Flashcards in Accidents and Emergencies Deck (30):
What can cause apnea?
barbiturate or propofol induction
If the animal is not breathing what do you do?
- Check pulse first! If it is cardiac arrest will need CPR.
- Control ventilation at 2-3 breaths per minute until spontaneous breathing occurs, this allows CO2 to accumulate and supplies patient with oxygen
(Wait for propofol to disperse and decline while still delivering O2 and anesthetic to the patient)
Animal stops breathing when arterial P CO2 falls into the ____. Therefore a high even CO2 level is required for normal spontaneous respiration
When do we use doxapram?
Don't! mechanical/manual assistance is safer and more effective!
Signs of an airway obstruction?
dyspnea, stridor/snoring, jerky and sudden movement of reservoir bag, will take more pressure to squeeze reservoir bag
possible causes of an airway obstruction?
mass, laryngeal spasm, kinking of trach tube, overinflated cuff, blockage with mucus/blood/aspirated material
how can you prevent an airway obstruction?
use an armored tube if the procedure involves flexion of the neck
hypoventilation depends on?
Common cause of hypoventilation?
Isoflurane inhalant! Dose dependent
When do you ventilate the patient?
small animal v. horses?
SA: when arterial CO2 reaches 50 mmHg give a breath. If above 60 mmHg attach to ventilator.
Horse: 40-60mmHg is normal, start ventilating at 70mmHg, when over 80 mmHg needs a ventilator
Cardiac arrest most often occurs due to
Hypotension is defined as
MAP <60-70 mmHg
Causes of hypotension under anesthesia?
drugs (inhalants, propofol, ace), hypovolemia, shock, deep plane of anesthesia, excessive manipulation of viscera
Pulse and hypotension?
Can have both, need to check MAP! But normally have weak peripheral pulses in hypotensive
tx for hypotension
- cystalloid fluids (10 ml/kg over 10 minutes)
- positive inotropes CRI if not responding to fluids (dopamine in small animals, dobutamine in horses)
Why is hypotension worrisome in horses?
if 30 minutes long will cause myositis and they wont be able to stand = dead horse
VPCs are ____ and may _______.
wide and bizarre QRS complex, no p wave
may progress to life-threatening dysrhythmias (Vtach, Vfib)
causes of VPCs?
hypoxemia, hypercapnia, heart disease (HBC), often GDVs
When do administer lidocaine if there are ventricular dysrhythmias?
VPCs are multifocal, multiform, appear in pairs/runs(especially V tach) or >5-15 per minute
How to treat VPCs?
Lidocaine; If ineffective use procainamide
Causes of bradycardia?
excessive vagal tone (intubation, visceral traction, eyeball traction)
(may need to ask surgeon to stop manipulation momentarily)
When to use atropine or glycopyrrolate to treat bradycardia?
dogs HR falls < 50-60 bpm
medium sized <60
small dogs < 80
cat < 100
second degree AV block defined as
p wave without associated QRS
causes of sinus tachycardia?
pain due to light anesthetic plane
hypovolemia, hypovolemic shock
Steps to follow Cardiac arrest?
1. Feel lingual artery for pulse
2. stop anesthesia
3. increase oxygen flow
4. surgeon closes abdomen
5. move to lateral recumbancy
6. compressions 100/min
7. ensure open airway
tx for sinus tachycardia?
check anesthetic plane
check blood gas levels, inc. oxygen if necessary
check for a pulse, is it the machine?
will not have a pulse
pulse with normal ECG?
may be in cardiac arrest!