STANDARDS FOR SURGICAL PROCEDURES
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Prior to any surgery, we perform pre-anesthetic blood work to help us provide the safest anesthesia possible for your pet. On the day of the surgery, your doctor will admit your pet and perform a pre-anesthetic exam upon check-in.
Our veterinarians perform sterile surgeries in a separate surgery suite. Sterile surgeries include a scrubbing process for both surgeon and patient, caps, sterile gowns, gloves and sterile instrument packs are standard. The sterile field is maintained throughout the entire surgical procedure, resulting in less post-operative infections. **Instrument packs are NEVER shared between patients and there is no admittance to the surgical suite during a procedure unless a staff member is wearing a cap and mask**
Each surgeon is assigned a minimum of two technicians. A CVT, (Certified Veterinary Technician) directly assists the doctor and an additional technician helps monitor the patient throughout the procedure and during their recovery.
The following is a general introduction and description of our surgical procedures. These procedures can be applied to almost every major surgery we perform.
PREMEDICATIONS; MEDICATIONS ADMINISTRATED BEFORE ANESTHESIA: These serve to help calm your pet before induction. They also help facilitate the placement of an intravenous (IV) catheter which may be needed for induction. The premedication injection is the first pain management drug to be administered to your pet.
IV CATHETER PLACEMENT: An area is shaved on your pet's leg and an intravenous catheter is placed. This allows for administration of supportive IV fluids as well as any medications that may be indicated during the procedure. Having direct vascular access allows prompt response should any unforeseen complications occur.
INDUCTION OF ANESTHESIA: Usually an IV injection given to induce a state of anesthesia allowing for intubation.
INTUBATION: Intubation involves placing an endotracheal tube in your pet to provide an open airway in which to administer oxygen and/or anesthetic gases while under anesthesia. This allows controlled respirations if the patient is not breathing well on his or her own, and prevents accidental inhalation of stomach contents if the pet vomits while under anesthesia.
EYE LUBRICATION: When an animal is under anesthesia, the blink reflex is not present. An ointment is used to lubricate the eyes to prevent damage to the cornea.
PAIN MANAGEMENT INJECTIONS:
Intravenous, subcutaneous (under the skin) or intramuscular injections are given at induction of full anesthesia to help control post-operative pain.
SHAVING/SCRUBBING: We shave any surgery site to remove hair and debris. The site is then scrubbed with an antiseptic agent using sterile technique. This assures a sterile field for the procedure.
MAINTENANCE OF ANESTHESIA
ISOFLURANE ANESTHESIA: Isoflurane is a commonly used gas anesthetic that has fewer side effects on the patient than older anesthetic techniques. This gas does not require internal organ metabolism for the patient to "wake-up". This gives us more accurate control of the depth and length of the anesthetic period, thereby allowing for rapid recovery and minimal "hangover" effects.
PATIENT MONITORING DURING SURGERY
During the actual surgical procedure, many things need to be monitored to keep your pet safe. Respiratory rate, heart rate and EKG are just a few parameters that the technician is carefully watching for any change. Electronic monitoring devices help this process as well as the experience and attentiveness of the staff and surgeon.
PULSE OXIMETER- measures the heart rate and the blood oxygen level of your pet.
EKG- monitors the electrical activity of the heart. It can help determine the reason for irregular heartbeats and abnormal heart sounds and determine dysfunction in hearts that have no external signs of disease.
BLOOD PRESSURE- is monitored to determine if the values are too high, too low or normal. Changes in blood pressure can reflect the presence of disease. Monitoring the Blood pressure is an essential tool in the adjustment of rate of anesthetic and fluid administration
POST OPERATIVE CARE
Patient care does not end when your pet is transferred from the surgery suite to recovery. In fact, this is one of the most critical times for patient monitoring. Your pet will begin to wake up, starting with an eye blink, followed by movement. When a swallow reflex is present, the endotracheal tube is removed. Our technicians use a monitoring form to record vital readings post-operatively. Once your pet is fully alert, your pet's IV catheter is removed in preparation for your arrival.
POST SURGICAL MONITORING: Your pet's vital signs are continuously monitored while in the recovery process. Parameters monitored are temperature, heart rate, CRT (capillary refill time). If there are any questions during this time, your pet's technician will consult with the surgeon.
MONITORING FOR PAIN: We firmly believe that your pet should be as comfortable as possible during and after their procedure. Your pet's recovery technician is trained to monitor certain behaviors that may indicate an additional pain injection is needed. Examples might be: excessive vocalization, excessive panting and any discomfort.
WARMING BLANKET/HOT WATER BOTTLES: During any surgical procedure, the temperature of the patient has a tendency to drop. Monitoring and regulating body temperature is vital during any anesthetic procedure. Hypothermia can affect the heart, blood pressure and delay anesthetic recovery. We have heated pads that are put on the tables underneath your pet for the duration of the surgery, and a hot water pad and hot water bottles for the cages and as many blankets as needed to aid in their recovery.
DISCHARGE AND HOME CARE
Each patient is discharged by a technician and is sent home with personalized go-home instructions from their surgeon. These are written instructions regarding any medication that is to be given, any precautions that need to be taken, and feeding instructions. If there are any questions whatsoever, we ask that you please call the hospital and we will be happy to assist you.