Small Animal Anesthesia: Procedure Checklist and Fluid Management

What should be done on procedure day before anesthesia?

Take weight, TPR, and briefly examine the patient.

What should be communicated to the surgical DVM on procedure day?

Patient's signalment, known concerns, and present bloodwork.

What is the importance of reviewing the procedure ahead of time?

To be prepared to answer any questions from the DVM.

What is the recommended needle size for drawing up Rimadyl?

20G needle due to its thickness.

What is the effect time for SQ, IM, and IV medications?

SQ takes a while, IM takes effect in 15-20 minutes, and IV takes effect immediately.

What should be checked on the anesthetic machine before the procedure?

Ensure it is ready, check for leaks, trace the flow of oxygen and anesthetic, & ensure oxygen & anesthetic levels are full.

What materials are needed for IV catheter placement?

IV catheter choices, clippers, scrub, tape, flush, injection port, and bandage material.

What should be prepared for ET intubation?

Three possible ET tubes, tie material, gauze square, lubricant, and a laryngoscope.

What is anesthetic induction?

The process by which an animal loses consciousness and enters surgical anesthesia.

How should ketamine-diazepam or ketamine-midazolam be administered?

Slow and steady IV.

What is the recommended administration rate for Propofol?

Approximately ¼ of the total dose every 30 seconds to effect.

What is 'Kitty Magic' and how is it administered?

Dexmedetomidine, ketamine, butorphanol; given IM that takes effect in 5-10 minutes.

What should be done before attaching the patient to the anesthetic machine?

Turn on the oxygen.

What is the purpose of a fluid warmer during anesthesia?

To maintain the patient's temperature during prolonged anesthesia.

What is the importance of maintaining sterility during IV fluid administration?

To prevent infections and complications.

What should be done with the end of the fluid line?

Keep it capped or covered to maintain sterility.

What should be done to the monitoring equipment before surgery?

Ensure it is plugged in, set with the patient's name and species, and positioned for surgery.

What should be prepared for warming support during anesthesia?

Carbon tech heating mat, Bair Hugger, water blanket, or heated table; could also use paw socks, warm water bottle/bean bag, etc.

What is the significance of having an extra blade ready for clippers?

To ensure preparedness for IV catheter placement.

What is the first step in preparing a patient for anesthesia?

Turn on the inhalant anesthetic (isoflurane) to the appropriate level.

What should be assessed before placing the patient in lateral recumbency?

The patient's vital signs using a stethoscope and thermometer.

What monitoring equipment should be connected to the patient?

ECG, Pulse Ox, Capnograph, BP, and temperature probe.

How often should monitoring parameters be recorded?

At 5-minute intervals, but prioritize patient assessment over paperwork.

What should be done to the patient's eyes before surgery?

Lubricate the patient's eyes with artificial tears.

What should be checked before moving the patient?

All monitoring parameters and adequate anesthetic depth, including reflexes.

What should be done with the fluid line during patient transfer?

It can remain attached or be detached and capped, ensuring the fluid rate is the same.

What should be done immediately upon arrival at the new location?

Turn on the oxygen, reattach the ET tube, and set isoflurane to the previous level.

What should be communicated to the veterinarian before starting the procedure?

Inform them that the patient is at an adequate plane of anesthesia.

What should be monitored after the patient is moved back to its kennel?

The patient's temperature and ensure it is padded properly.

What action should be taken if the patient's temperature drops below 98 degrees?

Alert an instructor and implement additional warming measures.

What warming methods can be used post-surgery?

Use a fluid warmer, warming blanket, booties, and extra warm blankets.

What should be done with the E-collar post-surgery?

Ensure it is ready and ideally placed on patients before they are awake.

What should be done if a patient cannot stand on its own?

Do not attempt to take the dog outside.

What is important to remember to do with the anesthesia machine before attaching the patient?

Always open the pop-off valve after checking for leaks.

What should be given to cats after sedation or surgery?

Subcutaneous fluids (SQ fluids).

Who should be present during the recovery phase?

An RVT/DVM will be with you to help if issues arise.

What is the primary difference between a gravity-fed system and a fluid pump for IV administration?

A gravity-fed system relies on elevated fluid bags and manual adjustment of a roller clamp, while a fluid pump delivers a set amount of fluids over a specified time and can be programmed for total fluid volume.

What is one advantage of using a fluid pump for IV administration?

Fluid pumps provide accuracy in fluid amount and IV medication delivery, ensuring patients do not receive more fluids than intended.

What alerts does a fluid pump provide during IV administration?

Fluid pumps alert the user to inactivity or lack of delivery, helping to ensure continuous fluid delivery.

What are some clinical signs of fluid overload in patients?

Increased body weight (>10%), tissue edema, serous nasal discharge, increased respiratory rate, reduced SPO2, gastrointestinal signs, and novel heart sounds.

Why is it important to monitor the drip rate in a gravity-fed IV system?

Monitoring the drip rate ensures the patient receives the correct amount of fluid as intended.

What is the role of a fluid pump in managing multiple IV medications for a single patient?

More than one pump can be used to deliver fluids and medications simultaneously to address the patient's changing needs.

What should be done when changing out fluid bags in a fluid pump system?

Keep track of the total volume delivered over the course of the patient's hospitalization to ensure accurate fluid management.

What is a common misconception about hypertension and fluid overload?

Hypertension is rarely associated with fluid overload except in cases of acute kidney injury (AKI) or chronic kidney disease (CKD).

What type of patients might exhibit serous discharge from an endotracheal tube?

Anesthetized patients may show serous discharge from an endotracheal tube as a sign of fluid overload.

What is the importance of adjusting fluid delivery rates throughout a shift?

Adjusting fluid delivery rates is crucial to meet the changing needs of the patient during their treatment.

What are the potential gastrointestinal signs of fluid overload?

Abdominal distention, vomiting, diarrhea, inappetence, and anorexia can indicate fluid overload.

Canine sedation protocol?

Canine premed protocol?

Canine induction protocol?

Feline premed protocol?

Feline induction protocol?

Emergency drugs?

Atropine, epinephrine, & lidocaine.

How must IV fluids be used?

In a way that achieves therapeutic goals & minimizes complications.

How is maintenance fluid rate determined?

2 to 4 mL/kg/hour.

How is replacement fluid rate determined?

Dehydration volume + ongoing losses + maintenance rate

What type of IV fluids are normally used during anesthesia?

Lactated ringers solution (LRS), type of isotonic crystalloid fluids.

What is the initial anesthesia fluid rate for dogs?

5 mL/kg/hr.

What is the initial anesthesia fluid rate for cats?

3-5 mL/kg/hr.