The Veterinary Nurse's Practical Guide to Small Animal Anaesthesia

Cover
Title Page
Copyright Page
Contents
List of Contributors
Preface
Chapter 1 Pre-Anaesthetic Assessment and Premedication
	Patient Assessment
		History
		Physical Examination
			Cardiac and Thoracic Auscultation
			Body Condition Scoring (BCS)
			Hydration
			Patient Temperament
			Other Considerations
	Premedication
		Administration of Premedication
	Acknowledgements
	References
Chapter 2 Interpreting Blood Results
	Haematology
		Red Blood Cell Count and Packed Cell Volume (RBC and PCV)
			High PCV
			Low PCV
		White Blood Cell (WBC) and Neutrophil Count
			High Count
			Low Count
		Lymphocytes and Monocytes
		Eosinophils and Basophils
		Platelets
			High Count
			Low Count
	Biochemistry
		Proteins (TP, ALB, GLOB)
			High Levels (Hyperproteinaemia)
			Low Levels (Hypoproteinaemia)
		Hepatic Parameters (ALKP, ALT, BIL)
			High Levels
		Renal Parameters (CREA, BUN, InPHOS)
			High Levels
			Low Levels
		Glucose (GLU)
			High Levels (Hyperglycaemia)
			Low Levels (Hypoglycaemia)
	Electrolytes
		Sodium (Na+)
			High Levels
			Low Levels
		Potassium (K+)
			High Levels
			Low Levels
		Calcium (Ca2+)
			High Levels
			Low Levels
	Conclusion
	References
Chapter 3 Cardiovascular Physiology
	Blood Flow Through the Heart
	Conduction Through the Heart
	Vascular System
		Pulmonic Circulation
		Systemic Circulation
	Cardiac Output
		Stroke Volume
		Heart Rate
	Anaesthetic Considerations for Patients with Cardiovascular Disease
	References
Chapter 4 Respiratory Physiology and Ventilation
	Respiratory Anatomy
		Pulmonary Ventilation
		Central Regulation of Respiration
		Chemical Regulation of Respiration
	Mechanics of Breathing
		Inspiration
		Expiration
	The Effects of Anaesthesia on Normal Respiratory Physiology
	Indications for Ventilation
	Initiation of Ventilation
	Manual Ventilation
	Mechanical Ventilation
	Volume Cycling Versus Pressure Cycling Ventilation
	Positive End-expiratory Pressure (PEEP) and Alveolar Recruitment Manoeuvres (ARM)
	Possible Harmful Effects of Artificial Ventilation
	Ventilation Strategies to Prevent Some of the Possible Negative Effects of IPPV
		On the Lungs
		On the Cardiovascular System
		On the Intracranial Pressure
		On Blood Gas and Acid–Base Disturbances
	Troubleshooting During Mechanical Ventilation
		Anaesthetic Machine and Breathing System
		Ventilators
		Patient
	Weaning the Patient Off the Ventilator
	References
Chapter 5 Blood Pressure Regulation and Monitoring
	What Factors Contribute to Blood Pressure
	The Importance of Blood Pressure Regulation During Anaesthesia
	How Do We Measure Blood Pressure?
		Non-invasive/Indirect Blood Pressure Monitoring
			Doppler
			Oscillometric
			High Definition Oscillometric (HDO) Devices
		Invasive Blood Pressure Monitoring
	Treatment of Hypotension Under General Anaesthesia
	Drugs to Treat Hypotension
		Positive Inotropes
			Adrenaline/Epinephrine, Ephedrine, Dobutamine, Dopamine, Noradrenaline/Norepinephrine
		Vasopressors
			Adrenaline/Epinephrine, Dopamine, Ephedrine, Noradrenaline/Norepinephrine, Phenylephrine, Vasopressin
		Anticholinergics
			Glycopyrolate, Atropine
	Treatment of Hypertension Under General Anaesthesia
	Summary
	Quick Reference Terminology and Definitions
	References
Chapter 6 Capnography and Spirometry
	Capnography/Capnometry
	Capnograph Device Options
	Information Provided from a Capnograph
		Carbon Dioxide
		Interpretation of Carbon Dioxide Values
		The Normal Capnogram
	Analysis of the Capnogram
	Common Abnormal Capnography Waveforms and Their Interpretation
	Spirometry
	Acknowledgements
	References
Chapter 7 Pulse Oximetry
	Introduction
	How Does the Pulse Oximeter Work?
