Greater chance of a safe anesthetic episode and/or a more successful outcome for the patient

Why pre-anesthetic evaluation should be performed

PE - including BW and BCS

Step 3 of pre-anesthetic evaluation

Moribund patients not expected to survive without operation; extreme shock, terminal malignancy, severe trauma

Category V (ASA physical status scale)

Formulate an assessment of the patient's overall organ function and perioperative risk

Why pre-anesthetic evaluation should be performed

Feeding small amount of canned food 3 hours prior to anesthesia can reduce incidence of gastroesophageal reflux in dogs

Interesting research regarding fasting times

What animals are at risk for bleeding during surgery?

Animals with bleeding disorders (ex. doberman)

Prone to hypoglycemia within a few hours of starvation; increased metabolic rate in birds + small mammals

Reasons fasting is not necessary for neonates, small birds, + some mammals

Advanced diagnostics if indicated; ECG, BP, rads, abd U/S, echo, endocrine testing, etc.

Step 6 of pre-anesthetic evaluation

Cat does not equal small dog; wide variation in doses based on species (pharmacogenetics)

SA vs LA (considerations for dosing drugs)

Changes metabolic rate

Age (considerations for dosing drugs)

18-24 hours for food; 12-18 hours for water

Cattle - adult healthy (fasting + water deprivation times)

4-12 hours for food; up until premed given for water

Equine - adult healthy (fasting + water deprivation times)

12-18 hours for food; 8-12 hours for water

Small ruminants, calves - adult healthy (fasting + water deprivation times)

6-12 hours for food; up until premed given for water

Canine, Feline - adult healthy (fasting + water deprivation times)

History (w/ previous anesthesia events); symptoms (if present - severity + duration), recent/current meds + vxn

Step 2 of pre-anesthetic evaluation

Encourage defecation/urination prior to surgery; Bathe excessive dirty patient prior; clean out hooves; parasite control

Hygiene and patient comfort (patient preparation)

Provide the client with valuable information that will help them decide if they are willing to take the risk

Why pre-anesthetic evaluation should be performed

Normal healthy patients; OVH, castration, ear/tail docking, declaw

Category I (ASA physical status scale)

In clinic, but also during farm calls; quiet area

Location of pre-anesthetic evaluation

Blood and urine sampling

Step 4 of pre-anesthetic evaluation

Smaller animals will require a higher dose per unit of body weight; consider using BSA formulas

Size of patient (considerations for dosing drugs)

CBC/Chem/UA (minimum database); +/- T4, ECG, blood pressure, thoracic rads, echocardiogram, blood gas, coag, liver, 4Dx

Older patients w/ non/elective procedure, any recent hx of illness, sus. dx

Use stethoscope to auscultate for a murmur and use fingers to palpate a pulse simultaneously

Pulse - rate, rhythm, quality (PE findings)

Cefazolin IV 20-30 minutes prior to skin incision, then q 90-120 min

Preoperative antibiotic (patient preparation)

Juvenile to early adulthood

Increase dose of anesthetic drugs

Patient with severe systemic disease; fever, dehydration, anemia, cachexia, hypovolemia, uncontrolled DM, COPD

Category III (ASA physical status scale)

PCV/TS/Glucose/BUN (Big 4 or QATS)

Young (<5y) healthy patient having an elective procedure, no abnormal hx

Patient w/ severe systemic dz that is constant threat to life; uremia, toxemia, sepsis, shock, emaciation, heart failure

Category IV (ASA physical status scale)

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Anesthesia + Analgesia Lecture 2

