Week 2 lesson 18 JSAL lab duties

What duties must students be able to explain by the end of this session?

Supporting roles of assistant surgeon, scrub nurse, anesthetist, and supporting technical staff in the OR

What record-keeping format must students be able to apply to clinical monitoring?

SOAP format

What specific report must students be able to apply medical record-keeping principles to?

A surgical report

Where do the live patient castrations take place?

Veterinary Surgical Laboratory (VSL)

On which days are rounds held for live patient castrations?

Mondays and Wednesdays

What are the hours for Monday and Wednesday rounds?

5:30 PM to 7:30 PM

On which days are surgeries performed?

Tuesdays and Thursdays

What are the hours for Tuesday and Thursday surgeries?

7:30 AM to 12:30 PM

What are the hours for Tuesday and Thursday post-operative checks?

5:30 PM to 7:00 PM

On which days are patient discharges scheduled?

Wednesdays and Fridays

Where do the mock castrations take place?

Charter Hall Lab

When do mock castrations take place?

Tuesday or Thursday mornings depending on the assigned surgery slot

Who are the six faculty members listed under JSAL Surgery?

Dr. Marta Lanza-Perea, Dr. Keith Kalasi, Dr. Michel O’Brien, Dr. Lucian Thomas, Dr. Peter Augustine, and Dr. Allana Singh

Who is the regular surgery instructor mentioned?

Dr. Bhat

Who are the three visiting professors and instructors for surgery?

Dr. Ivaldi, Dr. Sylvester, and Dr. Martinez Bolmgreen

Who are the five faculty members listed under JSAL Anesthesia?

Dr. Mercedes Miccio, Dr. Nuria Quesada, Ms. Naudia Dundas, Dr. Julieta Mallea, and Dr. Hamaseh Tayari

Who is the Registered Veterinary Technician on the JSAL staff?

Liz Peachz

Who are the three JSAL staff members listed under Liz Peachz?

Mr. Jude Modeste, Ms. Rayanna Joseph, and Ms. Quency Peters

Who is the JSAL staff member listed from the simulation lab?

Mr. Kriston Phillip and Ms. Keshia John

Who makes up the JSAL Canine Procurement Team?

Mr. Quacy Matthew and Mr. Kimron Brathwaite

Why is the Canine Procurement Team critical to the JSAL laboratory?

Without them, students would not have patients

What three patient admission tasks are completed by doctors and staff the day before surgery?

Patient admission, physical exams, and blood sampling/screening

What safety precaution is explicitly required during blood sampling?

Wear gloves

What anatomical check is mandatory for male dogs during the pre-operative exam?

Check for 2 testicles in the scrotum

What six components make up the pre-surgical blood screening?

CBC, hematocrit, platelet count, Idexx SNAP 4Dx test, Chem 10, and Lyte4 test

What four pathogens are screened for using the Idexx SNAP 4Dx test?

Ehrlichia, Heartworm, Anaplasma, and Borrelia

What specific marker is detected for Ehrlichia in the SNAP 4Dx test?

Ehrlichia antibody

What specific marker is detected for Heartworm in the SNAP 4Dx test?

Heartworm antigen

What specific marker is detected for Anaplasma in the SNAP 4Dx test?

Anaplasma antibody

What specific marker is detected for Borrelia in the SNAP 4Dx test?

Borrelia antibody

At what time must students arrive at the Kennel Room on Monday or Wednesday?

5:30 PM

Where is the patient’s medical record located electronically?

Ezyvet

What board should students check for lab planning and instructions upon arrival?

The white board in the Kennel Room

What administrative document must be confirmed as completed upon arrival?

Consent form

What form must be completed and hung on the patient's cage?

Hospitalization form

What is the strict rule regarding the paper components of medical records?

They cannot leave the VSL

What are the six message signs that can be hung on a cage door?

May bite, Cage jumper, Monitor closely, Cage aggressive, Dog aggressive, and I need a home

What parameter must be recorded on the Kennel Room white board?

The patient's weight

When should treatments be checked off on the Kennel Room white board?

Once they are performed

What four main tasks must the student group work together to accomplish in the Kennel Room?

Clean and prepare the cage, take patients to the yard to eliminate, collect feces for a fecal float, and perform a physical exam and weigh the patient

Where should collected fecal samples be discarded?

In the bin outside

What weight unit must be used when weighing patients?

Kilograms (kg)

What emotional and behavioral challenge might JSAL dogs exhibit due to a lack of extensive handling?

Fear, anxiety, and stress (FAS)

What four types of aggression might be revealed in nervous or fearful patients?

Fear aggression, dog aggression, cage aggression, or food aggression

What methodology is used to handle anxious or nervous patients at JSAL?

Fear Free Handling techniques

What are three examples of Fear Free Handling techniques used for nervous dogs?

Reassurance, treats, and minimizing invasive parts of the physical exam

What protective equipment can be used for handler safety if a dog is aggressive?

A muzzle and an e-collar

What dog behaviors indicate mild stress during an exam?

Lip licking and yawning

Under Fear Free principles, what should you do if a cooperative dog shows mild signs of stress?

Pause the exam, offer high-value treats, and allow the dog to relax before continuing

What diagnostic test is mandatory for every surgery patient before discharge?

Passive Fecal Flotation

What are eight diagnostic tests available for students to perform at the VSL?

Ear cytology, ear smear, skin cytology, skin scrape, Schirmer Tear Test (STT), Fluorescein Stain, Vaginal cytology, and impression smear + cytology

What diagnostic tests are indicated for a patient with alopecia and erythematous skin?