	Data Interpretation
	SpO2 and PaO2
	Hypoxaemia
	Plethysmograph
	Anaemia and Abnormal Haemoglobin Forms
		Anaemia
		Methaemoglobin
		Carboxyhaemoglobin
	Tips and Tricks
	Advanced Technology – Masimo Pulse Co-Oximetry
	References
Chapter 8 Practical ECGs
	ECG Fundamentals
		Normal Conduction
		The ECG Machine
		The ECG Cables
		The ECG Complex
	Common ECG Complexes and Rhythms
		Sinus Rhythms
			Normal Sinus Rhythm
			Sinus Arrhythmia
			Sinus Tachycardia
			Sinus Bradycardia
		Supraventricular Arrhythmias
			Atrial Fibrillation
			Second Degree Atrioventricular Block
			Third Degree Atrioventricular Block
			Sick Sinus Syndrome
		Ectopic Ventricular Complexes
			Ventricular Premature Complex
			Ventricular Escape Complex
		Ventricular Arrhythmias
			Ventricular Tachycardia
			Accelerated Idiopathic Ventricular Rhythm
			Ventricular Fibrillation
	References
Chapter 9 Fluid Therapy
	Fluid Distribution and Composition
	Movement of Fluid in the Body
	Fluid Disturbances
		Dehydration vs. Hypovolemia
	Intravenous Fluid Therapy During the Peri-Anaesthetic Period
	Fluid Selection
		Crystalloids
			Hartmann’s Solution/Compound Sodium Lactate
			Lactated Ringer’s Solution
			Normal Saline
			5% Dextrose Solution
			Hypertonic Sal
		Colloids
			Gelatines
			Dextrans
			Hydroxyethylstarches (HES)
			Albumin
			Whole Blood
			Plasma (Fresh/Fresh Frozen/Stored)
	Fluid Supplementation
		Potassium
		Sodium Bicarbonate
		Calcium
		Glucose
	Fluid Delivery Systems
		Giving Sets
		Fluid Pumps and Syringe Drivers
	References
Chapter 10 Induction Agents
	Stages of General Anaesthesia
	Injectable Anaesthetics
		Propofol
			Pharmacokinetic Properties
			Pharmacodynamic Properties
			Tips and Tricks
			Special Considerations
		Alfaxalone
			Pharmacokinetic Properties
			Pharmacodynamic Properties
			Tips and Tricks
		Special Considerations
		Propofol and Alfaxalone Total Intravenous Anaesthesia – TIVA
			Special Considerations
		Ketamine
			Pharmacokinetic Properties
			Pharmacodynamic Properties
			Tips and Tricks
			Special Considerations
		Co-Induction
			Special Considerations
		Etomidate
			Pharmacokinetic and Pharmacodynamic Properties
			Special Considerations
		Thiopental
	Inhalational Anaesthesia Induction
	Acknowledgements
	References
Chapter 11 Inhalant Anaesthetic Agents
	Pharmacokinetics of Inhalant Agents
		Distribution
			The Inspired Concentration of Inhalants
			Blood: Gas Solubility
			Ventilation
		Elimination
	Minimal Alveolar Concentration (MAC)
	The Ideal Inhalant Agent
	Physiological Effects of Inhalant Agents
	Isoflurane
	Sevoflurane
	Desflurane
	Vaporisers
		Saturated Vapour Pressure
	Desflurane
	Position on the Back Bar
	Key Fill Systems
	Nitrous Oxide
		Advantages and Clinical Uses
		Disadvantages
	Personal Safety
		Monitoring of Exposure
		Limiting of Exposure
	References
Chapter 12 Intubation
	Placement of an ETT
	Equipment
		ETT or Similar Device
		Laryngeal Masks
			Armoured ETT
			Securing the ETT
			Laryngoscope
			A Stylet
			Lidocaine
	Technique
		Confirming Placement
		Inflating the Cuff
		Cleaning ETT
	Alternative Intubation Techniques
		Nasotracheal Intubation
		Intubation Using a Pharyngotomy
		Retrograde Intubation
		One Lung Intubation
		Tracheostomy
	Troubleshooting
