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Anesthesia Study Guide Exam I

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Lecture 1
Patient evaluation, risk assessment, and management
Learn how to obtain a history, perform a physical exam, and evaluate diagnostic tests for
the common domestic species.
History
Signalment Age, sex, species, breed, weight
Presenting complaint?
Reason for anesthesia?
Diagnostic procedure
Surgical procedure
Multiple procedures
Temperament, concurrent ds (neurological, cardiovascular, respiratory…),
concurrent medications, prior anesthetic episodes
Physical exam
Looks at temperament, breathing…
Mentation
Cranial nerve function pupillary light reflex, palpebral reflex, swallowing reflex
Peripheral nerve function
Sensory nerve function
Motor nerve function
Cardiovascular system
Heart rate and rhythm
Auscultation
Pulse strength and quality
Mucous membrane color
Hydration status
Exercise tolerance
Respiratory system
Respiratory rate and character
Ocular and nasal discharge
Cough
Tidal volume normal breath
Minute volume normal breath in a minute
Evaluate diagnostic tests
PCV/TP
Learn how to assess the risks associated with anesthesia for the common domestic
species.
The risks associated with anesthesia are very different from those associated with
diagnostic and surgical procedures
The goal of risk assessment is to identify the major anesthetic risk factors for each
patient
Ex: French bulldog airway complication occurs before and after the procedures

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Anesthetic Risk Classification
Status I
Normal healthy patients
Status II
Patients w/ mild systemic ds
Status III
Patients w/ moderate systemic ds
Status IV
Patients w/ severe systemic ds
Status V
Patients that are not expected to survive
Learn how to develop an anesthetic plan and manage anesthesia for the common
domestic species.
Obese patient reduced FRC (Functional Residual Capacity)
FRC = the amount of volume remaining in the lung after a normal exhalation
The goal of the anesthetic plan is to select drugs, techniques, equipment, and
supportive care that makes anesthesia as safe as possible for each patient
The anesthetic plan
Patient factors
Duration of procedure (short, intermediate, or long)
Type of procedures
Technical support
Anesthetic machines
Breathing circuits
Ventilators
Patient monitors
Patient preparation
Food and water withholding
Dogs and cats withhold food and water to prevent vomiting, regurgitation and
aspiration of stomach contents during anesthesia; food is withheld for 8-12
hours, and water is withheld on the morning of the procedure
Horses horses don’t vomit, withhold food and water to limit compression of
the diaphragm and improve pulmonary function during anesthesia; food is
withheld for 8-12 hours, and water is withheld on the morning of the procedure
Ruminants withhold food and water to prevent regurgitation and aspiration
of stomach contents during anesthesia, also prevent bloat, limit compression of
the diaphragm, and improve pulmonary function during anesthesia; food is
withheld for 24-48 hours, and water is withheld for at least 12 hours
Patient stabilization
When possible, major physiological disturbances should be corrected before
induction of anesthesia (anemia, hypoproteinemia, acid-base disturbance,
electrolyte disturbances, cyanosis, pneumothorax, CHF, cardiac arrhythmias…
Initial sedation and analgesia
Induction of anesthesia
Maintenance of anesthesia
Maintain anesthesia with an inhaled anesthetic?
Perform nerve block?

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Lecture 1 Patient evaluation, risk assessment, and management ❖ Learn how to obtain a history, perform a physical exam, and evaluate diagnostic tests for the common domestic species. ➢ History ▪ Signalment → Age, sex, species, breed, weight ▪ Presenting complaint? ▪ Reason for anesthesia? • Diagnostic procedure • Surgical procedure • Multiple procedures ▪ Temperament, concurrent ds (neurological, cardiovascular, respiratory…), concurrent medications, prior anesthetic episodes ➢ Physical exam ▪ Looks at temperament, breathing… ▪ Mentation ▪ Cranial nerve function → pupillary light reflex, palpebral reflex, swallowing reflex ▪ Peripheral nerve function • Sensory nerve function • Motor nerve function ▪ Cardiovascular system • Heart rate and rhythm • Auscultation • Pulse strength and quality • Mucous membrane color • Hydration status • Exercise tolerance ▪ Respiratory system • Respiratory rate and character • Ocular and nasal discharge • Cough • Tidal volume → normal breath • Minute volume → normal breath in a minute ➢ Evaluate diagnostic tests ▪ PCV/TP ❖ Learn how to assess the risks associated with anesthesia for the common domestic species. ➢ The risks associated with anesthesia are very different from those associated with diagnostic and surgical procedures ➢ The goal of risk assessment is to identify the major anesthetic risk factors for each patient ▪ Ex: French bulldog → airway complication ...
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