Clinical skills Flashcards
Why are asepsis techniques used in practise?
On the skin- bacteria sits on the skin, so when it is cut open to reach the organs it is possible for the bacteria from the skin to enter the body.
Reduces the chances of bacterial contamination
List areas of the body that might compromise asepsis and ways of minimising their contamination
Hands- wash hands
Nose/mouth- wear mask
Hair- wear a theatre cap
Arms- washed when hand washing
Square knot vs surgeons knot
On the first know, a square know has one throw whereas the surgeons know has two throws.
Surgeons knot is used when the first throw of a know would come loose, e.g. when the tissues are under pressure and will pull apart.
How would you assess an unconscious patient?
ABC
Airway, breathing, circulation
If B and C aren’t happening, begin CPR immediately
Describe the general principles of Cardiopulmonary resuscitation (CPR)
Done when in Cardiopulmonary arrest- patient has stopped breathing, heart has stopped beating
Severe emergency
Aim to achieve the return of spontaneous circulation
Brain damage occurs if left too long
What is the cardiac pump theory and when is it used?
Compressions directly above the heart in dorsal or lateral recumbency
Blood forced out of the heart to lungs and periphery
Pressure/relaxation of ventricles pulls blood back into the heart
Used on narrow chested dogs (greyhound), barrel chested dogs (bulldog), small animals and cats
What is the thoracic pump theory and when is it used?
Entire chest is compressed, all blood is forced out of the heart and air forced out of the lungs
Pressure difference/elastic recoil when compression removed means that more blood is drawn into the heart and air is drawn into the lungs
Used on round chested dogs eg Labrador/retriever
What are the three stages of normal partuition?
- Dilation of the cervix- restless animal, isolates from the flock, water bag forced out
- Delivery- foetus birthed, contractions, should be born within an hour of the water bag
- Expulsion of foetal membranes- afterbirth, must be collected to ensure not still inside as can be bad
When should lambing be intervened on?
Farmer has tried and failed to deliver Foetus is abnormally positioned No progress 30-60 minutes after water bag burst More than 30 minutes between offspring Abnormal discharge Prolapse
How is foetal disposition described?
- Position- anterior/posterior/transverse
- Position- dorsal/lateral/ventral
- Posture- are limbs or head extended or flexed
What are the routes of drug administration?
- topical- applied to a particular site
- enteral- via the GI tract (oral/rectal)
- parenteral- intramuscular, intravenous, sub-cutaneous
What do you need to know for drug dosing by enteral and parenteral administration?
weight, dose rate, concentration
What are the radiation safety protocols for doing a radiograph?
Wearing appropriate clothing (lead gowns)
Use a specialised lead lined room and table
Warning light and sound for when the machine is operating
Involve few people
Have dosimeters everywhere to measure exposure
Limit scatter
How is a patient positioned for a radiograph of the lateral thorax?
Lateral recumbency, extend limbs cranially with a foam wedge between and secured by ties/sandbags, ensure sternum and spine are level suing wedges, collimate to skin edges, including the thoracic inlet and last rib
How is a patient positioned for a dorsoventral thorax radiograph?
Sternal recumbency, place chin on a foam wedge, sandbag over neck, partially extend forelimbs cranially, check for axial rotation, ensure scapula at same height, make sure spine is straight, place markers
How is a patient positioned for a ventrodorsal radiograph of the thorax?
dorsal recumbency supported by foam wedges and sandbags, trough under caudal end of dog, extend forelimbs cranially and tie, check for axial rotation
How is a patient positioned for a radiograph of the lateral abdomen?
lateral recumbency, extend forelimbs cranially and hindlimbs caudally with sandbags/ties and foam pads between, collimate to include last rib and perimeum
How is a patient positioned for a mediolateral radiograph of the elbow?
lateral recumbency with limb closest to the plate, leave limb in a neutral position, upper limb extended and drawn caudally and supported out of the way, centre plate under elbow
How is a patient positioned for a mediolateral view of the stifle?
lateral recumbency with limb closest to the plate, leave limb in a neutral position, upper limb flexed and drawn cranially and supported out of the way, centre plate under stifle
How is a patient position for a craniocaudal radiograph of the stifle?
sternal recumbency, extend the limb caudally, raise other hindlimb and support with a foam wedge, place foam wedge under abdomen, centre plate under stifle, make sure tail is out of the way and collimate with distal femur and proximal tibia and fibula
What is collimation?
The restriction of the beam to the area under investigation
What factors are used to assess a radiograph?
Species and view, labelling, positioning (straight, centred etc), collimation, scatter, exposure, development
What is a packed cell volume test and how is it performed??
Haematocrit test
Measures the proportion of blood that is made up of red blood cells
Centrifuge blood in a capillary tube into its parts (rbc, buffy coat, plasma)
How is total plasma protein measured?
Refractometer
measured on the g/L scale
Carefully snap the capillary tube just above the buffy coat and insert eh needle into one end of the tube, and use the syringe to put a drop of plasma onto the refractometer
How is urine specific gravity tested and what can it be used for?
Refractometer to measure the concentration of urine
Evaluates kidney function, can be a measure of dehydration
What does a urine dipstick test show you? Which two things are to be ignored?
Gives an indication to abnormal presences in the urine
Ignore leucocytes and specific gravity
What does a blood smear allow you to evaluate?
rbc- density, colour, shape, size
wbc- differential count
platelets- density or platelet clumps