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Questions 71

Answers

1
Greater chance of a safe anesthetic episode and/or a more successful outcome for the patient
Why pre-anesthetic evaluation should be performed
When pre-anesthetic evaluation should be performed
Physical status
2
PE - including BW and BCS
Step 5 of pre-anesthetic evaluation
Step 3 of pre-anesthetic evaluation
Step 4 of pre-anesthetic evaluation
Step 6 of pre-anesthetic evaluation
3
Sick sinus syndrome (may also be seen in boxers)
Miniature schnauzers
Doberman pinschers
Pugs
Boxers
4
Moribund patients not expected to survive without operation; extreme shock, terminal malignancy, severe trauma
Category IV (ASA physical status scale)
Category III (ASA physical status scale)
Category II (ASA physical status scale)
Category V (ASA physical status scale)
5
Formulate an assessment of the patient's overall organ function and perioperative risk
When pre-anesthetic evaluation should be performed
Why pre-anesthetic evaluation should be performed
Physical status
6
Patients w/ evidence of CV disease; geriatric patients; hyperkalemia, GDV, splenomegaly, myocarditis -> arrhythmias
Routine ECG screening
Temperature (PE findings)
Respiration (PE findings)
Pulse - rate, rhythm, quality (PE findings)
7
Feeding small amount of canned food 3 hours prior to anesthesia can reduce incidence of gastroesophageal reflux in dogs
Interesting research regarding fasting times
What to consider for depriving water from patients w/ ^ fluid requirements
Reasons a patient is fasted prior to general anesthesia
Reasons fasting is not necessary for neonates, small birds, + some mammals
8
What animals are at risk for bleeding during surgery?
Animals with bleeding disorders (ex. doberman)
Young (<5y) healthy patient having an elective procedure, no abnormal hx
Location of pre-anesthetic evaluation
Older patients w/ non/elective procedure, any recent hx of illness, sus. dx
9
Prone to hypoglycemia within a few hours of starvation; increased metabolic rate in birds + small mammals
What to consider for depriving water from patients w/ ^ fluid requirements
Reasons a patient is fasted prior to general anesthesia
Interesting research regarding fasting times
Reasons fasting is not necessary for neonates, small birds, + some mammals
10
Certain substances can either induce of inhibit microsomal enzymes (ex. benadryl, prednisone, persticide)
False
True
11
Advanced diagnostics if indicated; ECG, BP, rads, abd U/S, echo, endocrine testing, etc.
Step 5 of pre-anesthetic evaluation
Step 3 of pre-anesthetic evaluation
Step 6 of pre-anesthetic evaluation
Step 4 of pre-anesthetic evaluation
12
Subtle loss of skin elasticity
5-6% dehydration
<5% dehydration
6-8% dehydration
10-12% dehydration
13
Cat does not equal small dog; wide variation in doses based on species (pharmacogenetics)
Obesity (considerations for dosing drugs)
Size of patient (considerations for dosing drugs)
Poor condition/starvation
SA vs LA (considerations for dosing drugs)
14
von Willebrand's disease
Miniature schnauzers
Pugs
Boxers
Doberman pinschers
15
What other systems are checked in the physical exam?
Genitourinary tract; CNS
GI tract/abdominal palpation/gut sounds
Integument; Lymph nodes
All of the above
16
Changes metabolic rate
Age (considerations for dosing drugs)
Poor condition/starvation
Obesity (considerations for dosing drugs)
Size of patient (considerations for dosing drugs)
17
When should the ASA PS be assigned?
All of the above
Elective vs. scheduled vs. urgent cases
After PE is complete and lab work or tests have been interpreted
E added to emergency surgeries
18
18-24 hours for food; 12-18 hours for water
Cattle - adult healthy (fasting + water deprivation times)
Bird - adult healthy (fasting + water deprivation times)
Bird <200g, Neonate, Rodents/rabbits (fasting + water deprivation times)
Swine - adult healthy (fasting + water deprivation times)
19
Definite signs of shock (tachycardia, cool extremities, rapid and weak pulses); death imminent
5-6% dehydration
12-15% dehydration
10-12% dehydration
6-8% dehydration
20
Not detectable
10-12% dehydration
<5% dehydration
5-6% dehydration
6-8% dehydration
21
4-12 hours for food; up until premed given for water
Equine - adult healthy (fasting + water deprivation times)
Cattle - adult healthy (fasting + water deprivation times)
Small ruminants, calves - adult healthy (fasting + water deprivation times)
Canine, Feline - adult healthy (fasting + water deprivation times)
22
12-18 hours for food; 8-12 hours for water
Cattle - adult healthy (fasting + water deprivation times)
Canine, Feline - adult healthy (fasting + water deprivation times)
Equine - adult healthy (fasting + water deprivation times)
Small ruminants, calves - adult healthy (fasting + water deprivation times)
23
ABCB1/MDR1 mutation
Rabbits
Quarter horses
Herding breeds
Pigs
24
General Anesthetic Concerns (4 H's):
All of the above
Hypotension; Hypoventilation
Hypoxemia
Hypothermia
25
Why is ASA PS important?
Used to assess anesthetic risk; can be used from a legal standpoint
