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What are 3 things a tech should know/do during an anesthetic emergency?: Recognize signs of crises & alert ver; anticipate needed supplies; assist the vet.
What are 6 factors which can attribute to an anesthetic emergency?: Geriatric (reached 75% of life expectancy), pediatric (<3mths), brachycephalic, sighthounds, obese, cesarean.
What can you do to help a geriatric patient during anesthesia?: Do a pre-anesthetic history, physical & screening test; reduce anesthetic doses by 30-50%; allow more time to take effect.
What are some problems than can occur with a geriatric patient?: They have a poor response to stress; recovery may be pronounced; hypothermia; overhydration.
What can you do to help a pediatric patient during anesthesia?: Weigh accurately & dilute injectable drugs; reduce dosages; use inhalation.
What are some problems that can occur with a pediatric patient?: Hypoglycemia (avoid prolonged fasting); high risk for hypothermia & overhydration.
What are some problems that can occur with brachycephalic breeds?: Airway obstruction - preoxygenate, induce rapidly (IV), delay extubation, observe closely during recovery. They have a high vagal tone, use an anticholinergic.
What type of drug should you avoid in sighthounds?: Barbiturates
What are some things you can do to help an obese patient during anesthesia?: Preoxygenate; dose according to actual weight; induce rapidly; assist ventilation if necessary; delay extubation; observe closely during recovery.
What are some things you can to help a c-section patient during anesthesia?: Preoxygenate; IV fluids; lowest effective dose of anesthetic; avoid ketamine/diazepam & barbiturates.
What drugs should you avoid giving a cesarian patient?: Ketamine/diazepam & barbiturates.
What should you do for a neonate during a c-section?: Oxygen by mask; atropine for bradycardia; reversing agents; doxapram.
What are some types of emergency situations?: Shock, patient doesn't stay anesthetized, patient too deep, respiratory depression, abnormal breathing patterns, bradycardia, tachycardia, cardiac dysrhythmias, cardiac arrest, vom/aspiration/regurgitation, malignant hyperthermia.
Definition of shock: Inadequate tissue perfusion leading to cellular hypoxia, metabolic acidosis & ultimately, cell death.
What are the 4 types of shock?: Hypovolemic, vasculogenic, cardiogenic & obstructive.
What are 4 types of shock?: Hypovolemic, vasculogenic, cardiogenic & obstructive.
What is hypovolemic shock?: A decrease in circulating blood volume due to loss of fluid.
What conditions can cause hypovolemic shock?: Hemorrhage, vomiting, diarrhea, diuresis, burns or fluid sequestration.
What is vasculogenic shock?: The vascular space is increased which leads to a decrease in blood pressure.
What conditions can caue vasculogenic shock?: Sepsis, anaphylaxis, drug overdose.
What is cardiogenic shock?: A failure of cardiac output.
What conditions may cause cardiogenic shock?: Dysrhythmias, valvular insufficiency, congenital defects, heart muscle problems.
What is obstructive shock?**: A restriction in blood flow.
What conditions may cause obstructive shock?: GDV, pneumothorax, cardiac tamponae (cardiac output is blocked).
What are some signs of shock?: Tachycardia, tachypnea, hypotension (prolonged CRT), hypothermia, weakness, restlessness, depressio, reduced urine output, coma, pupil dilation, leads to cardiopulmonary arrest.
How do you treat shock?: Rapid IV fluids, dopamine or dobutamine, lidocaine or propranolol, glucocorticoids, antibiotics for sepsis, diuretics for oliguria/anuria.
Why do you give dopamine or dobutamine for shock?: To increase the contraction of the heart.
Why do you give lidocaine or propranolol for shock?: It helps with arrhythmias.
What are 5 errors/problems which can lead to a patient not staying anesthetized?: The endotrach tube, vaporizer, delivery system, oxygen tank & patient.
What do you need to check with the endotrach tube to make sure it's working?: Is it in the trachea, large enough, cuff inflated, kinked, firmly connected to the machine?
What do you check with the vaporizer to make sure it's working properly?: Is it connect to the oxygen, to the delivery system, correctly set, filled, calibrated?
What do you check with the delivery system to make sure it's working properly?: Are there any leaks, is the oxygen flow adequate?
What do you check with the oxygen tank to make sure it's working properly?: Is it on, is there an adequate supply in the tank?
What do you check with the patient if they're not staying under?: Are they hypoventilating?
What are some signs that the patient is too deep?: Dilated pupils, no reflexes, bradycardia, delayed CRT, hypoventilation, no muscle tone.
What are 2 things that can cause a patient to become too deep?: The equipment or the patient.
What should you check with the equipment if the patient is too deep?: Is the vaporizer setting or calibration correct? Is the correct anesthetic in the vaporizer?
What should you check with the patient if they are too deep?: Are they hypothermic, in shock, have a preexisting disease, check drug doses or interactions.
How do you treat/avoid a patient becoming too deep?: Proper machine checkout, decrease or turn off vaporizer setting; ventilate patient; warm patient; reverse drugs if possible.
What are some signs of respiratory depression?: Reduced respiratory rate, reduced tidal volume, cyanosis.
