Today was the last day of surgery lab. The students did their presentations and at one point Dr. Young sent me up to the office to get the evaluation forms he left up there. After their presentations, we had them fill out the evaluation forms as well as their skills assessment forms. Then after lab, Maura and I went through all the records and checked for mistakes and to check to see if the correct amount of physical exams were done.
Thursday, December 6, 2007
We decided we were going to do the two other cats today so Maura and I decided to do the blood work and start getting ready while the students were giving their presentations. At first, we got Lynx and Venus out and got blood from both of them. Then we realized that Maura and fasted the wrong male cat, and we really needed Galaxy. So we put Lynx back and I took Galaxy’s food and water away. Dr. Young decided that since it would be awhile before the surgery, and since he wouldn’t be under anesthesia for that long that it would be okay if we still did him today.
Then we helped with the rest of the presentations which went great.
Then there was some confusion between myself, Maura, Dr. Young and Kim. Basically, we thought that since we were not doing Galaxy until later since he had eaten this morning, that we were just doing both after the second lab instead of the castration between the labs like we had originally planned. So we decided that Dr. Young should look at the few animals on the medical board while we had some time. Come to find out, Dr. Young wanted us to switch the surgeries, and do the spay between classes and the castration after class. But he looked at the animals on the medical board anyway, and decided we should do Galaxy’s castration before the second lab got there. Maura and I finished getting him ready for surgery and then we used the induction chamber to knock him down. Once he was sedate enough, we took him out of the box and placed a mask on him and got ready to intubate. I held him while Maura intubated. Then Dr. Young had me open glove and help him with the castration. After he was done, Kim and I stayed with him until he woke up.
The second lab came in half way through this, since it took Galaxy a long time to go down. They just watched while we finished. Next they did their presentations and Maura and I set up for Venus’s spay. Then when the students were done, we did the spay. I gave the premedication of butorphanol, acepromizine, and glycopyrrolate. Then when she was sedate, I placed a 22gauge catheter in her left cephalic vein. Maura gave her induction drugs of ketamine and diazepam. Then I intubated her after placing lidocaine on the laryngeal folds. At first, I was in her stomach, but then I went down to a smaller tube, a 3.0mm, and that went in much better. Once I inflated the cuff and she was under anesthesia, Kim shaved and scrubbed her while I opened the surgical pack and scalpel blade and suture material for Dr. Young. Then she was moved into surgery and I acted as one of the anesthetists taking down her vitals and Maura, Kim and I worked as a great team. We were done from start to finish in about an hour and then we stayed to recover her. Once she was extubated, I gave her a dose of buprenorphine IM. Then we had to clean up all the instruments and repack everything, as well as clean up the surgery suite and the lab room. Dr. Young had to go to class, so it took us a while to clean up. Dr. Young is coming to give the pain medication to both cats tonight and tomorrow morning.
Then we helped with the rest of the presentations which went great.
Then there was some confusion between myself, Maura, Dr. Young and Kim. Basically, we thought that since we were not doing Galaxy until later since he had eaten this morning, that we were just doing both after the second lab instead of the castration between the labs like we had originally planned. So we decided that Dr. Young should look at the few animals on the medical board while we had some time. Come to find out, Dr. Young wanted us to switch the surgeries, and do the spay between classes and the castration after class. But he looked at the animals on the medical board anyway, and decided we should do Galaxy’s castration before the second lab got there. Maura and I finished getting him ready for surgery and then we used the induction chamber to knock him down. Once he was sedate enough, we took him out of the box and placed a mask on him and got ready to intubate. I held him while Maura intubated. Then Dr. Young had me open glove and help him with the castration. After he was done, Kim and I stayed with him until he woke up.
