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"Don't Sweat the Small Stuff :When Not to Panic During…

- - - - Take a moment to evaluate where you will be positioned & field of view
        
        Location & position of patient table, anesthetic table & monitor placed
        
        Ensure the wires are not tangled
    - - Eyes, ears, fingertips
        
        Anesthetic reflex
        
        Palpeberal reflex
        
        Movement & response to stimulation
        
        Muscle or jaw tone
        
        Eye position
        
        Physiologic function
        
        Oxygenation
        
        Ventilation
        
        Auscultation of heartbeat, lung sounds
        
        Palpation of peripheral pulses
        
        Chest wall movement
        
        Reservoir bag excursion
        
        Capillary refill time
- - - - Motion artifact: Shivering & recovery
        
        Peripheral vasoconstriction
        
        Low tissue perfusion
        
        Pigmentation
        
        Thick hair coat
  - - - Assess ventilation
        
        Manual ventilation until spontaneous ventilation resumes
    - - Decrease vaporizer setting
        
        Consider drug reversal
- - - - Identify & treat underlying cause
- - - - Drugs: opioids, alpha 2 agonists
        
        Reduce anesthetic depth
- - - - Anticholinergic drug
- - - - Correct underlying cause
        
        Lidocaine given at bolus or CRI

Providing balance anesthesia

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Type of drug to select
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Choice & rate of IV fluid
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Techniques for pain management
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Taking into consideration on the available resources

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Anesthesia monitoring equipment
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Nursing staff
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Drug availability in the clinic
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