Anaesthetic emergencies

• How can we limit anaesthetic risks/ emergencies?

  Adequate pre-anaesthetic assessment,.

  
  

  Appropriate use of anaesthetic drugs.

  
  

  Careful monitoring.
• Name some causes to anaesthetic emergencies?

  Human Error, Equipment failure, drugs, patient factors.
• Factors of human error?

  Fatigue, failure to follow procedure, personal (pre-occupied), lack of familiarity with equipment and incorrect calculations/ administration of drugs.
• Factors of equipment failure?

  Vaporiser problems, malfunction of anaesthetic machine, APL valve problems, empty O2 cylinder, CO2 absorber exhausted.
• Factors of drugs?

  Inappropriate or individual reaction to drugs.
• examples of drug scenarios which cause emergencies?

  ACP in hypovolemic animals, Volatile agents are cardiorespiratory depressant at high doses, out of date drugs, poorly stored drugs.
• Patient factors?

  Respiratory or CVD, neonatal/geriatric, brachycephalic ect.
• what are the 3 principles of emergency care?

  Teamwork and organisation.

  
  

  CRASH protocol

  
  

  know how to deliver IPPV and cardiac compressions.
• what is the process/ protocol during emergencies?

  Alert VS, stay calm, assess what the issue is, prioritise, know location of emergency kit, turn of vaporisers, CRASH protocol.
• How is the emergency kit managed?

  Identified persons responsibility, Regular checks on content and dates, maintain check lists and sign off, Keep drug dosage sheet in crash box.
• What drugs are found in the crash kit?

  Atropine, Adrenaline, lignocaine, diazepam, naloxone, dopamine, dopamine atipamezolem, Sodium bicarbonate.
• what equipment is found in crash kit?

  Ambu bag, defibrillator, urinary catheter, IV catheter.
• What is an ambu bag?

  Used in respiratory arrest to provide IPPV, May use mask or attach to ET tube.
• when is a defibrillator used?

  Used in cardiac arrest to stimulate heartbeat and myocardial contractions.
• how does a defibrillator work?

  electrical change applied to stimulate cardiac muscle contraction.
• why is a urinary catheter used?

  To administer drugs via ET tube (adrenaline/ atrophine)
• why is a IV catheter placed?

  to allow for emergency access for drugs (fluid)
• what problems can be seen during anaesthesia?

  Patient too light or deep, respiratory arrest, cardiac arrest.
• How is IPPV performed?

  Close APL valve, fill reservoir bag with O2, gently squeeze the bag until patient chest rises slightly, open APL valve, repeat every 6 seconds until signs of recovery and vitals improve, crease for 30 secs watch for spontaneous breathing or continue.
• CPR process?

  Animal in lateral recumbency, heal of hand at 5th intercostal space. Compress chest by 1/3 width of check.
• How is compressions given to small dogs or cats?

  Using thumb and fingers.
• What is the rate of compressions per minute?

  100 compressions.
• What should be used on dogs over 20kg during CPR?

  Thoracic pump.
• What should occur if CPR isnt successfult?

  Continue until spontaneous return of pulse and breathing occurs.

  
  

  Use drugs (adrenaline)

  
  

  Use defibulator/ VS for open cardiac massage.

  
  

  After 15-20 mins poor outcome.
• After an anaesthetic emergencies what occurs during recovery?

  IV fluids and drugs.

  
  

  Keep patient warm.

  
  

  Continual monitoring

  
  

  Potential blood analysis, ECG.