Physical status effects PK and PD and aids in selection of drugs/technique
All of the above
Important criteria used in selection of patients in research studies
26
Sicker the patient -> poorer the physical status -> increased likelihood of cardiopulmonary emergencies
False
True
27
Malignant hyperthermia
Rabbits
Quarter horses
Pigs
Herding breeds
28
6-12 hours for food; up until premed given for water
Small ruminants, calves - adult healthy (fasting + water deprivation times)
Canine, Feline - adult healthy (fasting + water deprivation times)
Equine - adult healthy (fasting + water deprivation times)
Cattle - adult healthy (fasting + water deprivation times)
29
History (w/ previous anesthesia events); symptoms (if present - severity + duration), recent/current meds + vxn
Step 3 of pre-anesthetic evaluation
Step 4 of pre-anesthetic evaluation
Step 2 of pre-anesthetic evaluation
Step 1 of pre-anesthetic evaluation
30
Dog: 100-102.5F; Cat: 100-102.5F Cattle: 100.5-102.5F Equine: 99-101.5F Pig: 101-103F Sheep: 102-103F Goat: 100.5-103.5F
Pulse - rate, rhythm, quality (PE findings)
Routine ECG screening
Temperature (PE findings)
Respiration (PE findings)
31
Encourage defecation/urination prior to surgery; Bathe excessive dirty patient prior; clean out hooves; parasite control
Preoperative antibiotic (patient preparation)
Correct dehydration and electrolyte imbalance (patient preparation)
Hygiene and patient comfort (patient preparation)
Specific prep for procedure
32
Provide the client with valuable information that will help them decide if they are willing to take the risk
Physical status
Why pre-anesthetic evaluation should be performed
When pre-anesthetic evaluation should be performed
33
Arrhythmogenic Right Ventricular Cardiomyopathy
Pugs
Doberman pinschers
Miniature schnauzers
Boxers
34
Normal healthy patients; OVH, castration, ear/tail docking, declaw
Category I (ASA physical status scale)
Category IV (ASA physical status scale)
Category II (ASA physical status scale)
Category III (ASA physical status scale)
35
In clinic, but also during farm calls; quiet area
Animals with bleeding disorders (ex. doberman)
Young (<5y) healthy patient having an elective procedure, no abnormal hx
Location of pre-anesthetic evaluation
Older patients w/ non/elective procedure, any recent hx of illness, sus. dx
36
Tented skin stands in place, definite prolongation of CRT, eyes sunken in orbits, dry mm, poss. signs of shock
10-12% dehydration
12-15% dehydration
5-6% dehydration
6-8% dehydration
37
Blood and urine sampling
Step 3 of pre-anesthetic evaluation
Step 6 of pre-anesthetic evaluation
Step 5 of pre-anesthetic evaluation
Step 4 of pre-anesthetic evaluation
38
Pounds and kilograms
Respiration (PE findings)
Body weight (PE findings)
mm/CRT (PE findings)
Pulse - rate, rhythm, quality (PE findings)
39
Smaller animals will require a higher dose per unit of body weight; consider using BSA formulas
Size of patient (considerations for dosing drugs)
Poor condition/starvation
Obesity (considerations for dosing drugs)
SA vs LA (considerations for dosing drugs)
40
CBC/Chem/UA (minimum database); +/- T4, ECG, blood pressure, thoracic rads, echocardiogram, blood gas, coag, liver, 4Dx
Location of pre-anesthetic evaluation
Young (<5y) healthy patient having an elective procedure, no abnormal hx
Animals with bleeding disorders (ex. doberman)
Older patients w/ non/elective procedure, any recent hx of illness, sus. dx
41
Enemas or osmotic bowel prep 1-2 days before perineal or colon surgery
Hygiene and patient comfort (patient preparation)
Correct dehydration and electrolyte imbalance (patient preparation)
Specific prep for procedure
Preoperative antibiotic (patient preparation)
42
Other concerns that are species, age, disease, or procedure specific:
Hemorrhage; pain; delayed recovery
Dysphoria; arrhythmias; myopathy or neuropathy
Regurgitation; laryngeal spasm; difficult intubation
All of the above
43
Use stethoscope to auscultate for a murmur and use fingers to palpate a pulse simultaneously
Pulse - rate, rhythm, quality (PE findings)
Body weight (PE findings)
mm/CRT (PE findings)
Respiration (PE findings)
44
Cefazolin IV 20-30 minutes prior to skin incision, then q 90-120 min
Correct dehydration and electrolyte imbalance (patient preparation)
Hygiene and patient comfort (patient preparation)
Preoperative antibiotic (patient preparation)
Specific prep for procedure
45
Juvenile to early adulthood
Decrease dose of anesthetic drugs
Increase dose of anesthetic drugs
46
Patient with severe systemic disease; fever, dehydration, anemia, cachexia, hypovolemia, uncontrolled DM, COPD
Category II (ASA physical status scale)
Category III (ASA physical status scale)
Category IV (ASA physical status scale)
Category V (ASA physical status scale)
47
What concurrent medications could cause problems during the peri-anesthesia episode?
Clomipramine; Phenylpropanolamine; Pseudoephedrine; Phenobarb; Sulfonamides
Tramadol w/ MOA inhibitor, TCA, PPA; Opioids; Selegiline (MOA in.); Chemo
