Surgical Assisting

What information does blood give? (pre-surgery)

• insight to health of organs

• confirms pet is safe to go under anesthesia

How does blood show hydration status?

↑ RBC = dehydrated

How does blood show kidney function?

BUN = Blood Urea Nitrogen

How does blood show liver function?

CBC = Complete Blood Count

What does free thyroxine (Free T4) in the blood show?

thyroid function

How does blood show glucose levels?

↑ glucose could be diabetes

How does blood detect heartworms?

SNAP test or microfilaria

After drawing blood, where will it be sent?

sent to lab or run in-house

sterilization

process of killing all present microorganisms

disinfectant

chemical that kills infectious materials on surfaces

antiseptic

chemical that inhibits infection or infectious material during surgery

sepsis

presence of infection or infectious material = septic environment

asepsis

absence of infection or infectious material = sterile or aseptic environment

How should you prep surfaces in the surgery room?

dust and disinfect all surfaces

How should you prep equipment in the surgery room?

make sure necessary surgical equipment is easily accessible

How should you prep surgery packs in the surgery room?

must be in place and left unopened prior to scrubbing

What does scrubbing mean during surgery prep?

process of washing hands hands and forearms thoroughly BEFORE engaging in surgery

How must you preform the patient’s physical exam?

• pre-op blood work

• weight

• TPR

How must you prepare the patient’s pre-anesthetic given by doctor?

SubQ after physical exam

How must you prepare the surgical site?

• Shave

• DO NOT sterilize area until patient is moved to surgical suite

• vacuum/lint roller to remove extra hair

When patient enters the surgery room, where is the anesthesia injection administered?

IV catheter

When patient enters the surgery room, how fast/slow must you administer the anesthesia injection?

SLOWLY push the meds and monitor anesthetic depth

How must you monitor anesthetic depth?

determined by jaw tone (jaw is easily moved)

What is the FIRST step for prepping the surgical site?

1. Clean site w antiseptic pads

What is the SECOND step for prepping the surgical site?

2. Rotate antisept. pad each time (repeat 3x)

What is the THIRD step for prepping the surgical site?

3. NEVER go over the same area twice with the same pad. NEVER…………..

How is Heart Rate monitored during surgery?

measured w EKG or pulse oximeter

What are the normal values of Heart Rate in DOGS?

80-120 bpm

What are the normal values of Heart Rate in CATS?

100-180 bpm

How is Oxygen monitored during surgery?

measured with pulse oximeter

What are the normal values of Oxygen?

95-100%

What is the Electrocardiogram monitor’s purpose during surgery?

detects HR and rhythm changes

What is the Anesthesia machine’s purpose during surgery?

gives continuous supply of med gas for sedation

How will the surgical assistant (you) control the Anesthesia machine?

increase/decrease anesth. depending on anesth. plane of the patient or point of surgery you’re in

What is IV Drip Equipment used for?

• fluid replacement

• puts blood/medication into veins

What does the pulse oximeter do?

• monitors O2 saturation

• clipped to tongue

What does ASA stand for?

American Society of Anesthesiologists

What are ASA ratings used for?

Assess health of patient b4 anesthesia

ASA I

healthy patient w/o underlying disease

ASA II

patient w mild disease

• EX: minor heart murmur

ASA III

patient w moderate disease that limits normal activity

• EX: controlled diabetes

ASA IV

patient w severe disease that is constant threat to life

• EX: Kidney faliure

ASA V

patient that is not expected to survive w/o surgery

• EX: critical disease/trauma

What type of induction agent is Propofol?

Non-barbiturate

What type of induction agent is Alfaxalone?

Non-barbiturate

What is Propofol used for?

rapid induction of anesthesia

What is Alfaxalone used for?

induction & maintenance of anesthesia

What are some adverse effects of Propofol?

• respiratory depression

• hypotension

What are some adverse effects of Alfaxalone?

• respiratory disease

• hypotension

What is the normal respiratory rate for DOGS?

10-30 bpm

What is the normal respiratory rate for CATS?

20-30 bpm

What is the ideal body temperature during surgery?

98.6-102.2°F

Why is it important to monitor HR and RR during surgery?

• helps determine anesthetic depth and if patient is reacting negatively to anesthesia

What can happen if the body temp drops too low during surgery?

