Additional Information
Book Details
Abstract
With focused coverage of the veterinary technician's specific role and responsibilities in small animal surgery, Small Animal Surgical Nursing, 3rd Edition helps you gain exceptional clinical competency. Topics include protocol, sterilization, gowning, gloving, anesthesia, wound management, and care of the animals before and after surgery. This new edition will also expand on common complications that might be encountered during surgical procedures and outlines how to best avoid or prepare for this situation. Plus, with enhanced online resources including interactive exercises, you will have all the tools needed to master the full gamut of surgical nursing responsibilities involving small animals.
- Complete coverage of small animal surgical nursing as it relates to the roles and responsibilities of the veterinary technician provides a full review of the role of the technician in the surgical setting.
- Focus on exceptional clinical skills and practice tips draws from the author’s real-world experiences of what is most commonly encountered in the clinical setting.
- Attention to detail fosters appropriate comprehension levels in required veterinary technician surgical nursing courses.
- Extensive full-color illustrations and photographs vividly guide learning in the areas of necessary equipment, instruments, sterile techniques, suturing techniques, and wound management.
- Well-written performance objectives are included at the beginning of each chapter to help readers identify what should be mastered in the upcoming chapter.
- Key points and review questions are included at the end of each chapter to focus and reinforce learning.
- Practical appendices cover dosage calculations, how to quickly set IV fluid drip rates, how to make up various solutions of medications for constant rate infusions, and more to further facilitate the reader’s ability to work quickly and efficiently.
- NEW! Online user resources on the Evolve companion website include interactive video clips of common procedures and interactive activities.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Small AnimalSurgical Nursing: Skills and Concepts | i | ||
| Small AnimalSurgical Nursing: Skills and Concepts | iii | ||
| Copyright | iv | ||
| Dedication | v | ||
| Contributors | vi | ||
| Preface | vii | ||
| Acknowledgments | viii | ||
| Contents | ix | ||
| Detailed Contents | x | ||
| 1 - Preoperative Room Considerations | 1 | ||
| LAYOUT OF THE SURGERY SUITE | 2 | ||
| PREPARATION AREA | 2 | ||
| SCRUB AREA | 2 | ||
| SURGERY ROOM | 2 | ||
| EQUIPMENT CLEANING | 3 | ||
| NONMOVABLE (PERMANENT) EQUIPMENT | 3 | ||
| MOVABLE EQUIPMENT | 3 | ||
| GENERAL CLEANING INSTRUCTIONS | 4 | ||
| ANESTHESIA MACHINE | 4 | ||
| COMPONENTS | 5 | ||
| Oxygen Source | 6 | ||
| Yoke | 6 | ||
| Tank Pressure Gauge | 6 | ||
| Pressure-Reducing Valve | 6 | ||
| Flowmeter | 7 | ||
| Fast Flush Valve | 7 | ||
| Vaporizer | 8 | ||
| Precision Vaporizer. The precision vaporizer has many advantages over the nonprecision style (Fig. 1.17). Precision vaporizers a... | 8 | ||
| Nonprecision Vaporizer. Nonprecision vaporizers are seen less and less in veterinary medicine with the development of safer inha... | 9 | ||
| Unidirectional Inspiratory Valve | 9 | ||
| Negative-Pressure Relief Valve | 9 | ||
| Corrugated Breathing Tubing and Y Piece | 9 | ||
| Unidirectional Expiratory Valve | 10 | ||
| Adjustable Pressure Relief Valve (“Pop-Off” Valve) | 10 | ||
| Manometer | 10 | ||
| Rebreathing Bag (Reservoir Bag) | 10 | ||
| Carbon Dioxide Absorber | 11 | ||
| Scavenging System | 11 | ||
| LEAK TESTING | 12 | ||
| BREATHING CIRCUITS | 13 | ||
| Rebreathing Circuit | 13 | ||
| Nonrebreathing Circuit | 13 | ||
| OXYGEN FLOW RATES | 13 | ||
| SUMMARY | 14 | ||
| PERIOPERATIVE EQUIPMENT | 14 | ||
| PATIENT WARMING DEVICES | 14 | ||
| SURGICAL LIGHTS | 15 | ||
| SURGERY TABLE | 15 | ||
| ELECTROSURGERY | 16 | ||
| SUCTION | 17 | ||
| Suction Machines | 17 | ||
| Suction Tips | 18 | ||
| Poole. A Poole suction tip is a two-piece instrument best used to remove large volumes of liquid or fluid (Fig. 1.40). The inner... | 18 | ||
