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SAFETY, ANESTHESIA, POSITIONING Veterinary dental nursing procedures SAFETY, ANESTHESIA, POSITIONING.

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Presentation on theme: "SAFETY, ANESTHESIA, POSITIONING Veterinary dental nursing procedures SAFETY, ANESTHESIA, POSITIONING."— Presentation transcript:

1 SAFETY, ANESTHESIA, POSITIONING Veterinary dental nursing procedures SAFETY, ANESTHESIA, POSITIONING

2 5888H - Veterinary Dental Nursing Usual GA precautions Appropriate monitoring equipment IV catheter and fluids as required

3 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Contaminated Surgery Veterinarians should in general avoid performing dirty dentals on an individual animal at the same time as major sterile surgery – Bacteria entering the blood stream during dental work can lodge in the blood clots of the major surgery site.

4 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Safety Considerations Patient safety Operator safety

5 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Patient Safety Head movement > endotracheal tube induced tracheal trauma; if tracheal trauma: –subcutaneous emphysema – if tracheal air escapes –tracheal stricture – can appear days or weeks later. Head movement > tube twisting and kinking Head tilted up > fluids, blood, blood clots, calculus easily enter trachea. Cuffed tube > distal cuff still permits fluid to enter proximal trachea. Wet face, cold table/grill > greater heat loss and hypothermia Wet ET tube tie > loosens and falls out easily

6 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Use Cuffed ET tube Just enough to occlude air leakage

7 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Good grip on ET tube Ensure good grip on tube tie; might use –Rubber elastic band (not too tight on face) –Drip tubing (not too tight on face or tube)

8 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Good grip on ET tube

9 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Disconnect Tube When turning or moving animal

10 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Dont turn over the back Turn under belly –with legs kept underneath –reduces chance of fluid entering trachea

11 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Slight incline for trachea Tilt table, or Use padding (eg bubble wrap) –More under shoulders, less under neck –Just think of airway position!

12 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Patient Positioning Options –Dorsal –Lateral

13 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Dorsal Recumbency

14 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Lateral Recumbency

15 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Place absorbent wad in pharynx eg swabs, throat pads –Past hump of tongue –REMEMBER TO REMOVE when finished have a reminder check system – eg a marker on the ET tube when swab placed

16 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Pharyngeal Packing

17 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Ocular lubricant To protect eyes from aerosol –Artificial tears –Lacrilube

18 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Is used to protect operator and improve visibility –But not too wide! Care with Mouth Prop

19 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Warmth Consider –Heating mat –Bubble wrap –Warm water bottles Some methods need care as may have risks of either scalding and/or electrocution

20 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Head on a grill To keep body and face drier

21 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Monitor Temperature Usually rectal temp measured

22 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Recovery Place in lateral or sternal recumbency with the head and neck extended, preferably head below thorax –Monitor temp, pulse, respiration, consciousness until able to maintain sternal recumbency –Keep orifices clear, clean and dry –Remove pharyngeal swabs –Remove endotracheal tube at appropriate time –Analgesics as indicated –Report recovery problems –Final grooming before discharge

23 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Operator Safety What operator safety precautions shown here?

24 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Risk of being bitten Especially under light GA –Use a mouth prop

25 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Eye protection. Risks –Calculus flicked into eyes –Aerosol in eyes (possible conjunctivitis) Protection –Full head visor –Goggles or glasses

26 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Pneumonia Large numbers of bacteria in aerosolised water droplets –These small droplets float deep into lungs Possible bacterial pneumonia Use face mask –Quality type, well fitted –But discard after use

27 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing General contamination Build up of debris on the skin or under the fingernails Moisture contaminates clothing (hospital hygiene)

28 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Posture Often a lengthy procedure in fixed posture –Use adjustable stool

29 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Sharps Discard of scalpel blades, needles, old burs into sharps container Care with handling sharp instruments

30 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Anaesthetic gases Usual scavenging systems –Good fittings required if patient movement

31 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Electrocution Electric heating mats Faulty electric dental equipment

32 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing Other protection Gloves Cap Apron - waterproof

33 SAFETY, ANESTHESIA, POSITIONING 5888H - Veterinary Dental Nursing The End


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