The second lab came in half way through this, since it took Galaxy a long time to go down. They just watched while we finished. Next they did their presentations and Maura and I set up for Venus’s spay. Then when the students were done, we did the spay. I gave the premedication of butorphanol, acepromizine, and glycopyrrolate. Then when she was sedate, I placed a 22gauge catheter in her left cephalic vein. Maura gave her induction drugs of ketamine and diazepam. Then I intubated her after placing lidocaine on the laryngeal folds. At first, I was in her stomach, but then I went down to a smaller tube, a 3.0mm, and that went in much better. Once I inflated the cuff and she was under anesthesia, Kim shaved and scrubbed her while I opened the surgical pack and scalpel blade and suture material for Dr. Young. Then she was moved into surgery and I acted as one of the anesthetists taking down her vitals and Maura, Kim and I worked as a great team. We were done from start to finish in about an hour and then we stayed to recover her. Once she was extubated, I gave her a dose of buprenorphine IM. Then we had to clean up all the instruments and repack everything, as well as clean up the surgery suite and the lab room. Dr. Young had to go to class, so it took us a while to clean up. Dr. Young is coming to give the pain medication to both cats tonight and tomorrow morning.
Wednesday, December 5, 2007
Kim had me run over to the rat lab when lab started because there was some confusion about whether or not the rat lab was being taken care of. It was but I changed the rabbit’s food, water and pan liners anyway because they were pretty dirty. Then when I got back, the students were doing their presentations and we role played with them again. We had them fill out evaluation forms, and then we also had them fill in their names on the skills evaluation lists. After the students left, Dr. Young wanted to go over their final grades with us and then we decided when we were going to do the last two surgeries that did not get done yet. We waited until the end of the semester for these two cats incase there were students right on the edge of passing and could use another chance. However, there were no students that needed this. We are doing the surgeries tomorrow between labs and then after the second lab.
Tuesday, December 4, 2007
The students had to do presentations today for their lecture. They had to role play admitting a patient into the hospital and then discharging them. Each student had a different surgery. Kim, Maura and I pretended to be the clients. Then we had them fill out the evaluation forms for the lab and made comments on their role playing.
Monday, December 3, 2007
Thursday, November 29, 2007
Wednesday, November 28, 2007
Tuesday, November 27, 2007
Monday, November 26, 2007
Today we did dentals on Moonbeam and Nash. The dentals themselves went well, however the students did not do well at being anesthetists. We had to push them to get things done and really hand walk them through everything. At this point, they should be doing everything on their own, with minimal help from us. But they eventually got it done. After we graded, Maura and I stayed and started to put the new dental machine together. We followed the instructions and got almost all of it done except we needed to finish putting the oil in but we both had to go so we decided we’d finish it tomorrow.
Tuesday, November 20, 2007
Today was a make up lab for the Thursday afternoon lab when we had to cancel because the USDA came. They started their dentals and we used Krypton and Leo. My group had Leo. Everything was going great, until we tried to place the catheter. The clinical labs have been practicing blood draws and both of his front legs had been used a lot. One of the students tried to place the catheter twice, and could not get it, they would hit the vein, but the catheter would not feed through. Two tries is the limit, so then I attempted to place one, and again, the catheter would not feed. So then Maura tried, and the same thing happened. Now it was Dr. Young’s turn. He too could not get the catheter to feed in a cephalic vein, so we went to a saphenous and it went right in. The only thing that this changed was that it was a little harder to move him because we needed to be careful it would not come out. Then the students did their dental and it went very well.
We graded them, and then we saw that our new dental machine had arrived. Maura and I started to try to put it together, but we needed a wrench to take it out of the box, and we did not have one.
We graded them, and then we saw that our new dental machine had arrived. Maura and I started to try to put it together, but we needed a wrench to take it out of the box, and we did not have one.
Monday, November 19, 2007
Thursday, November 15, 2007
The first lab today did dentals on Dipper and Gemini. My group had Dipper. Everything went very well; it took them just as long as the other groups, but they are still learning. We then graded them on being anesthetists and dentists again.
The second lab is still a week behind, so they did their cat neuter on Lynx. Then we explained the dental units and how the dentals will work.