All of the above
Aminoglycosides; ACE inhibitors; Digotoxin; Beta blockers; Diuretics; NSAID
48
PCV/TS/Glucose/BUN (Big 4 or QATS)
Location of pre-anesthetic evaluation
Animals with bleeding disorders (ex. doberman)
Older patients w/ non/elective procedure, any recent hx of illness, sus. dx
Young (<5y) healthy patient having an elective procedure, no abnormal hx
49
Patient w/ severe systemic dz that is constant threat to life; uremia, toxemia, sepsis, shock, emaciation, heart failure
Category II (ASA physical status scale)
Category V (ASA physical status scale)
Category IV (ASA physical status scale)
Category III (ASA physical status scale)
50
12y Quarter horse w/ 12h colic; 9m pregnant; pawing + rolling; tachycardia, no gut sounds, mm dark pink; What ASA PS?
ASA 2E
ASA 4E
ASA 4
ASA 5
51
Presence or absence of disease (determined by history, PE, lab tests); severity of pain; level of stress
Why pre-anesthetic evaluation should be performed
When pre-anesthetic evaluation should be performed
Physical status
52
Decrease food/fluid in stomach, risk of aspiration; distended stomach impairs ventilation; horse: full could rupture
Interesting research regarding fasting times
What to consider for depriving water from patients w/ ^ fluid requirements
Reasons fasting is not necessary for neonates, small birds, + some mammals
Reasons a patient is fasted prior to general anesthesia
53
Describe what you hear, not just WNL; palpate trachea
mm/CRT (PE findings)
Respiration (PE findings)
Body weight (PE findings)
Pulse - rate, rhythm, quality (PE findings)
54
Tells you hydration status and hemodynamic status
Respiration (PE findings)
Pulse - rate, rhythm, quality (PE findings)
mm/CRT (PE findings)
Body weight (PE findings)
55
Hyperkalemic Periodic Paralysis (HYPP)
Quarter horses
Rabbits
Herding breeds
Pigs
56
Patients with mild systemic disease; skin tumor, fracture, local infection, compensated cardiac disease, pregnant
Category II (ASA physical status scale)
Category I (ASA physical status scale)
Category III (ASA physical status scale)
Category IV (ASA physical status scale)
57
4-6 hours for food; no preference for water
Cattle - adult healthy (fasting + water deprivation times)
Swine - adult healthy (fasting + water deprivation times)
Bird <200g, Neonate, Rodents/rabbits (fasting + water deprivation times)
Bird - adult healthy (fasting + water deprivation times)
58
Overall efficiency and function of organ systems
Physical status
Why pre-anesthetic evaluation should be performed
When pre-anesthetic evaluation should be performed
59
Day before or up to 1wk before procedure; emergency -> do immediately prior; short exam day of
When pre-anesthetic evaluation should be performed
Physical status
Why pre-anesthetic evaluation should be performed
60
Neonate or pediatric; Geriatric
Increase dose of anesthetic drugs
Decrease dose of anesthetic drugs
61
Not necessary for food; no preference for water
Bird <200g, Neonate, Rodents/rabbits (fasting + water deprivation times)
Swine - adult healthy (fasting + water deprivation times)
Cattle - adult healthy (fasting + water deprivation times)
Bird - adult healthy (fasting + water deprivation times)
62
Renal insufficiency, febrile, diabetes, hot environment
Interesting research regarding fasting times
Reasons a patient is fasted prior to general anesthesia
Reasons fasting is not necessary for neonates, small birds, + some mammals
What to consider for depriving water from patients w/ ^ fluid requirements
63
Volume of distribution for drugs
Poor condition/starvation
Size of patient (considerations for dosing drugs)
Obesity (considerations for dosing drugs)
Age (considerations for dosing drugs)
64
Brachycephalic syndrome
Miniature schnauzers
Boxers
Pugs
Doberman pinschers
65
Need signed consent form by owner; can get verbal confirmation over phone, but need 2nd person to confirm consent
False
True
66
Temperament/mentation and level of pain and stress
Step 6 of pre-anesthetic evaluation
Step 4 of pre-anesthetic evaluation
Step 3 of pre-anesthetic evaluation
Step 5 of pre-anesthetic evaluation
67
3y MI beagle; emergency 4in laceration on R flank from barbed wire; PE WNL; up-to-date on everything; What is ASA PS?
ASA 3
ASA 1
ASA 2E
ASA 1E
68
Always start with the signalment!
Step 1 of pre-anesthetic evaluation
Step 4 of pre-anesthetic evaluation
Step 2 of pre-anesthetic evaluation
Step 3 of pre-anesthetic evaluation
69
Definite delay in return of skin to normal position, slight prolongation of CRT, eyes poss. sunken in orbits + dry mm.
10-12% dehydration
12-15% dehydration
6-8% dehydration
5-6% dehydration
70
12-24 hours for food; no preference for water
Bird - adult healthy (fasting + water deprivation times)
Cattle - adult healthy (fasting + water deprivation times)
Swine - adult healthy (fasting + water deprivation times)
Bird <200g, Neonate, Rodents/rabbits (fasting + water deprivation times)
71
Pre-anesthetic evaluation of patient is ultimately the responsibility of the veterinarian in charge of the patient
False
True