| Frazier/Adson. The Frazier/Adson suction tip is a single tube with a fairly small opening (see Fig. 1.40). Often there is a thum... | 18 | ||
| Yankauer. The Yankauer suction tip is also a single-tube design, but it is bulkier than the Frazier (see Fig. 1.40). The Yankaue... | 18 | ||
| Plastic Tubing Connector | 18 | ||
| SURGICAL INSTRUMENTS | 18 | ||
| MANUFACTURING | 18 | ||
| COMPONENTS | 19 | ||
| GENERAL SURGERY INSTRUMENTS | 20 | ||
| Scissors | 20 | ||
| Operating Scissors. The intended use of operating scissors is to cut only inanimate objects (e.g., suture, paper drapes, and spo... | 20 | ||
| Mayo Scissors. The Mayo scissors are used when cutting large muscle masses, cartilage, or any other nondelicate tissue. The blad... | 20 | ||
| Metzenbaum Scissors. The Metzenbaum scissors are used for delicate surgical dissection. The blades are thin, delicate, and appro... | 20 | ||
| Suture Removal Scissors. Sometimes called suture scissors, the suture removal scissors usually are not found in the surgery pack... | 20 | ||
| Hemostats | 20 | ||
| Halstead Mosquito Hemostatic Forceps. The Halstead hemostat has small jaws with fine horizontal serrations that extend the entir... | 21 | ||
| Kelly Hemostatic Forceps. The Kelly hemostat is larger than the Halstead hemostat. The horizontal serrations are wider and only ... | 21 | ||
| Crile Hemostatic Forceps. The Crile hemostat is similar to the Kelly hemostat, with the difference being how far the serrations ... | 21 | ||
| Ferguson Angiotribe. Although not a true hemostat, the Ferguson angiotribe is an extremely strong forceps that is quite traumati... | 21 | ||
| Rochester-Carmalt Hemostatic Forceps. The Rochester-Carmalt hemostat is quite different from other hemostats. The instrument has... | 21 | ||
| Rochester-Pean Hemostatic Forceps. The Rochester-Pean hemostatic forceps is a large hemostat (usually 8 inches in length) with h... | 21 | ||
| Needle Holders | 21 | ||
| Derf. The Derf needle holder is small in length and is used with small animals, with special species, and in extraocular ophthal... | 21 | ||
| Olsen-Hegar. The Olsen-Hegar instrument is different from other needle holders in that it has scissors built into the jaws. This... | 21 | ||
| Mayo-Hegar. The Mayo-Hegar needle holder is a commonly used instrument available in a variety of lengths, depending on the surgi... | 22 | ||
| Crile-Wood. Although similar to the Mayo-Hegar needle holder, the Crile-Wood needle holder has a finer, more delicate jaw | 22 | ||
| Scalpels | 22 | ||
| Scalpel Blade Handles. Scalpel blade handles are designed to hold scalpel blades for easier and safer use. Scalpel blades number... | 22 | ||
| Scalpel Blades. The most common scalpel blade used in small animal surgery is the No. 10 (Fig. 1.54). This blade is used primari... | 22 | ||
| Thumb Tissue Forceps | 22 | ||
| DeBakey Thoracic Thumb Tissue Forceps. Originally designed as a cardiovascular instrument, the DeBakey thoracic thumb tissue for... | 23 | ||
| Tissue Thumb Forceps. The tissue thumb forceps has a straight shaft and can range in length from 5 to 12 inches. The tips can ha... | 23 | ||
| Russian Thumb Tissue Forceps. The Russian thumb tissue forceps has a very traumatic, bulky tip. This instrument is generally res... | 23 | ||
| Adson Thumb Tissue Forceps. The Adson thumb tissue forceps has a very narrow tip that broadens to a ½-inch-wide shaft. The tips ... | 23 | ||
| Adson Dressing. The Adson dressing forceps tip has no teeth but does have flat, atraumatic serrations. This Adson style is gener... | 23 | ||
| Adson-Brown. The tip of the Adson-Brown instrument has two parallel rows of nine shallow teeth on both tips. A common general su... | 23 | ||
| Adson 1 × 2. The tip of the Adson 1 × 2 Adson style has one tooth on one tip and two teeth on the other. The teeth interdigitate... | 23 | ||
| Allis Tissue Forceps. The Allis tissue forceps is neither a hemostat nor a thumb tissue forceps. Its intended use of grasping ti... | 23 | ||
| Retractors | 23 | ||
| Handheld Retractors | 23 | ||
