit a particular wound size |
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Definition
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Term
| Know which part of a ring-handled surgical instrument is most likely to lock the instrument closed during a surgical procedure. |
|
Definition
|
|
Term
| which forceps are the most appropriate to clamp a large mass on the flank of a Thoroughbred horse |
|
Definition
| Rochester-Carmalt hemostatic forceps |
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