A skin scrape and tape cytology

Why are a skin scrape and tape cytology performed on a dog with hair loss and red skin?

To rule out mange and evaluate for microorganism overgrowth

What parasite egg has a characteristic shape with bipolar plugs seen on fecal float?

Whipworm

What two medications are given to all JSAL patients before surgery?

Pyrantel and Capstar

What three medications are JSAL patients discharged with?

Rimadyl, Interceptor Plus, and Credelio

What is the required contact time for medicated shampoos like KetoHex?

Must be lathered and allowed to sit for 10 minutes prior to rinsing

What is the Capstar dose for a dog weighing less than 25 lbs?

11.4 mg PO once

What is the Capstar dose for a dog weighing over 25 lbs?

57 mg PO once

What is the standard dose of Pyrantel pamoate suspension?

10 mg/kg PO once

What is the standard concentration of the Pyrantel suspension in the clinic?

50 mg/mL

How much Pyrantel volume is administered to a 6.8 kg patient at a dose of 10 mg/kg?

1.4 mL PO once

Why is 1.4 mL administered instead of the mathematically calculated 1.36 mL of Pyrantel?

A 3 mL syringe cannot measure to the hundredth, so the dose is rounded to the nearest tenth

What is the standard feeding volume for a regular-sized JSAL patient?

Approximately 1 cup BID

What is the standard feeding volume for a small dog at JSAL?

Approximately 1/2 cup

What ink colors are acceptable for completing paper records?

Blue or black ink only

Which part of the medical record can be worked on outside of the JSAL/VSL?

The electronic record (ezyVet)

How should paper forms be organized in the patient's physical file?

Hole punched and placed in their correct place in the file folder

What is the only form allowed to be hung on the patient's cage?

Hospitalization form

What five details must be included on the cage Hospitalization Form?

Student group number, names of students in the group, blood test results, comments and notes, and student initials

When are JSAL Treatment Forms used instead of the Hospitalization Form?

For patients residing in the facility outside of the three days of surgery

How should students always access their surgery patient's record in ezyVet?

Through the Dashboard

Which day of the calendar week should you select in ezyVet to find your patient?

The Monday of the week you are performing surgery

Under which column headers in ezyVet will you find your patient’s name?

Tuesday or Thursday surgeries column

What four sections make up the initial SOAP record in ezyVet?

History, Physical Exam, Assessments, and Plan (plus Vitals)

When and where do Monday and Wednesday surgery rounds start?

6:00 PM in the Prep Room

What is the correct order of presentation for patient signalment?

Name, age, sex, breed, species

Give an example of a proper signalment presentation for rounds.

Fluffy is a 6 year old male intact mixed breed canine

When and where do anesthesia rounds start?

6:00 PM Monday and Wednesday in the Operating Room (OR)

What clothing restriction is enforced during anesthesia rounds?

No white coats are allowed

What must be done with food and water the night before surgery?

Remove all remaining food from the cage, but leave water available all night

By what time must students arrive at JSAL on the day of surgery?

7:30 AM

Why must your white coat be buttoned up when working with your patient before surgery?

To keep your scrubs clean

What four clinical tasks must be completed on the morning of surgery before premedication?

Walk the patient, pick up feces, perform a pre-operative physical exam, and write In-Clinic notes

Under what tab and template do you write pre-surgical notes in ezyVet?

In-Clinic Notes template

What three sections must be completed in the ezyVet "In-Clinic Notes" template?

Vitals, ASA status, and fitness for surgery

What are five duties of the Primary Surgeon during a canine castration?

Over-drape placement, advancing the testicle and making the initial incision, three-clamp technique, closure of tissue layers, and team communication

What are four duties of the Second/Assistant Surgeon?

Minimize blood loss, three-clamp technique (placement, procedure, and flashing), anticipate the surgeon's needs, and communicate with the team

What are six duties of the Scrub Nurse?

Patient clip and scrub in prep room, draping, Mayo stand setup and maintenance, passing instruments, anticipating surgical needs, and maintaining the surgical field

What are five duties of the Anesthetist?

Equipment setup and testing, premedication/IV catheterization/induction/ET intubation, patient monitoring and recording, patient recovery, and team communication

What are seven duties of the Nurse’s Assistant?

Aseptic patient prep in OR, open first wrapper of instrument tray, provide supplies (saline, blade, suture), hold gauze bowl, perform gauze count on the floor, team communication, and clean instruments in the scrub room

What should be placed on the patient immediately after surgery to prevent self-trauma?

An e-collar

What should be done to the IV catheter immediately after surgery?

Cover it with vet wrap (do NOT pull the catheter)

In what voice and person must the ezyVet Surgery Report be written?

Third person, passive voice

What does writing a surgery report in passive voice mean?

You record what happened to the patient, not who did what to the patient

At what time must students arrive for evening post-operative evaluations?

5:30 PM

What clinical assessments are recorded during the evening post-op check?

Post-operative physical exam, incision site assessment, and Glasgow pain scale assessment

What forms and records must be completed during the evening check on surgery day?

Hospitalization form, printed immunization form, Post-op SOAP in ezyVet, and Discharge instructions in ezyVet

Who must approve the draft Discharge Instructions in ezyVet before use?

The technician on duty

True or False: A patient should be administered carprofen at 4 mg/kg twice daily for post-operative analgesia.

False (carprofen is typically dosed once daily