| U.S. Army. The U.S. army handheld retractor is a double-ended retractor with different lengths of blades on either end. It has n... | 23 | ||
| Senn. The Senn retractor is also a double-ended handheld retractor. One end is a narrow, blunt blade, and the other end is a too... | 23 | ||
| Self-Retaining Retractors | 23 | ||
| Gelpi. With its single, sharp-pointed tips, the Gelpi self-retaining retractor is a fairly traumatic instrument. It has limited ... | 23 | ||
| Weitlaner. The Weitlaner self-retaining retractor has teeth in the jaw that can be blunt or sharp. Although it is used more ofte... | 24 | ||
| Balfour. The Balfour retractor is one of the few self-retaining retractors commonly used in soft tissue surgery (Fig. 1.61). Ava... | 24 | ||
| Towel Clamps | 24 | ||
| Backhaus. The most common style of towel clamp, the Backhaus has penetrating tips and is available in 3½- or 5½-inch sizes | 24 | ||
| Roeder. The Roeder style is unique in that it has balls on the tips. The balls prevent the towel clamp from being placed too dee... | 24 | ||
| Jones. A penetrating towel clamp, the Jones is more delicate and lightweight than the other styles. Instead of the usual ratchet... | 24 | ||
| Lorna (Edna). Also known as the Edna nonpenetrating towel clamp, the Lorna, like the Backhaus, is available in 3½- and 5½-inch s... | 24 | ||
| Miscellaneous General Instruments | 24 | ||
| Snook Spay Hook. Some surgeons use the Snook spay hook to find and exteriorize the uterine horns when performing an ovariohyster... | 24 | ||
| Dowling Spay Retractor. The Dowling spay retractor was designed to assist the solo veterinary surgeon in performing an ovariohys... | 24 | ||
| Needle Rack. The needle rack is a spring mounted on a metal base designed to store “eyed” free needles during the autoclaving pr... | 24 | ||
| Groove Director. The groove director is designed to aid the surgeon in making incisions on the linea alba. This instrument provi... | 24 | ||
| Staple Remover. When skin staples are used instead of suture, a special instrument is required to remove the staples (Fig. 1.65)... | 25 | ||
| Bowls. Some instrument packs include a sterile bowl. The bowls can be used for holding saline for lavage or for storing sharps d... | 25 | ||
| SOFT TISSUE SURGERY INSTRUMENTS | 25 | ||
| Intestinal Clamps | 25 | ||
| Thoracic Instrumentation | 26 | ||
| Retractors. Thoracic surgery requires the use of appropriately designed instrumentation. A Finochietto retractor is designed to ... | 26 | ||
| Thoracic Forceps. Depending on the procedure being performed, specific thoracic clamps can be very beneficial. Satinsky clamps, ... | 26 | ||
| Biopsy Instrumentation | 26 | ||
| Punch Biopsy. A punch biopsy instrument comes in a variety of sizes (Fig. 1.69). Usually 2-mm, 4-mm, and 6-mm are available. The... | 26 | ||
| Needle Punch Biopsy. Needle punch biopsy instruments are currently manufactured by a variety of companies. Instruments are equip... | 26 | ||
| Bone Biopsy. Bone biopsy specimens are often collected using either a Michele trephine or a Jamshidi biopsy needle. Both these i... | 26 | ||
| ORTHOPEDIC SURGERY INSTRUMENTS | 26 | ||
| Bone Holders | 26 | ||
| Periosteal Elevators | 27 | ||
| Bone Rongeurs | 27 | ||
| Bone Cutters | 27 | ||
| Bone Curettes | 27 | ||
| Hand Chuck (Jacob’s Chuck) | 27 | ||
| SURGICAL “POWER TOOLS” | 27 | ||
| INTERNAL FIXATION IMPLANTS | 27 | ||
| Intramedullary Pins | 28 | ||
| Pin Cutter | 29 | ||
| Orthopedic Wire | 29 | ||
| Bone Plates and Screws | 29 | ||
| Bone Plating Specialty Instrumentation. Many special instruments are needed to place bone plates and screws to hold the plates t... | 29 | ||
| External Fixation Implants | 30 | ||
| NEUROSURGERY INSTRUMENTS | 30 | ||
| OPHTHALMIC SURGERY INSTRUMENTS | 31 | ||
| Beaver Blade Handle | 31 | ||
| Lid Speculum | 31 | ||
| Lacrimal Cannulas | 31 | ||
| Thumb Tissue Forceps | 31 | ||
| Scissors | 31 | ||
| Needle Holders | 32 | ||
| Miscellaneous Ophthalmic Equipment | 32 | ||
| SURGICAL NEEDLES | 32 | ||
| NEEDLE POINT | 32 | ||
| NEEDLE BODY | 32 | ||
| SUTURE ATTACHMENT END | 32 | ||
| SUTURE MATERIAL | 33 | ||
| CHARACTERISTICS | 33 | ||
| Tensile Strength | 33 | ||
