Anesthesia & Analgesia for Emergency and Critical Care Patients
Speaker: Tamara Grubb
Reviewed by: Dr Philip Judge
Event Name: WSAVA World Congress 2024
Key Takeaways
Top Tips
Key Takeaways
- Anesthesia Risk Management:
- Emergency and critical care patients often present with multiple comorbidities, which can significantly impact the safety of anesthesia.
- Reducing anesthetic risk is crucial, particularly in patients with vital organ involvement such as the heart, lungs, and brain.
- ASA Classification System:
- Understanding and utilizing the American Society of Anesthesiologists (ASA) classification system is essential for assessing anesthetic risk.
- Efforts should be made to reduce a patient’s ASA risk category by addressing correctable conditions, thus lowering associated mortality.
- Medication Considerations:
- Various pre-medications, induction agents, and maintenance anesthetic agents can be used, but require evaluation of their pros and cons.
- Inhalant anesthetics like isoflurane can have negative cardiovascular effects, which are particularly harmful in emergency patients.
- Continuous Infusion Approach:
- Using continuous infusions of medications like ketamine, lidocaine, and opioids can reduce the need for inhalant anesthetics, improving patient safety.
- Anesthetic Recovery:
- The highest risk period for anesthesia-related mortality is during recovery. Close monitoring is vital to address abnormal parameters like temperature and blood pressure.
- Vigilance during recovery is crucial, especially in critical patients, to ensure they safely regain consciousness and stabilize.
Top Tips
- Pre-Procedure Optimization:
- Identify and treat underlying conditions before anesthesia to reduce overall risk, especially in critical patients.
- Minimize Inhalant Anesthetic Use:
- Where possible, reduce the use of inhalant anesthetics by opting for continuous infusions of other drugs to mitigate cardiovascular risks.
- Monitor Recovery Closely:
- Anesthetic recovery is a high-risk phase. Ensure close supervision with constant monitoring of vital signs and corrective interventions as needed.
- Team Effort:
- Effective anesthetic care and recovery involve coordinated efforts between veterinarians, veterinary nurses, and support staff, along with the use of monitoring tools.