Week 10 - Surgical Veterinary Nursing Flashcards
Name 7 different types of surgeries that occur in a veterinary practice?
- Orthopaedic surgery - fracture repairs and cruciate surgery
- Soft tissue surgery - Foreign body surgery, organ biopsies, liver lobectomies, splenectomies, nephrectomies, GDV (gastric dilation volvulus), cystomies, caesareans
- Thoracotomies - diaphragmatic hernias and lung lobectomies
- Neurological surgery - intervertebral disc disease
- Fluoroscopic surgery
- Laparoscopic surgery - organ biopsies, cystotomies (bladder stone removal) - minimally invasive
- Arthroscopic surgery
What is the surgery flow chart?
- patient admittance (history and physical exam)
- pre operative planning
- surgical suite preparation
- patient preparation
- move into operating theatre
- Post operative management
- theatre cleaning
- instrument cleaning and sterilisation
- Patient discharge
What is involved with the process of patient admittance?
- booking cases/ rescheduling
- Run through the plan with the client from patient admit to discharge
- Check with clients if they have any Questions
- Confirm with the clients current medications/other known issues
- Check the schedule and make an operating plan
What is involved with the process of pre-operative planning?
- blood work
- urinalysis
- fine needle aspirates
- Diagnostic imaging ( radiology, CT, MRI, contrast studies, ultrasound)
- Anaesthesia and analgesia - customised for each patient
- surgery plan
- surgical suite preparation
- prep room: Catheterisation, induction of anaesthesia,
preparation of patients surgical sites, fluid therapy,
bandaging, splint and cast placements
- prep room: Catheterisation, induction of anaesthesia,
What is the following word
- Sepsis
- Asepsis
- Sterile
- Non-sterile
- Disinfection
- Sepsis: presence of pathogenic microbes in the blood or tissues
- Asepsis: Complete absence of living pathogenic microbes
- Sterile: Item that have undergone a pathogenic microbial elimination through a cleaning process
- Non-sterile: ITem that have not gone through a cleaning process, may or may not be contaminated
- Disinfection: the application of an agent to destroy microorganisms or inhibit their growth
What are the 4 levels of surgical contamination levels
- clean - no break in asepsis
- Clean-contaminated - minor break in asepsis, a contaminated area is entered without spillage or spread of contamination e.g. urine or mucus
- Contaminated- where there is spillage from an open wound or severe inflammation is encountered, operative wounds with major breaks in asepsis, open tramatic wounds/fractures
- Dirty - active infection present in traumatic wounds, pus is present and containing devitalised tissue
What are the 3 levels of surgical cases
- elective and non urgent
- Necessary or urgent - not immediately life threating but requires prompt attention
- Emergency surgery
What are the 3 levels of surgical cases
- elective and non urgent
- Necessary or urgent - not immediately life threating but requires prompt attention
- Emergency surgery
What is the best way to prepare the surgical site for surgery?
Elective surgeries- should be bathed 24 hours prior to procedure
Hair removal using 40 clipper blade
Vacuum the loose hair away
Stage 1: use chlorhexidine scrub 4% (antibacterial agent) mixed with warm water to potentiate cleaning action
Soapy scrub to clean area
creates lather
with warm water 5 min contact time - clean from the middle line outwards
Stage 2: Methylated spirits (alcohol)
Apply to the site in a concentric circular manner, start inside outwards
Stage 3: Chlorhexidine + alcohol solution sprayed directly to the surgery site
What are alternative skin preps for;
Birds and reptiles?
Use aqueous Chlorhexidine or iodine solution
do not used alcohol due to cooling and irritant effects
When do you used iodine solution as an alternative skin prep?
Ophthalmic and intra oral
How do you prep an animal with an open wound?
- place wet swab or sterile lubricant over exposed tissued before clipping the hair away
- When clipped, remove swab and irrigate saline to flush out any contaminants
- Use aqueous chlorhexidine on the skin
- Using alcohol will devitalise healthy tissue
What is involved in post-operative care? including if the patient is in ICU
- cleaning wound and incision site
- Post op Imaging
- Apply new dressing
If in ICU management of fluid therapy management of pain comfort active heating bandage, wound and drain care
How do you maintain a sterile field in a surgery?
Yoave a theatre team in place to assist with surgical attire such as clean scrubs, surgical caps, boot covers mask.
There is unscrubbed personal such as the anaesthesia tech who monitoring the patient
Sout tech who passes sterile equipment to the surgeon in a sterile manner, organises and counts the equipment, assists with gowning and providing nurse care.
Scrubbed personal works within a sterile field witht he surgeon, passing suture & swabs, suction at surgical site, lavage site and provide wound retraction
What are 5 rules to maintaining a sterile field?
do not lean over the sterile field do no touch inner surfaces of sterile packs do not turn your back on sterile field Do avoid contact with scrubbed personnel do keep sterile field dry