| Memory | 33 | ||
| Flexibility | 35 | ||
| Absorbability | 35 | ||
| Capillarity | 35 | ||
| Structure | 35 | ||
| Knot Security | 35 | ||
| Color | 35 | ||
| ORIGIN OF MATERIAL | 35 | ||
| SIZING | 36 | ||
| PACKAGING | 36 | ||
| STAPLES | 36 | ||
| External Staples | 36 | ||
| Internal Staples | 37 | ||
| SETTING UP THE SURGERY SUITE | 38 | ||
| TYPES OF PACKS | 38 | ||
| SCHEDULING SURGICAL PROCEDURES | 38 | ||
| CONCLUSION | 39 | ||
| BIBLIOGRAPHY | 40 | ||
| 2 - Preoperative Patient Considerations | 42 | ||
| HISTORY TAKING | 42 | ||
| PHYSICAL EXAMINATION | 43 | ||
| GENERAL BODY CONDITION AND MENTATION | 43 | ||
| THORACIC AUSCULTATION | 43 | ||
| TAKING THE TEMPERATURE | 44 | ||
| CONSENT FORM | 45 | ||
| PREANESTHETIC DIAGNOSTIC TESTS | 45 | ||
| MINIMUM DATABASE | 45 | ||
| Packed Cell Volume (Hematocrit) | 45 | ||
| Total Solids or Proteins | 47 | ||
| Blood Glucose | 48 | ||
| Blood Urea Nitrogen | 48 | ||
| Alanine Aminotransferase | 49 | ||
| ADDITIONAL TESTS | 49 | ||
| PREOPERATIVE MEDICATIONS | 49 | ||
| BALANCED ANESTHESIA | 50 | ||
| PRINCIPLES OF PAIN MANAGEMENT | 50 | ||
| ANALGESICS | 50 | ||
| Opioids | 50 | ||
| How Opioids Work. Opioids bind to opioid receptors in the spinal cord. The mu (μ) and kappa (κ) opioid receptors are primarily r... | 51 | ||
| Side Effects. Opioids have few clinically significant cardiovascular effects, other than bradycardia, in dogs and cats when admi... | 52 | ||
| Nonsteroidal Antiinflammatory Drugs | 52 | ||
| How Nonsteroidal Antiinflammatory Drugs Work | 52 | ||
| Side Effects. As a class, NSAIDs are associated with specific types of potential side effects. Some of these are species specifi... | 52 | ||
| Alpha2-Adrenergic Agonists | 52 | ||
| How α2-Agonists Work. α2-Agonists inhibit release of the excitatory neurotransmitter norepinephrine to produce analgesia and sed... | 53 | ||
| Side Effects. α2-Agonists can have profound effects on the CNS and cardiovascular system, but using low dosages can minimize the... | 53 | ||
| Local Anesthetics | 53 | ||
| How Local Anesthetics Work. Local anesthetics act by inhibiting transduction and transmission of nerve impulses and by modifying... | 53 | ||
| Side Effects. When administered at an appropriate dose, local anesthetics have relatively few, if any, adverse side effects. The... | 53 | ||
| SEDATION AND TRANQUILIZATION | 53 | ||
| ANTICHOLINERGICS | 54 | ||
| ANTIBIOTICS | 54 | ||
| BIBLIOGRAPHY | 56 | ||
| 3 - Patient Preparation | 57 | ||
| INTRAVENOUS CATHETERS | 58 | ||
| PERIPHERAL CATHETERS | 58 | ||
| Supplies | 58 | ||
| Catheter. Many styles of catheter are available for use. The choice of catheter style is primarily determined by the site of pla... | 58 | ||
| Injection Caps, T-ports, and Fluid Administration Sets. Injection caps may be placed on the catheter if occasional injections or... | 59 | ||
| Extension Sets. An extension set may be used in conjunction with an administration set to add length to the line and allow for b... | 59 | ||
| Tape. The tape is one of the most important components of the catheter. Without proper anchoring, even the best placed catheter ... | 60 | ||
| Catheter “Prep” Materials. Clippers with a number 40 (No. 40) blade are required for hair removal from the catheter site (Fig. 3... | 60 | ||
| Fluids or Heparinized Saline. Either continuous infusion of IV fluids or regular flushing of the catheter is necessary to mainta... | 60 | ||
| Bandage Materials. Bandage materials are needed if the catheter is to remain in place after the surgical procedure is completed.... | 60 | ||
| Placement Technique | 60 | ||
| JUGULAR CATHETERS | 63 | ||
| Supplies | 63 | ||
| Placement | 63 | ||
| Sample Collection | 63 | ||
| Central Venous Pressure | 64 | ||
| ENDOTRACHEAL INTUBATION | 64 | ||
| COMPONENTS OF TUBE | 64 | ||
| SELECTION OF PROPER TUBE SIZE | 64 | ||
| SUPPLIES | 65 | ||
| Endotracheal Tube | 65 | ||
| Securing the Tube | 65 | ||
| Lubricant | 65 | ||
| Cuff Syringe | 65 | ||
| Laryngoscope or Light Source | 65 | ||
| Mouth Speculum | 66 | ||
| TUBE PLACEMENT | 66 | ||
| Patient Anatomy | 66 | ||
| One-Person Technique | 66 | ||
