Anaesthesia assignment

Re: Anaesthesia assignment

Elerrina — Tue, 28 May 2013 22:38:32 GMT

I had to actually monitor the anaesthetic and this is the one I did and its only for the VCA course so i don't have to go into that much detail i dont think

Re: Anaesthesia assignment

Nick Shackleton — Tue, 28 May 2013 20:20:37 GMT

Maybe you could chose a better case such as the fracture repair itself cos then you can discuss adequate pain relief more effectively such as use of constant rate infusions and gaseous pain relief. However these are still need to be considered. You can talk about what you might notice in the patients response pain stimuli, such as extracting the pin and obviously what you would do. Remember that when you a monitoring your patient you are looking or trends rather than one off high/low readings.

Re: Anaesthesia assignment

Elerrina — Tue, 28 May 2013 19:40:50 GMT

Thanks for all the help and advice its great =)

Re: Anaesthesia assignment

Siobhan Steven — Tue, 28 May 2013 12:00:29 GMT

I just reread your question, in regards to how you would detect them...

Pressure testing your machine/circuit helps ensure you won't have leaks (including inflating cuffs on ET tubes to check them). Check Iso & O2 levels.

Change soda lime after 8 hours use so you ensure its always fresh and won't lead to high CO2 levels in your patient.

Administer premed suitable for the procedure, using your pin removal as an example an opioid, e.g Methadoen at 0.5mg/kg IM or 0.2 mg kg IV with 5 ug/kg IM or 3 ug/kg IV would be a premed you could use, this would ensure a nice sedation and then induction with proposal 2-6 mg/kg to effect. If you give too much induction you can get induction apnoea. Pre measure ET tubes to the thoracic inlet to avoid intubating past the bifurcation. Visualise the trachea with a laryngoscope to avoid intubating the esophagus. Only inflate tube enough to prevent gas leaking, this means having someone squeeze the reservoir bag with the popoff closed while you listen for air escaping while carefully inflating cuff, not just pumping air into cuff...

Ensure you work out O2 flow for the circuit and size of animal. Administer the appropriate amount of Iso to keep the patient at surgical level of anaesthesia.

Monitor with pulse ox to ensure O2 saturation over 95%. Monitor capnogrophy to ensure end tidal CO2 levels are appropriate, 35-45 mmHg. Administer IVF to assist perfusion = maintaining blood pressure.

Re: Anaesthesia assignment

Siobhan Steven — Tue, 28 May 2013 11:47:08 GMT

It depends where they want you to start. Is it in regards to monitoring and anaesthetic or an anaesthetic from start to finish?

You can have equipment failure,e.g a leak in your ET tube cuff or anywhere else in the system, run out of isoflurane or O2, exhausted soda lime or inefficient scalage. Atmospheric pollution affecting staff if there are leaks.

Your premedication or induction agent may be inadequate, both in sedative or analgesic effect. You could intubate past the bifurcation of the bronchi leading to hypoxia. Intubate the esophagus instead of trachea. Insufficient inflation of ET tube cuff. Tracheal laceration if the patient is moved/rotated and the tube is not disconnected from the tube first (turn off the O2 so no gases are flowing while you do this). Pressure necrosis in the tracheal from an overinflated cuff.

Insufficient/incorrect O2 flow or isoflurane level. Leading to hypoxia/hypoxeamia (O2) or ineffective anaesthesia depth. Hypotension (MAP <60mmHg) which can only be detected by NIBP monitoring or arterial line (palpating pulses does not indicate BP). Hypo/hypercarbia if CO2 is not expelled effectively and respiratory acidosis/alkalosis if homeostasis is not maintained, leading to metabolic disorders.

Organ disfunction if blood pressure is not maintained and if intravenous fluids are not administered (or incorrect fluid therapy provided for various conditions).

Is that the sort of thing you mean?

Re: Anaesthesia assignment

Katie_W — Tue, 28 May 2013 02:35:12 GMT

Hypothermia is another common problem that can be identified and rectified, think about ways you could prevent and manage this.

Re: Anaesthesia assignment

Johnathan Prior — Mon, 27 May 2013 17:15:47 GMT

Ensuring you have enough oxygen by reading the valve is another point

Re: Anaesthesia assignment

Johnathan Prior — Mon, 27 May 2013 17:15:01 GMT

Don't just think patient problems. What about leaks in circuits and the checks you make etc

Re: Anaesthesia assignment

bongo — Mon, 27 May 2013 14:27:00 GMT

Think of other problems that can occur under anaesthesia and what signs might you see before this happens. For example, hypotension is something which you can observe but normally unless something awful has happened it gradually occurs and you can normally rectify it before you have a major prob. Same with heart rate or some arrythmias.