Preparing animals for scheduled operations Flashcards
What should be done in preparation prior to surgery?
- bathe their pets (elective procedures)
- thorough history report, blood tests, physical exam
What are important steps to take during the patient admission?
- confirm procedure being performed
- check with owner for; medications, recent changes, last meal, food status
- advised owner of potential risks, tattoos with desexing, microchipping, amount of hair clipped
- discharge procedure
- sign consent form - estimated costs, deposit, risks
What are the preparation steps for anaesthesia?
Preparation for anaesthesia – Pre Operative
* Basic blood tests
* More comprehensive blood tests (eg clotting profile etc)
* Urine tests
* Radiographs, ultrasound, more advanced imaging
Selecting pre-medication, setting up anaesthetic equipment, drugs,
monitors, placement of intravenous catheters, fluid therapy
What are two types of medicines used during analgesic plan? and when should it be administered?
NSAIDS and opioids
pre-emptively and continued post-operatively
What does prophylaxis prevent?
infection
Do antibiotics have an advantage after 24hrs?
no
what are important considerations when patient positioning for surgery?
head resting stable
anaesthetic tubing placed properly - connected and secure
patient in optimal position for lighting and instrument access
warming devices place
limbs tied to help stabilize the patient
where should the clipping be avoided?
in theatre
What clipping blade is used? and what size margin?
- Use No. 40 clipper blade
hold clippers 90 degrees - Clippers should be used gently, parallel to the skin
- Try not to cut skin!
- May need >20 cm margin (depending on surgery)
- Clip at the incision site extending 10 cm in all directions
What is the steps for clipping hair?
First clipped along the same direction of hair growth, then again
against direction
remove hair with vacuum
wipe table down with moist cloth
change towel under patient before skin prep
What is the aim of a skin prep?
major source of contamination through endogenous bacteria - skin cannot be sterilised just reduce amount of microbes
How do you prep the prepuce?
Flush prepuce with dilute chlorhexidine solution
* Pinch prepuce closed around syringe tip before emptying syringe
* Gently massage solution in prepuce
* Place towel over end of prepuce and release solution
* Flush prepuce four to five times using 20 ml syringe
What are the steps to preparing the skin?
Step 1
* Antibacterial and dirt remover
* Chlorhexidine or iodine detergent with water
* Dilute with warm water
* Repeat a total of 3 times after all gross debris has
been removed
Step 2
* Antiseptic
* Methylated spirits - remove the oils, rapid onset of action
* Kills most bacteria
Step 3
* Spray of chlorhexidine + methylated spirits alcohol
OR
* Methylated spirits spray
* 70% methylated spirit
What are the contact times with chlorhexidine solutions, iodine solutions and chlorhexidine-alcohol solutions?
3-5 minutes with chlorhexidine solutions
* 2-5 minutes with iodine solutions
* 30 seconds with some chlorhexidine-alcohol
solutions
What is the the dilution factor for dilute aqueous chlorhexidine?
Mix the surgical scrub with warm water in a 60:40 dilution
What is in alcohol surgical spray?
Chlorhexidine mixed with 70% alcohol (synergistic effect)
What is the difference between chlorhexidine and methylated spirits?
chlorhexidine
Wide spectrum, rapid effect, long residual effect, good cleansing capacity,
minimal or no skin irritation, broad spectrum activity, strong binding to skin, low
toxicity
* Very rapid onset of activity
methylated spirits
rapid bactericidal activity
rapid onset of action
not good gleaning agents - efficacy of alcohol is decreased substantially in the presence of organic debris
Synergistic effect with other agents
What is the most effective concentration of methylated spirits?
60 - 70%
What should be avoid when using methylated spirits?
mucous membranes and sensitive areas
* Anus, mouth, eyes, inside ears
* DO NOT USE ALCOHOL on open wounds/fractures = cytotoxic
What is the minimum amounts of times you spray and wipe the skin with methylated spirits?
3 - final spray leave on alcohol to dry
What is iodine used for and what dilution rate?
Available as solution and scrub
* For intact surfaces only
diluted 50:50 with tap water
Equal with chlorhexidine for lowering bacterial numbers on skin
* Iodine has loss of residual activity when lavage fluids, blood or pus present
If you have sensitive areas to clean, what solutions do you use?
sterile isotonic saline
What two solutions should not be mixed during the whole procedure?
chlorohexidine or iodine
What is the purpose of the patient draping?
Goal is to create a barrier that prevents microbial spread from the patient into
the surgical field or onto surgical personnel
Drapes should be readjusted towards the incision site
true or false?
false - translocated bacteria onto sterile surgical site
How many drapes are used to isolate the unprepared/unsterile area?
4
How do you apply drapes and what are factors to keep in mind?
Drapes should be placed evenly around clipped area and sterile surgical area
1. first drape - positioned closest to you (hold drape around hands so they are covered)