Anesthesia + Analgesia Lecture 2 Flashcards | StudBud

Anesthesia + Analgesia Lecture 2

71 termsStudBud Administration10 plays

Imported from external platform

Flashcards71 cardsFPractice quizPHost liveL

Questions 71

Answers

1
Greater chance of a safe anesthetic episode and/or a more successful outcome for the patient
Why pre-anesthetic evaluation should be performed
When pre-anesthetic evaluation should be performed
Physical status
2
PE - including BW and BCS
Step 5 of pre-anesthetic evaluation
Step 3 of pre-anesthetic evaluation
Step 4 of pre-anesthetic evaluation
Step 6 of pre-anesthetic evaluation
3
Sick sinus syndrome (may also be seen in boxers)
Miniature schnauzers
Doberman pinschers
Pugs
Boxers
4
Moribund patients not expected to survive without operation; extreme shock, terminal malignancy, severe trauma
Category IV (ASA physical status scale)
Category III (ASA physical status scale)
Category II (ASA physical status scale)
Category V (ASA physical status scale)
5
Formulate an assessment of the patient's overall organ function and perioperative risk
When pre-anesthetic evaluation should be performed
Why pre-anesthetic evaluation should be performed
Physical status
6
Patients w/ evidence of CV disease; geriatric patients; hyperkalemia, GDV, splenomegaly, myocarditis -> arrhythmias
Routine ECG screening
Temperature (PE findings)
Respiration (PE findings)
Pulse - rate, rhythm, quality (PE findings)
7
Feeding small amount of canned food 3 hours prior to anesthesia can reduce incidence of gastroesophageal reflux in dogs
Interesting research regarding fasting times
What to consider for depriving water from patients w/ ^ fluid requirements
Reasons a patient is fasted prior to general anesthesia
Reasons fasting is not necessary for neonates, small birds, + some mammals
8
What animals are at risk for bleeding during surgery?
Animals with bleeding disorders (ex. doberman)
Young (<5y) healthy patient having an elective procedure, no abnormal hx
Location of pre-anesthetic evaluation
Older patients w/ non/elective procedure, any recent hx of illness, sus. dx
9
Prone to hypoglycemia within a few hours of starvation; increased metabolic rate in birds + small mammals
What to consider for depriving water from patients w/ ^ fluid requirements
Reasons a patient is fasted prior to general anesthesia
Interesting research regarding fasting times
Reasons fasting is not necessary for neonates, small birds, + some mammals
10
Certain substances can either induce of inhibit microsomal enzymes (ex. benadryl, prednisone, persticide)
False
True
11
Advanced diagnostics if indicated; ECG, BP, rads, abd U/S, echo, endocrine testing, etc.
Step 5 of pre-anesthetic evaluation
Step 3 of pre-anesthetic evaluation
Step 6 of pre-anesthetic evaluation
Step 4 of pre-anesthetic evaluation
12
Subtle loss of skin elasticity
5-6% dehydration
<5% dehydration
6-8% dehydration
10-12% dehydration
13
Cat does not equal small dog; wide variation in doses based on species (pharmacogenetics)
Obesity (considerations for dosing drugs)
Size of patient (considerations for dosing drugs)
Poor condition/starvation
SA vs LA (considerations for dosing drugs)
14
von Willebrand's disease
Miniature schnauzers
Pugs
Boxers
Doberman pinschers
15
What other systems are checked in the physical exam?
Genitourinary tract; CNS
GI tract/abdominal palpation/gut sounds
Integument; Lymph nodes
All of the above
16
Changes metabolic rate
Age (considerations for dosing drugs)
Poor condition/starvation
Obesity (considerations for dosing drugs)
Size of patient (considerations for dosing drugs)
17
When should the ASA PS be assigned?
All of the above
Elective vs. scheduled vs. urgent cases
After PE is complete and lab work or tests have been interpreted
E added to emergency surgeries
18
18-24 hours for food; 12-18 hours for water