| Two-Person Technique | 66 | ||
| Laryngospasms | 66 | ||
| Confirmation of Proper Tube Placement | 68 | ||
| PATIENT PREPARATION | 68 | ||
| ANESTHESIA FORM | 69 | ||
| Demographics | 69 | ||
| Preanesthetic Values and Disposition | 69 | ||
| Preanesthetic Drugs | 69 | ||
| Premedication Results | 70 | ||
| Anesthetic Induction | 70 | ||
| Breathing System | 70 | ||
| Intraoperative Updates | 70 | ||
| Postoperative Values | 70 | ||
| HAIR REMOVAL | 70 | ||
| URINATION | 73 | ||
| SURGICAL SITE PREPARATION | 74 | ||
| ANTISEPTICS | 74 | ||
| RINSING AGENTS | 74 | ||
| APPLICATORS | 74 | ||
| SPECIAL MALE DOG PREPARATION | 74 | ||
| PATTERNS FOR SCRUBBING | 75 | ||
| Target Pattern | 75 | ||
| Orthopedic Pattern | 75 | ||
| Perineal Pattern | 76 | ||
| POTENTIAL REACTIONS | 77 | ||
| Clipper-Related Reactions | 77 | ||
| Chemical-Related Reactions | 77 | ||
| SITE PREPARATION AND POSITIONING | 78 | ||
| SECURING PATIENT IN POSITION ON SURGERY TABLE | 78 | ||
| POSITIONING FOR SPECIFIC PROCEDURES | 79 | ||
| Abdominal Surgery | 79 | ||
| Castration | 79 | ||
| Orthopedic and Extremity Surgery | 79 | ||
| Tail and Perianal Surgery | 80 | ||
| Back Surgery | 80 | ||
| Thoracic Surgery | 80 | ||
| FINAL (STERILE) SURGICAL SITE PREPARATION | 81 | ||
| Solutions (Paint) | 81 | ||
| TECHNIQUES FOR MAINTAINING BODY TEMPERATURE | 82 | ||
| BIBLIOGRAPHY | 85 | ||
| 4 - Patient Monitoring | 86 | ||
| ROLE OF THE VETERINARY TECHNICIAN ANESTHETIST | 86 | ||
| MONITORING | 87 | ||
| HEART RATE AND RHYTHM | 88 | ||
| TISSUE PERFUSION | 89 | ||
| MUCOUS MEMBRANES | 89 | ||
| CAPILLARY REFILL TIME | 89 | ||
| PULSE AND BLOOD PRESSURE | 89 | ||
| HYPOTENSION | 90 | ||
| RESPIRATORY RATE AND RHYTHM | 90 | ||
| BODY TEMPERATURE | 91 | ||
| NEUROLOGIC PARAMETERS | 91 | ||
| Reflexes | 91 | ||
| Muscle Tone | 91 | ||
| Eyes | 92 | ||
| SPECIAL SURGICAL CASE CONSIDERATIONS | 92 | ||
| CRANIAL PROCEDURES | 92 | ||
| RESPIRATORY COMPROMISE | 92 | ||
| PATIENT POSITIONING FACTORS | 93 | ||
| ANESTHESIA MONITORING DEVICES | 93 | ||
| PULSE OXIMETER | 93 | ||
| Models | 93 | ||
| Sensors | 93 | ||
| Unit Options | 94 | ||
| Troubleshooting | 95 | ||
| CAPNOMETER OR CAPNOGRAPH | 95 | ||
| Measurement | 95 | ||
| Display Wave | 95 | ||
| Normal Values | 95 | ||
| BLOOD PRESSURE MONITOR | 96 | ||
| Indirect Monitoring | 96 | ||
| Direct Monitoring | 97 | ||
| ELECTROCARDIOGRAPH | 97 | ||
| BIBLIOGRAPHY | 98 | ||
| 5 - Asepsis | 99 | ||
| ASEPSIS | 99 | ||
| MAINTAINING ASEPSIS | 99 | ||
| STERILE FIELD | 99 | ||
| OPENING ITEMS FOR USE IN THE STERILE FIELD | 100 | ||
| OPENING FLUIDS FOR USE IN THE STERILE FIELD | 100 | ||
| MOVING AROUND THE STERILE FIELD | 101 | ||
| DUTIES OF THE CIRCULATING NURSE | 101 | ||
| OPENING PEEL-AWAY POUCHES | 101 | ||
| OPENING WRAPPED PACKS | 102 | ||
| OPENING GOWNS AND GLOVES | 102 | ||
| BIBLIOGRAPHY | 103 | ||
| 6 - Operating Room Personnel | 104 | ||
| NUTRITION AND HYGIENE | 104 | ||
| PROPER ATTIRE IN SURGICAL AREA | 105 | ||
| SCRUB SUIT | 105 | ||
| HEAD COVERS | 106 | ||
| MASKS | 106 | ||
| SHOES AND SHOE COVERS | 106 | ||
| JEWELRY | 106 | ||
| FINGERNAILS | 106 | ||
| SURGICAL HAND SCRUB AND HAND RUB | 107 | ||
| TYPES OF SCRUB SOLUTIONS | 108 | ||
| PRESCRUBBING GUIDELINES | 109 | ||
| SURGICAL HAND SCRUB USING ANTIMICROBIAL SCRUB AGENT | 109 | ||
| SURGICAL HAND RUB USING ANTIMICROBIAL RUB AGENT | 111 | ||
| GOWNING AND GLOVING | 111 | ||
| DRYING THE HANDS | 111 | ||
| GOWNING | 112 | ||
| GLOVING | 113 | ||
| Closed Gloving | 113 | ||
| Open Gloving | 114 | ||
| Assisted Gloving | 116 | ||
| CONTAMINATED GOWN | 116 | ||
| RESPONSIBILITIES | 117 | ||
| BIBLIOGRAPHY | 118 | ||
| 7 - Surgical Assisting—Duties during Surgery | 119 | ||
| INSTRUMENT HANDLING AND PASSING | 119 | ||
| SCALPEL BLADES AND HANDLES | 120 | ||
| THREADING EYED NEEDLES | 120 | ||
| PASSING RING-HANDLED AND OTHER INSTRUMENTS | 121 | ||
| TISSUE HANDLING | 121 | ||
| KEEPING TISSUES MOIST | 122 | ||
| MAINTAINING HEMOSTASIS | 122 | ||
| EQUIPMENT COUNT | 123 | ||
| INSTRUMENT COUNT | 123 | ||
| SPONGE COUNT | 123 | ||
| DRAPING—BASIC PRINCIPLES | 123 | ||
| DRUG ADMINISTRATION | 125 | ||