What are some causes for respiratory depression?: Patient is too deep; anesthetic drugs; surgical positioning (pressure on check or diaphram); hypocarbis (ventilating too fast); CNS or metabolic disease.
How do you treat respiratory depression?: Lighten plane; 'sigh' all patients; supplement if <10rpm; correct surgical positioning; use doxapram if nothing else is effective.
What are some signs of abnormal breathing patterns?: Increase effort -abdominal breathing; decreased movement of chest or reservoir bag; cyanosis; unusual sounds -rales, crackles, muffled.
What are some causes of abnormal breathing?: Patient too deep; misplaced endotrach tube; obstruction w/in resp system(aspirated material, musous); obstruction w/in equipment (endotrach tube, delivery tube, closed popoff valve; disease of respiratory system.
How do you treat abnormal breathing?: Check popoff valve & ventilation bag first!! Assess depth-lighten if necessary; ventilate & watch chest-no movement ~obstruction; can disconnect system & aspirate endotrach tube.
Sign of bradycardia?: Dogs = <60 bpm
Cats = <100 bpm
What are some causes of bradycardia?: Anesthetic plane too deep; increased vagal tone; hypothermia; metabolic problems; late stages of hypoxia.
How do you treat bradycardia?: Lighten anesthetic plane if possible; support ventilation; keep patient warm; administer anticholinergic (atropine).
What are signs of tachycardia?: Dogs - large >120bpm
medium >140bpm
small >150bpm
Cats - >200bpm
What are some causes of tachycardia?: Patient too light; hypotension, hypovolemia, shock; inadequate ventilation-early stage of hypoxemia; drug induced (ketamine, anticholinergics); hyperthermis.
How do you treach tachycardia?: Adjust anesthetic depth if necessary; provide adquate fluid support; support ventilation; check temp, maintain normothermia.
What are some signs of a cardiac arrhythmia?: Irregular pulse rate & pressure; pulse deficits; irregular heart sounds; hypotension; pallor, cyanosis; abnormal ECG tracing.
What are some causes of cardiac arrhythmias?: **Drug sensitizes heart to epinephrine. Too light or too deep; anesthetic drugs; hypoxemia; hypercarbia; electrolyte or acid-base imbalance; surgical manipulation.
How can you prevent cardiac arrhythmias?: Presurgical PE & labwork; correct any hydration & metabolic imbalances b/4 anesthesia; fluids for cardiac support; porper anesthetic depth monitoring; follow proper drug protocol.
How can you treat cardiac arrhythmias?: Assess & adjust anesthetic depth; ventilation; fluid therapy.
What are some signs of cardiac arrest?: Resp arrest; no pulse; no heart sounds; dilated, fixed pupils; lack of bleeding at surgical sites; blue/gray tissue color; ECG changes.
What are some causes of cardiac arrest?: Inadquate ventilation which leads to resp arest; anesthetic overdose; hypothermia; acidosis, other metabolic problems; cardiovascular disturbances.
How do you treat cardiac arrest?: CPR; epinephrine; after resuscitation give dopamine or dobutamine; evaluate CNS status.
What are some causes for vomiting, aspiration, regurgitation?: ***Drugs (opiates, barbiturates, xylazine); light anesthesia (stage 2); feeding b/4 anesthesia; stress, excitement; surgical manipulation.
What are some signs of aspiration?: Cyanosis; bronchospasm (wheezing, can't breath in); apnea or tachypnea. On radiograph: pulmonary edema, pneumonia.
How do you prevent aspiration?: Fast 12 hours b/4 anesthesia; avoid stress & excitement; acepromazine; rapid induction techniques (avoid stage 2); leave cuff inflated until ready to extubate.
How do you treat vomiting?: Place in sternal recumbancy; keep mouth open, tongue out; tilt table head downward; afterward, examine & cleanse pharynx.
How do you treat aspiration?: Suction airway, may lavage w/ sterile saline; administer O2; broad-spectrum antibiotics; steam or mist; coupage; if bronchospasm occurs - steroids or aminophylline.
What is malignant hyperthermia?***: A hypermetabolic state induced by drugs which leads to uncontrolled increase in temperature, metabolic crisis which may lead to death.
What are some predisposing factors to malignant hyperthermia?: Genetics; infections; drugs (ketamine, anticholinergics, inhalation drugs, succinylcholine); environmental stress & excitement.
What are some early signs of malignant hyperthermia?: Hyperventilation, tachypnea; elevated body temp; skin & MM flushed which leads to cyanosis; tachycardia & dysrhythmmias; BP first elevated, the profoundly decreased; muscle rigidity.
What are some late signs of malignant hyperthermia?: Muscle rigidity; core body temp 108-110; severe metabolic acidosis; hemolysis, coagulopathy; acute renal failure; hypoglycemia; cerebral edema; death.
How can you prevent malignant hyperthermia?: Be aware of signs to recognize while monitoring post-anestheic patients.
How do you treat malignant hyperthermia?: Remove triggering agents, if possible; IV fluids; cool body -bath, snow, hose down; oxygen; diuretics; corticosteroids.

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