Cattle - adult healthy (fasting + water deprivation times)
Bird - adult healthy (fasting + water deprivation times)
Bird <200g, Neonate, Rodents/rabbits (fasting + water deprivation times)
Swine - adult healthy (fasting + water deprivation times)
19
Definite signs of shock (tachycardia, cool extremities, rapid and weak pulses); death imminent
5-6% dehydration
12-15% dehydration
10-12% dehydration
6-8% dehydration
20
Not detectable
10-12% dehydration
<5% dehydration
5-6% dehydration
6-8% dehydration
21
4-12 hours for food; up until premed given for water
Equine - adult healthy (fasting + water deprivation times)
Cattle - adult healthy (fasting + water deprivation times)
Small ruminants, calves - adult healthy (fasting + water deprivation times)
Canine, Feline - adult healthy (fasting + water deprivation times)
22
12-18 hours for food; 8-12 hours for water
Cattle - adult healthy (fasting + water deprivation times)
Canine, Feline - adult healthy (fasting + water deprivation times)
Equine - adult healthy (fasting + water deprivation times)
Small ruminants, calves - adult healthy (fasting + water deprivation times)
23
ABCB1/MDR1 mutation
Rabbits
Quarter horses
Herding breeds
Pigs
24
General Anesthetic Concerns (4 H's):
All of the above
Hypotension; Hypoventilation
Hypoxemia
Hypothermia
25
Why is ASA PS important?
Used to assess anesthetic risk; can be used from a legal standpoint
Physical status effects PK and PD and aids in selection of drugs/technique
All of the above
Important criteria used in selection of patients in research studies
26
Sicker the patient -> poorer the physical status -> increased likelihood of cardiopulmonary emergencies
False
True
27
Malignant hyperthermia
Rabbits
Quarter horses
Pigs
Herding breeds
28
6-12 hours for food; up until premed given for water
Small ruminants, calves - adult healthy (fasting + water deprivation times)
Canine, Feline - adult healthy (fasting + water deprivation times)
Equine - adult healthy (fasting + water deprivation times)
Cattle - adult healthy (fasting + water deprivation times)
29
History (w/ previous anesthesia events); symptoms (if present - severity + duration), recent/current meds + vxn
Step 3 of pre-anesthetic evaluation
Step 4 of pre-anesthetic evaluation
Step 2 of pre-anesthetic evaluation
Step 1 of pre-anesthetic evaluation
30
Dog: 100-102.5F; Cat: 100-102.5F Cattle: 100.5-102.5F Equine: 99-101.5F Pig: 101-103F Sheep: 102-103F Goat: 100.5-103.5F
Pulse - rate, rhythm, quality (PE findings)
Routine ECG screening
Temperature (PE findings)
Respiration (PE findings)
31
Encourage defecation/urination prior to surgery; Bathe excessive dirty patient prior; clean out hooves; parasite control
Preoperative antibiotic (patient preparation)
Correct dehydration and electrolyte imbalance (patient preparation)
Hygiene and patient comfort (patient preparation)
Specific prep for procedure
32
Provide the client with valuable information that will help them decide if they are willing to take the risk
Physical status
Why pre-anesthetic evaluation should be performed
When pre-anesthetic evaluation should be performed
33
Arrhythmogenic Right Ventricular Cardiomyopathy
Pugs
Doberman pinschers
Miniature schnauzers
Boxers
34
Normal healthy patients; OVH, castration, ear/tail docking, declaw
Category I (ASA physical status scale)
Category IV (ASA physical status scale)
Category II (ASA physical status scale)
Category III (ASA physical status scale)
35
In clinic, but also during farm calls; quiet area
Animals with bleeding disorders (ex. doberman)
Young (<5y) healthy patient having an elective procedure, no abnormal hx
Location of pre-anesthetic evaluation
Older patients w/ non/elective procedure, any recent hx of illness, sus. dx
36
Tented skin stands in place, definite prolongation of CRT, eyes sunken in orbits, dry mm, poss. signs of shock