• delay recovery from anesthesia

• slow wound healing

What is the most common time for an animal to die after surgery?

in the first 3 hours of recovery

Pre-Operative Procedure: Step 1

Check patient in for surgery

Pre-Operative Procedure: Step 2

DR will do PE

Pre-Operative Procedure: Step 3

DR administers pre-anesth. injection

Pre-Operative Procedure: Step 4

Prep IV-Catheter site and place IV Cath

Pre-Operative Procedure: Step 5

Administer anesthes. IV

Pre-Operative Procedure: Step 6

Place E-tube and begin gas anesth.

Pre-Operative Procedure: Step 7

Place vital monitoring equipm. on patient

Pre-Operative Procedure: Step 8

move patient into surgical suite

Pre-Operative Procedure: Step 9

prep surgical site

Pre-Operative Procedure: Step 10

Let doc know patient is ready

Anesthesia Machine: What does the O2 tank do?

stores pure O2 and used to deliver O2 to patient

Anesthesia Machine: What does the flowmeter do?

controls flow of O2 into system

Anesthesia Machine: What does the Vaporizer do?

Adds Anesthetic gas to O2, mixes to put animal under anesth.

Anesthesia Machine: What does the breathing circuit do?

delivers Anesthetic/O2 gas mixture to animal and allows for removal of exhaled gases

Anesthesia Machine: What does the scavenger system do?

removes waste gases to prevent from accumul. in room

Anesthesia Machine: What does the pressure gauge do?

moniters pressure within anesth. machine

Anesthesia Machine: What does the charcoal system do?

• absorbs waste from anesth gas b4 they are released into air

• prevents exposure to harmful gases by trapping

How does Respiratory Depression contribute to animals dying during first 3 hours of recovery?

anesth can slow breathing/animal struggle to regain normal breathing

How does Low Blood Pressure and Shock contribute to animals dying during first 3 hours of recovery?

body may have trouble stabilizing after surg

How to prevent Hypothermia/Temperature regulation issues during first 3 hours of recovery?

animals cannot reg body temp when unconscious, must be kept in warm environment or heating pads

How does Airway Blockage contribute to animals dying during first 3 hours of recovery?

if animal vomits/has difficulty swallowing they can choke

How do Undiagnosed Health Conditions contribute to animals dying during first 3 hours of recovery?

these conditions may not be noticeable until triggered by stress

Why is warmth critical for neonatal puppies?

low temps can cause death, cannot regulate own temp w/o mom

What are the best methods to warm neonatal puppies?

• incubators

• heat lamps

• heating pads

How do you stimulate a puppy to U/D? How often?

gently stimulate genitalia w cotton balls, soft damp cloth, etc.

every 2 hrs for 1st wk of life

How often should a 0-1wk old orphaned puppy be fed?

q2h

How often should a 1-2wk old orphaned puppy be fed?

q3h

How often should a 3-4wk old orphaned puppy be fed?

q4h

What are Elastrators used for?

castration and docking

How do Elastrators work?

• squeeze handle to stretch band

• cuts off circulation for testicles

Does this cause bleeding?

No, its bloodless

What are Burdizzos used for?

castration

Does this cause bleeding?

No, its bloodless

How do Burdizzos work?

• immediately crush spermatic cord - kills blood supply

• testicles take a few weeks to fall off

What is some safety to remember with Burdizzos and Emasculators?

must have correct placement

What are Emasculators used for?

castration

How do Emasculators work?

• Crimps blood vessels & cuts testicles off same time

• better for summer (less flies)

What is some safety to remember with Emasculators?

flat part must be ON TOP

How does the Barnes Dehorner work?

placed against skull to scoop horn out of skull

What is some safety to remember with the Barnes Dehorner?

• use correct size based on animal

• correct placement

• have a way to stop bleeding/cauterize

What is some safety to remember with the Electric Dehorner?

• only use on horns as big as opening

• used on young calves, otherwise it wont work

• correct placement

How does the Electric Dehorner work?

burns cells around horns

Local anesthesia

only specific part of body is numbed

When is local anesthesia used?

minor, less invasive procedures

Would you use local or general anesthesia on the jaw area? (livestock)

local