| SUTURE-RELATED RESPONSIBILITIES | 125 | ||
| COMMON SUTURE PATTERNS | 126 | ||
| Subcuticular versus Subcutaneous | 126 | ||
| Continuous Patterns | 126 | ||
| Interrupted Patterns | 126 | ||
| SUTURE REMOVAL | 127 | ||
| BIBLIOGRAPHY | 128 | ||
| 8 - Surgical Procedures | 129 | ||
| RESPONSIBILITIES OF THE SURGICAL TECHNICIAN | 130 | ||
| ABDOMINAL PROCEDURES | 130 | ||
| Instruments | 130 | ||
| Patient Positioning and Preparation | 130 | ||
| Patient Draping | 131 | ||
| General Procedure. A blade is used to incise the subcutaneous tissues, and the abdominal wall should be tented to make a sharp i... | 131 | ||
| Abdominal Wall Closure | 131 | ||
| Postoperative Considerations and Instructions | 131 | ||
| Surgery Report | 132 | ||
| SPECIFIC ABDOMINAL PROCEDURES | 132 | ||
| ABDOMINAL EXPLORATORY SURGERY | 132 | ||
| Definition | 132 | ||
| Indications | 132 | ||
| Abdominal Exploratory Procedure | 133 | ||
| GASTRIC FOREIGN BODIES AND GASTROTOMY | 133 | ||
| Definition | 133 | ||
| Indications | 133 | ||
| Special Instruments | 134 | ||
| Patient Positioning | 134 | ||
| Patient Draping | 134 | ||
| Gastrotomy Procedure | 134 | ||
| Stomach Closure | 135 | ||
| Postoperative Considerations and Instructions | 135 | ||
| INTESTINAL FOREIGN BODIES AND ENTEROTOMY | 135 | ||
| Definition | 135 | ||
| Indications | 136 | ||
| Special Instruments | 136 | ||
| Enterotomy Procedure | 136 | ||
| Intestine and Abdominal Wall Closure | 137 | ||
| Postoperative Considerations and Instructions | 137 | ||
| INTESTINAL RESECTION AND ANASTOMOSIS | 138 | ||
| Definition | 138 | ||
| Indications | 138 | ||
| Special Instruments | 138 | ||
| Intestinal Resection and Anastomosis Procedure | 138 | ||
| Intestine and Abdominal Wall Closure | 139 | ||
| Postoperative Considerations and Instructions | 140 | ||
| GASTRIC DILATION AND VOLVULUS | 140 | ||
| Definition | 140 | ||
| Indications | 140 | ||
| Special Instruments | 143 | ||
| Patient Positioning | 143 | ||
| Procedure for Treatment of Gastric Dilation and Volvulus | 143 | ||
| Permanent Gastropexy Procedures | 143 | ||
| Abdominal Wall Closure | 143 | ||
| Postoperative Considerations and Instructions | 143 | ||
| REPRODUCTIVE PROCEDURES | 144 | ||
| OVARIOHYSTERECTOMY | 144 | ||
| Definition | 144 | ||
| Indications | 144 | ||
| Special Instruments | 144 | ||
| Patient Positioning | 145 | ||
| Canine and Feline Ovariohysterectomy Procedures | 145 | ||
| Abdominal Wall Closure | 146 | ||
| Postoperative Considerations and Instructions | 146 | ||
| CESAREAN SECTION | 146 | ||
| Definition | 146 | ||
| Indications | 146 | ||
| Special Instruments | 146 | ||
| Patient Positioning | 146 | ||
| Cesarean Section Procedure | 146 | ||
| Neonatal Care | 147 | ||
| PYOMETRA | 148 | ||
| Definition | 148 | ||
| Indication | 148 | ||
| Pyometra Surgery | 149 | ||
| Postoperative Considerations and Instructions | 149 | ||
| CANINE AND FELINE CASTRATION | 149 | ||
| Routine Canine Castration | 149 | ||
| Definition. Canine castration refers to the surgical removal of the testicles in the dog | 149 | ||
| Indications. The primary indication for performing a canine castration is for sterilization of the dog. Other indications includ... | 149 | ||
| Instrumentation. A general use soft tissue surgical instrument pack should be sufficient for canine castration | 149 | ||
| Patient Positioning. The canine patient should be placed in dorsal recumbency for castration. The scrotum should be examined and... | 149 | ||
| Canine Castration Procedure. The surgeon may decide to do an open castration or closed castration. In the closed procedure, the ... | 149 | ||
| Open Castration. The surgeon selects the first testicle and applies pressure cranially to advance the testicle into the prescrot... | 150 | ||
| Closed Castration. Closed castration is performed much like open castration except for the incision of the parietal vaginal tuni... | 150 | ||
| Postoperative Considerations and Instructions. Common complications associated with canine castration include hemorrhage and scr... | 151 | ||
| Routine Feline Castration | 151 | ||