The second lab is still a week behind, so they did their cat neuter on Lynx. Then we explained the dental units and how the dentals will work.
Wednesday, November 14, 2007
We did dentistry’s again today. The two dogs were supposed to be Cassiopeia and Comet. However, the kennel shift forgot to not feed Comet even though he had a sign on his cage, so we could not use him. So all 8 people had to use one dog, but we got it done eventually. We then graded them on being anesthetists and dentists.
Tuesday, November 13, 2007
We started dentistry’s today. The two dogs we performed dentals on were Andromeda and Callisto. Maura and I were in charge of Andromeda’s group and we used the new machine. Everything went well, although it took the students a long time to get the animals under anesthesia since we are not helping to move them along as much to see how much they know. And also because this is the first time most of them have done dentals, so it understandably takes them a little longer to finish. We graded them on being anesthetists as well as being dentists. (See procedures for more explanations)
Monday, November 12, 2007
Thursday, November 8, 2007
The first lab neutered Jupiter first, and then we explained the dental instruments and machines. Again, everything went fine.
The second lab is still a week behind, and they spayed Lyra. Everything went according to the normal cat spay. However, at the end, I was holding Lyra for one of the students to take her catheter out and she was upset and tried to escape my hold and ended up biting my hand. She then jumped to the floor and Kim, Dr. Young and Maura had to get her back into her cage while I cleaned myself up. After the students finished cleaning everything and we finally got the catheter out of Lyra and after we graded them, Maura took me to the hospital so I could get antibiotics. It wasn’t a bad bite, so I wasn’t worried about it.
The second lab is still a week behind, and they spayed Lyra. Everything went according to the normal cat spay. However, at the end, I was holding Lyra for one of the students to take her catheter out and she was upset and tried to escape my hold and ended up biting my hand. She then jumped to the floor and Kim, Dr. Young and Maura had to get her back into her cage while I cleaned myself up. After the students finished cleaning everything and we finally got the catheter out of Lyra and after we graded them, Maura took me to the hospital so I could get antibiotics. It wasn’t a bad bite, so I wasn’t worried about it.
Wednesday, November 7, 2007
Tuesday, November 6, 2007
Today we started the cat neuters, and also we explained how to use the dental machines. First, we neutered Aries. The cat neuters are much different. The students need to be exposed to how to use an induction chamber, so we do this by using one for all of the male cats. Everything starts the same and is the same until they get to the point of inducing. Once the catheter is placed, the cat then goes into the chamber and the O2 flow rate and the Isoflurane level is turned up to 5 to get as much gas into the chamber. Once the cat is anesthetized enough; which they know by tilting the chamber back and forth to see if the cat moves; the cat is taken out and the box is placed outside to air out. Then a mask is hooked up to the anesthetic machine, both gas flows are changed to 3 and the mask is placed on the cat to keep him anesthetized. Each student that was not an anesthetist the last week had a chance to intubate this week, again using the Lidocaine. Once he is intubated for the final time, the cuff is inflated and he is hooked up directly to the machine. His scrotum is then plucked and wiped with alcohol. Dr. Young has one of the students open glove with him, and they neuter the cat. The rest of the students are to be monitoring the cat and cleaning up. (See procedures for further explanation)
After the cat was awake and recovering, Kim, Maura and I explained how the dentistry’s work and how each dental machine works. We first explained each hand piece and what they do, and also what protection they need to wear; a face shield and gloves. Then we split into two groups and Kim explained the old machine, and Maura and I explained the new machine, and then the two groups switched. (See procedures for further explanation of machines and tools) We did not grade the students on the cat neuters since they were all anesthetists and the procedure was so short.
After the cat was awake and recovering, Kim, Maura and I explained how the dentistry’s work and how each dental machine works. We first explained each hand piece and what they do, and also what protection they need to wear; a face shield and gloves. Then we split into two groups and Kim explained the old machine, and Maura and I explained the new machine, and then the two groups switched. (See procedures for further explanation of machines and tools) We did not grade the students on the cat neuters since they were all anesthetists and the procedure was so short.