10-12% dehydration
12-15% dehydration
5-6% dehydration
6-8% dehydration
37
Blood and urine sampling
Step 3 of pre-anesthetic evaluation
Step 6 of pre-anesthetic evaluation
Step 5 of pre-anesthetic evaluation
Step 4 of pre-anesthetic evaluation
38
Pounds and kilograms
Respiration (PE findings)
Body weight (PE findings)
mm/CRT (PE findings)
Pulse - rate, rhythm, quality (PE findings)
39
Smaller animals will require a higher dose per unit of body weight; consider using BSA formulas
Size of patient (considerations for dosing drugs)
Poor condition/starvation
Obesity (considerations for dosing drugs)
SA vs LA (considerations for dosing drugs)
40
CBC/Chem/UA (minimum database); +/- T4, ECG, blood pressure, thoracic rads, echocardiogram, blood gas, coag, liver, 4Dx
Location of pre-anesthetic evaluation
Young (<5y) healthy patient having an elective procedure, no abnormal hx
Animals with bleeding disorders (ex. doberman)
Older patients w/ non/elective procedure, any recent hx of illness, sus. dx
41
Enemas or osmotic bowel prep 1-2 days before perineal or colon surgery
Hygiene and patient comfort (patient preparation)
Correct dehydration and electrolyte imbalance (patient preparation)
Specific prep for procedure
Preoperative antibiotic (patient preparation)
42
Other concerns that are species, age, disease, or procedure specific:
Hemorrhage; pain; delayed recovery
Dysphoria; arrhythmias; myopathy or neuropathy
Regurgitation; laryngeal spasm; difficult intubation
All of the above
43
Use stethoscope to auscultate for a murmur and use fingers to palpate a pulse simultaneously
Pulse - rate, rhythm, quality (PE findings)
Body weight (PE findings)
mm/CRT (PE findings)
Respiration (PE findings)
44
Cefazolin IV 20-30 minutes prior to skin incision, then q 90-120 min
Correct dehydration and electrolyte imbalance (patient preparation)
Hygiene and patient comfort (patient preparation)
Preoperative antibiotic (patient preparation)
Specific prep for procedure
45
Juvenile to early adulthood
Decrease dose of anesthetic drugs
Increase dose of anesthetic drugs
46
Patient with severe systemic disease; fever, dehydration, anemia, cachexia, hypovolemia, uncontrolled DM, COPD
Category II (ASA physical status scale)
Category III (ASA physical status scale)
Category IV (ASA physical status scale)
Category V (ASA physical status scale)
47
What concurrent medications could cause problems during the peri-anesthesia episode?
Clomipramine; Phenylpropanolamine; Pseudoephedrine; Phenobarb; Sulfonamides
Tramadol w/ MOA inhibitor, TCA, PPA; Opioids; Selegiline (MOA in.); Chemo
All of the above
Aminoglycosides; ACE inhibitors; Digotoxin; Beta blockers; Diuretics; NSAID
48
PCV/TS/Glucose/BUN (Big 4 or QATS)
Location of pre-anesthetic evaluation
Animals with bleeding disorders (ex. doberman)
Older patients w/ non/elective procedure, any recent hx of illness, sus. dx
Young (<5y) healthy patient having an elective procedure, no abnormal hx
49
Patient w/ severe systemic dz that is constant threat to life; uremia, toxemia, sepsis, shock, emaciation, heart failure
Category II (ASA physical status scale)
Category V (ASA physical status scale)
Category IV (ASA physical status scale)
Category III (ASA physical status scale)
50
12y Quarter horse w/ 12h colic; 9m pregnant; pawing + rolling; tachycardia, no gut sounds, mm dark pink; What ASA PS?
ASA 2E
ASA 4E
ASA 4
ASA 5
51
Presence or absence of disease (determined by history, PE, lab tests); severity of pain; level of stress
Why pre-anesthetic evaluation should be performed
When pre-anesthetic evaluation should be performed
Physical status
52
Decrease food/fluid in stomach, risk of aspiration; distended stomach impairs ventilation; horse: full could rupture
Interesting research regarding fasting times