		Brachycephalic Patients
		Equipment for Difficult Intubation
		How to Deal with an ETT that Is Difficult to Remove
	Summary
	References
Chapter 13 The Anaesthetic Machine and Breathing Systems
	Introduction
	Gas Supply
		Oxygen Cylinders
		Nitrous Oxide Cylinders
		Oxygen Concentrators
		Cylinder Manifold
		Liquid Oxygen
		Pressure Gauges and Regulators
		Alarms
		Safety Features
	The Anaesthetic Machine
		Flowmeters
		Back Bar
		Common Gas Outlet
		Oxygen Flush
	Anaesthetic Machine Leak Test
	Scavenging System
		Active Scavenging System
		Passive Scavenging System
	Breathing Systems
	Non-Rebreathing Systems
		Fresh Gas Flow
		Paediatric T-Piece
		Bain
		Lack
	Rebreathing Systems
		Circle Fresh Gas Flow Rates
		Carbon Dioxide Absorbing
	Hybrid System
		Fresh Gas Flow
	Breathing System Selection
	Storage and Repeated Use of Breathing Systems
	References
Chapter 14 Anaesthesia Recovery
	Introduction
	Preparing to Recover
	Handover to the Recovery Team
	Monitoring in the Recovery Period
	Delayed Recovery
	Sedation in the Recovery Period
	Pain Management
	Airway Management and Hypoxaemia
		Airway Obstruction
		Hypoxaemia
	Temperature Management
		Hypothermia
		Hyperthermia
	Haemodynamic Instability
	Coexisting Disease Considerations
	Conclusion
	References
Chapter 15 Pain
	The Pain Pathway
		Transduction
		Transmission
		Modulation
		Projection
		Perception
	Pain Management
		Opioids
		Ketamine
		Lidocaine
		Alpha-2-Adrenergic Agonists
		Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
		Other Analgesics
		Nursing Care for the Painful Patient
	Pain Assessment
		Pain Scoring Systems
			Validation
			Application of Pain Scales
			Pitfalls of Pain Scoring Systems
	Acknowledgements
	References
Chapter 16 Local Anaesthetic Techniques
	The Nervous System
	Mechanism of Action
	Performing Local Anaesthetic Techniques
	Techniques for the Head
		Techniques for the Upper Jaw and Nose
			Maxillary Nerve Block
			Infraorbital Nerve Block
			Palatine Nerve Block
		The Lower Jaw
			The Mandibular Nerve Block
			The Mental Nerve Block
	Ocular Nerve Blocks
		The Retrobulbar Block
	Auricular Nerve Blocks
	Techniques for the Forelimbs
		Brachial Plexus Nerve Block
		RUMM Block
	Techniques for the Hindlimbs
		The Epidural
		Femoral, Sciatic, and Psoas Nerve Block
		Bier’s Nerve Block
		Digital Nerve Block
	Thoracic Nerve Block
		Intercostal Nerve Block
	Techniques for Neutering
		Testicular Block
		Ovarian Pedicle
	Other Techniques
		The Erector Spinae Plane Nerve Block
		Quadratus Lumborum Nerve Block
	Local Anaesthesia for Post-Operative or Chronic Pain Conditions
		Wound Soaker Catheters
		Intrapleural Analgesia
		Epidural Catheters
	Nursing Care for Patients Following Local Anaesthetic Techniques
	Acknowledgements
	References
Chapter 17 Constant Rate Infusions and Calculations
	What Are CRIs
	Advantages of CRIs
	Analgesia
	Blood Pressure Regulation
	Hypnosis
	Administration
	Calculations
	Acknowledgements
	References
Chapter 18 Case Studies
	Brachycephalic Patients
	Renal Disease
	Hyperthyroidism
	Diabetes Mellitus
	Hepatic Disease
	The Aggressive Patient
	Paediatric Patient
	Geriatric
	Respiratory Patient
	Caesarean Section
	Gastric Dilation-Volvulus
	Urethral Obstruction
	Cardiac Disease
	Acknowledgements
Index
EULA