| Definition. Feline castration refers to the surgical removal of the testicles in the cat | 151 | ||
| Indications. The primary indication to perform a castration is for sterilization of the male cat. Other indications include the ... | 151 | ||
| Instrumentation. No special instrumentation is required to perform a feline castration. The surgeon may prefer to use metal clip... | 151 | ||
| Feline Castration Procedure. An examination of the testicles should be conducted before anesthesia is induced, to ensure that bo... | 151 | ||
| Postoperative Considerations and Instructions. Scrotal bleeding can be a common complication associated with feline castration. ... | 152 | ||
| CYSTOTOMY | 152 | ||
| Definition | 152 | ||
| Indications | 152 | ||
| Special Instruments | 153 | ||
| Cystotomy Procedure | 154 | ||
| EAR PROCEDURES | 154 | ||
| AURAL HEMATOMA REPAIR | 154 | ||
| Definition | 154 | ||
| Indications | 154 | ||
| Instrumentation | 154 | ||
| Patient Positioning | 154 | ||
| 9 - The Postoperative Patient | 209 | ||
| RECOVERY FROM ANESTHESIA AND EXTUBATION | 210 | ||
| POSTOPERATIVE MONITORING | 211 | ||
| COMPLICATIONS RELATED TO ANESTHESIA | 211 | ||
| HYPOTHERMIA | 211 | ||
| EMERGENCE DELIRIUM | 213 | ||
| PROLONGED RECOVERY | 214 | ||
| Anesthesia-Related Causes | 214 | ||
| Excessive Depth of Anesthesia. If the patient was maintained for a long time under anesthesia (>1 hour) and the depth of anesthe... | 214 | ||
| Breed Predisposition. Sight hounds are sensitive to barbiturate anesthetics. In most dogs, barbiturates are redistributed from t... | 214 | ||
| Patient-Related Causes | 214 | ||
| Hypotension, Poor Perfusion, or Shock. Hypotension is defined as a systolic pressure less than 80 mm Hg or a mean arterial press... | 214 | ||
| Liver or Kidney Disease. Many anesthetics are metaboli | 214 | ||
| Intracranial Disease. Patients with an altered level of consciousness (LOC) caused by central nervous system (CNS) disease are e... | 214 | ||
| Hypoglycemia. Neonatal patients are extremely suscep | 214 | ||
| Hypothermia. The cells of the body function best at a normal body temperature. The cellular enzymes involved in metabolizing ane... | 215 | ||
| Therapeutic Measures | 215 | ||
| Physical Stimulation. Physical stimulation by rubbing, massaging, and turning from side to side are simple ways to increase the ... | 215 | ||
| Ventilation. The patient that is still intubated can be manually ventilated with pure oxygen. Gas anesthetic agents are mainly e... | 215 | ||
| Fluid Therapy. A bolus of IV fluids can help increase the blood pressure of the hypotensive patient and improve perfusion of int... | 215 | ||
| Reversal Agents. Some injectable anesthetic agents have reversal agents. The technician should consult with the veterinarian bef... | 215 | ||
| Warming Measures. The hypothermic patient recovers slowly from anesthesia and will benefit from warming measures (see earlier di... | 215 | ||
| Dextrose. Hypoglycemia may be documented through a blood test or may be suspected from the patient’s symptoms and risk factors. ... | 215 | ||
| COMPLICATIONS RELATED TO SURGERY | 215 | ||
| HEMORRHAGE | 215 | ||
| SEROMA | 216 | ||
| DEHISCENCE | 217 | ||
| SELF-TRAUMA | 218 | ||
| Preventive Measures | 218 | ||
| Block Access to Surgical Site | 218 | ||
| Elizabethan Collar. The flat, plastic Elizabethan collar, or E-collar, is placed around the neck. It is attached to the animal’s... | 218 | ||
| BiteNot Collar. While fitted with the BiteNot Collar (Bite | 218 | ||
| Bandaging the Area. A bandage may be enough to block the patient from licking the area (Fig. 9.13). Surgical sites are not alway... | 218 | ||
| Basket Muzzle. A dog can be fitted with a basket muzzle, which prevents the patient from chewing at the site. The dog may rub th... | 219 | ||
| Hobbles. Taping the hind legs together can prevent the patient from scratching at the surgical site (Fig. 9.14) | 219 | ||
| Block Desire to Reach Surgical Site | 219 | ||
| Foul-tasting Product Applied around the Site. Bitter-apple liquid and Yuk2e or YukForte ointments (Vet Planet LLC, Boyds, MD) ar... | 219 | ||