What to consider for depriving water from patients w/ ^ fluid requirements
Reasons fasting is not necessary for neonates, small birds, + some mammals
Reasons a patient is fasted prior to general anesthesia
53
Describe what you hear, not just WNL; palpate trachea
mm/CRT (PE findings)
Respiration (PE findings)
Body weight (PE findings)
Pulse - rate, rhythm, quality (PE findings)
54
Tells you hydration status and hemodynamic status
Respiration (PE findings)
Pulse - rate, rhythm, quality (PE findings)
mm/CRT (PE findings)
Body weight (PE findings)
55
Hyperkalemic Periodic Paralysis (HYPP)
Quarter horses
Rabbits
Herding breeds
Pigs
56
Patients with mild systemic disease; skin tumor, fracture, local infection, compensated cardiac disease, pregnant
Category II (ASA physical status scale)
Category I (ASA physical status scale)
Category III (ASA physical status scale)
Category IV (ASA physical status scale)
57
4-6 hours for food; no preference for water
Cattle - adult healthy (fasting + water deprivation times)
Swine - adult healthy (fasting + water deprivation times)
Bird <200g, Neonate, Rodents/rabbits (fasting + water deprivation times)
Bird - adult healthy (fasting + water deprivation times)
58
Overall efficiency and function of organ systems
Physical status
Why pre-anesthetic evaluation should be performed
When pre-anesthetic evaluation should be performed
59
Day before or up to 1wk before procedure; emergency -> do immediately prior; short exam day of
When pre-anesthetic evaluation should be performed
Physical status
Why pre-anesthetic evaluation should be performed
60
Neonate or pediatric; Geriatric
Increase dose of anesthetic drugs
Decrease dose of anesthetic drugs
61
Not necessary for food; no preference for water
Bird <200g, Neonate, Rodents/rabbits (fasting + water deprivation times)
Swine - adult healthy (fasting + water deprivation times)
Cattle - adult healthy (fasting + water deprivation times)
Bird - adult healthy (fasting + water deprivation times)
62
Renal insufficiency, febrile, diabetes, hot environment
Interesting research regarding fasting times
Reasons a patient is fasted prior to general anesthesia
Reasons fasting is not necessary for neonates, small birds, + some mammals
What to consider for depriving water from patients w/ ^ fluid requirements
63
Volume of distribution for drugs
Poor condition/starvation
Size of patient (considerations for dosing drugs)
Obesity (considerations for dosing drugs)
Age (considerations for dosing drugs)
64
Brachycephalic syndrome
Miniature schnauzers
Boxers
Pugs
Doberman pinschers
65
Need signed consent form by owner; can get verbal confirmation over phone, but need 2nd person to confirm consent
False
True
66
Temperament/mentation and level of pain and stress
Step 6 of pre-anesthetic evaluation
Step 4 of pre-anesthetic evaluation
Step 3 of pre-anesthetic evaluation
Step 5 of pre-anesthetic evaluation
67
3y MI beagle; emergency 4in laceration on R flank from barbed wire; PE WNL; up-to-date on everything; What is ASA PS?
ASA 3
ASA 1
ASA 2E
ASA 1E
68
Always start with the signalment!
Step 1 of pre-anesthetic evaluation
Step 4 of pre-anesthetic evaluation
Step 2 of pre-anesthetic evaluation
Step 3 of pre-anesthetic evaluation
69
Definite delay in return of skin to normal position, slight prolongation of CRT, eyes poss. sunken in orbits + dry mm.
10-12% dehydration
12-15% dehydration
6-8% dehydration
5-6% dehydration
70
12-24 hours for food; no preference for water
Bird - adult healthy (fasting + water deprivation times)
Cattle - adult healthy (fasting + water deprivation times)
Swine - adult healthy (fasting + water deprivation times)
Bird <200g, Neonate, Rodents/rabbits (fasting + water deprivation times)
71
Pre-anesthetic evaluation of patient is ultimately the responsibility of the veterinarian in charge of the patient
False
True