monitoring

Question 1

why do we monitor anaesthesia

Answer 1

• to prevent patient response to surgical stimulation (nociception)
• to detect abnormalities before they turn into major complications
• to maintain tissue perfusion and oxygenation so we can improve patient outcome and prevent worsening of subclinical disease

Question 2

how do you establish depth of anaesthesia

Answer 2

• check jaw tone
• eye position
• palpebral reflex
• capnography
• HR
• RR
• BP

Question 3

A cat under anaesthesia has a central eye. why might this be

Answer 3

• was given ketamine –> increases muscle tone and therefore eyes dont rotate down
• too light
• too deep (if pupils dilated)

Question 4

which breed often maintains some jaw tone under anaesthesia

Answer 4

brachycephalic breeds

Question 5

what anaesthetic drug increases muscle tone and what are the consequences

Answer 5

ketamine
- central eye position
- some jaw tone

Question 6

list methods of patient warming

Answer 6

• bubble wrap
• bair hugger warming device
• foil blanket
• electric heat pad
• fluid warmer
• heat and moisture exchange device
• heated operating table
• use warm prep solution
• socks

Question 7

what should the HR of an anaesthetised patient be

Answer 7

60-120

Question 8

what drugs cause vasoconstriction leading to pale mm and slow crt

Answer 8

alpha 2 agonists

Question 9

what breed has naturally blue tinged mucus membranes

Answer 9

chows

Question 10

name 2 methods of measuring bp

Answer 10

• doppler
• oscillometric

Question 11

what should the width of a BP cuff be

Answer 11

40% of the circumference of the area of the limb you are placing it on

Question 12

a doppler measures which blood pressure parameters in cats vs dogs

Answer 12

closer to MAP in cats
systolic in dogs

Question 13

MAP of < 60mmHg for over 30 mins can lead to

Answer 13

• renal failure
• delayed recovery
• neuromuscular complications
• decreased hepatic metabolism of drugs
• CNS abnormalities such as blindness

Question 14

what MAP is required for proper perfusion of the heart, brain and kidneys

Answer 14

60 mmHg

Question 15

what does pulse oximetry tell us

Answer 15

spo2 =% hemoglobin that is saturated with oxygen (healthy pt should be over 95
- detects hypoxaemia
- measures pulse rate
- displays pleth waveform

Question 16

what are the limitations of pulse oximitry

Answer 16

• patient may not be hypoxaemic but may be hypoxic (blood is well oxygenated but the circulation is insufficient to distribute oxygenated blood)
• can give inaccurate readings due to: vasoconstriciton, hypoperfusion, movement, hypothermia, bright overhead lights, smoke inhalation, pigmented skin, anaemia, shock

Question 17

list indications for capnography

Answer 17

• monitoring of ventilation in spontaneously breathing anaesthetised patients
• monitoring of patients undergoing mechanical or manual ventilation
• monitoring of patients undergoing CPR
• monitoring of ventilation in intubated coma patients
• confirmation of ETT placement
• contrimation of naso-oesophgeal feeding tube placement

Question 18

what information do we get from capnography

Answer 18

metabolism, perfusion, ventilation
- breathing or not/resp rate
- expired and inspired CO2 levels
- waveform profile

Question 19

outline common waveform changes in capnography

Answer 19

Question 20

what is the normal EtCO2 ranges for dogs and cats

Answer 20

35 to 45 mmHg but cats a bit lower at 28-45mmHG

Question 21

name a possible cause of hypocapnia

Answer 21

hyperventilation (CO2 is exhaled faster than it is being produced)

Question 22

list a possible cause of hypercapnia

Answer 22

hypoventilation (the CO2 is being exhaled slower than it is being produced)

Question 23

What information does a pulse oximeter provide about the patient?

Answer 23

haemoglobin oxygen saturation

Question 24

When it comes to monitoring the respiratory system, we pay attention to: Tick all that apply

Answer 24

resp rate
resp rhythm
resp effort
lung sounds
capnography

Question 25

A pulse deficit can be identified by:

Answer 25

palpating a peripheral pulse whilst listening to the heart through a stethoscope at the same time

Question 26

A pulse deficit may indicate:

Answer 26

an arrythmia of some sort

Question 27

Which of the following measures systolic Bp, diastolic Bp and mean arterial pressure? oscillometric doppler

Answer 27

oscillometric