| Sedation. Chemical restraint can be very effective. Chronic tranquilization during the recuperative period may be necessary to p... | 219 | ||
| Stainless Steel Suture or Staples. The surgeon may anticipate a problem with licking and elect to place staples in the skin rath... | 219 | ||
| INFECTION | 220 | ||
| POSTOPERATIVE NURSING CARE | 220 | ||
| WOUND MANAGEMENT | 220 | ||
| WOUND CLASSIFICATION | 220 | ||
| Clean Wound | 220 | ||
| Clean-Contaminated Wound | 220 | ||
| Contaminated Wound | 220 | ||
| Infected Wound | 221 | ||
| WOUND CLEANSING | 222 | ||
| Lavage | 222 | ||
| Débridement | 222 | ||
| Wound Dressings | 223 | ||
| Antimicrobial Agents | 223 | ||
| Drains | 223 | ||
| WOUND CLOSURE | 224 | ||
| Bandages, Splints, Casts, and Slings | 225 | ||
| INTRAVENOUS CATHETER MAINTENANCE | 225 | ||
| URINARY CATHETER MAINTENANCE | 227 | ||
| NUTRITIONAL SUPPORT | 227 | ||
| PHYSICAL THERAPY | 229 | ||
| POSTOPERATIVE ANALGESIA | 230 | ||
| COMMON ANALGESIC CLASSES | 230 | ||
| WIND-UP | 231 | ||
| Epidural and Block Analgesia | 231 | ||
| DISPENSED ANALGESIA | 231 | ||
| Nonsteroidal Antiinflammatory Drugs | 231 | ||
| Opioids | 231 | ||
| KEY POINTS | 231 | ||
| BIBLIOGRAPHY | 233 | ||
| 10 - The Technician’s Role in Pain Management | 235 | ||
| UNDERSTANDING PAIN | 236 | ||
| THE TECHNICIAN’S ROLE IN PAIN MANAGEMENT | 237 | ||
| COMMUNICATING WITH CLIENTS | 237 | ||
| ANTICIPATING PAINFUL PROCEDURES | 237 | ||
| ADMINISTERING INTRAOPERATIVE PAIN MANAGEMENT | 237 | ||
| ASSESSING THE POSTOPERATIVE PATIENT | 238 | ||
| REQUESTING APPROPRIATE ANALGESIA | 241 | ||
| BIBLIOGRAPHY | 242 | ||
| 11 - Postoperative Cleaning | 243 | ||
| CLEANING OF THE SURGERY ROOM | 244 | ||
| DISINFECTANTS | 244 | ||
| DEFINITIONS | 244 | ||
| EFFECTIVENESS | 245 | ||
| TYPES OF DISINFECTANTS | 245 | ||
| Technician Notes | 246 | ||
| INSTRUMENT CLEANING | 246 | ||
| PRESOAKING OF INSTRUMENTS | 247 | ||
| DECONTAMINATION OF INSTRUMENTS | 247 | ||
| ULTRASONIC CLEANING OF INSTRUMENTS | 247 | ||
| PACK WRAPPING | 248 | ||
| RECIPES | 248 | ||
| WRAPPING MATERIAL | 248 | ||
| SEALING OF THE PACK | 249 | ||
| EXPIRATION DATING | 250 | ||
| STERILIZATION | 250 | ||
| GRAVITY AIR-DISPLACEMENT STERILIZER | 250 | ||
| HIGH-VACUUM STERILIZER | 251 | ||
| PREPARATION AND LOADING | 252 | ||
| FLASH STERILIZATION | 252 | ||
| ETHYLENE OXIDE (GAS) STERILIZATION | 253 | ||
| PLASMA STERILIZATION | 253 | ||
| STERILIZATION INDICATORS | 254 | ||
| SPECIALTY INSTRUMENT CLEANING | 254 | ||
| HIGH-LEVEL DISINFECTION | 254 | ||
| DRILL CLEANING | 255 | ||
| LAPAROSCOPIC INSTRUMENT CLEANING | 255 | ||
| ENDOSCOPE INSTRUMENT CLEANING | 255 | ||
| ROTATING AND RESTOCKING SUPPLIES | 256 | ||
| DISPOSABLE SUPPLIES | 257 | ||
| REUSABLE SUPPLIES | 257 | ||
| 12 - Client Education for Postoperative Care | 261 | ||
| DISCHARGE INSTRUCTIONS | 261 | ||
| GENERAL POSTANESTHESIA INSTRUCTIONS | 264 | ||
| GENERAL POSTOPERATIVE INSTRUCTIONS | 264 | ||
| POSTOPERATIVE CARE OF PATIENTS WITH DRAINS | 265 | ||
| POSTOPERATIVE CARE OF PATIENTS WITH A BANDAGE, SPLINT, OR CAST | 265 | ||
| POSTOPERATIVE INSTRUCTIONS FOR COMMON PROCEDURES | 266 | ||
| DENTAL EXTRACTION | 266 | ||
| FEEDING TUBE PLACEMENT | 266 | ||
| GASTROINTESTINAL ENTEROTOMY OR ANASTOMOSIS | 267 | ||
| PERIANAL SURGERY | 267 | ||
| CYSTOTOMY | 267 | ||
| FELINE DECLAW (ONYCHECTOMY) | 268 | ||
| AURAL HEMATOMA | 268 | ||
| LATERAL EAR CANAL RESECTION OR ABLATION | 268 | ||
| ORTHOPEDIC PROCEDURES | 269 | ||
| CESAREAN SECTION | 269 | ||
| CASTRATION (ORCHIECTOMY) | 270 | ||
| SPAY (OVARIOHYSTERECTOMY) | 270 | ||
| A - Quick Reference for Common Intravenous Infusions and Analgesic Protocols | 273 | ||
| B - EPA Registered Hard Surface Disinfectants Comparison Chart | 277 | ||
| Glossary | 281 | ||
| Index | 285 | ||
| A | 285 | ||
| B | 286 | ||
| C | 286 | ||
| D | 287 | ||
| E | 287 | ||
| F | 288 | ||
| G | 288 | ||
| H | 289 | ||
| I | 289 | ||
| J | 289 | ||
| K | 290 | ||
| L | 290 | ||
| M | 290 | ||
| N | 290 | ||
| O | 290 | ||
| P | 291 | ||
| Q | 292 | ||
| R | 292 | ||
| S | 292 | ||
| T | 293 | ||
| U | 293 | ||
| V | 294 | ||
| W | 294 | ||
| Y | 294 | ||
| Z | 294 |