Monday, November 5, 2007
Thursday, November 1, 2007
Wednesday, October 31, 2007
Tuesday, October 30, 2007
Today we started the cat spays. We spayed Electra. The difference between the cat spays and the dog spays is that we use different induction drugs. The premedication is the same, we use Butorphanol, acepromizine and glycopyrrolate (see drug list for dosages). However, for induction we use a combination of ketamine and Valium instead of propofol. Everything else is the same, they need to do a physical and obtain the pre-op blood work, draw up their drugs and have them checked by either myself, Maura or Kim; administer the premedication, place a catheter after the medication had taken effect and then induce and intubate, hook the animal up to the anesthetic machine and prep the animal for surgery. When the cat was intubated, a drop of 2% Lidocaine was placed on each laryngeal fold to prevent laryngeal spasms and then each of the anesthetists intubated the cat. Then they move the cat into the surgery suite and hook all of the monitors up and monitor the cat while Dr. Young performs the spay. Today went fine, the students did very well with the cat, and after the cat was recovered enough for the students to leave, we graded them and left. (See procedures for further explanation)
Monday, October 29, 2007
Thursday, October 25, 2007
Wednesday, October 24, 2007
Tuesday, October 23, 2007
Today we started spays, we did Andromeda today. Again, everything is the same in terms of what the students do, except they have to shave and scrub more; they shave from the xiphoid process down to the bottom of the pelvis and across to both sides. They also try to express the bladder; other then that, everything went very well. We graded the students and left. (See procedures for further explanation)
Monday, October 22, 2007
Thursday, October 18, 2007
Wednesday, October 17, 2007
Tuesday, October 16, 2007
Today was Nash, who was a unilateral cryptorchid. A cryptorchid is when one or both of the testes has not dropped down and the doctor has to go into the abdomen and find it so it does not cause issues later in life. In terms of the tasks of the students, nothing changes except the area where they scrub. The area scrubbed is all the way from the xiphoid process down do the end of the scrotum and all the way to the sides, like a spay. Then we graded the students.
Monday, October 15, 2007
Thursday, October 11, 2007
Leo was the first castration of the day, which went very well. The only difference from the previous days was that I had to place the catheter since the circulating nurses could not. Then we graded everyone and were about to let the next class in, but the USDA showed up and we canceled lab. Maura and I went over to the rat lab to clean up a bit, and then came back to help Kim.
Wednesday, October 10, 2007
Today was the castration of Krypton. Everything went very well, pretty much the same as yesterday. The only difference was that we had the circulating nurses autoclave some of yesterdays supplies to keep up with everything. At the end, we graded the students and made sure everything was off and put away.
Tuesday, October 9, 2007
Today was the first day of surgeries! We neutered Dipper. We arrived early so that the students could get a head start. First, we checked the anesthetist’s drug calculations for Torbugesic, acepromizine and glycopyrrolate for the premedications and then Propofol for the induction agent. Then they could draw up the drugs, and have either myself, Maura or Kim check the syringes, and then mix the premed into one syringe. Then the circulating nurses performed their physical exam and did a big four; blood glucose, BUN, PCV and a total solid. After Dr. Young checked the exam and the blood work, the anesthetists could give the premed IM.
While this is going on, the surgical assistants are preparing the surgical suite by turning the table and heating pad on, setting up all of the monitoring machines and getting out their gowns and gloves for after they scrub.
I then changed the scrub containers according to the correct procedure.
When Dipper was sedated enough, the circulating nurses attempted to place a catheter. They tried three times, so I had to put the catheter in.
Once the catheter was placed, the anesthetists induced him with the Propofol over 60-90 seconds. Then they intubated him, connected the tubes, inflated the cuff and turned on the oxygen and Isoflurane. Then they clipped the surgical area and scrubbed him.
While Dipper was being prepared for surgery, the surgical assistants scrubbed, gowned and gloved. Then they moved into the surgery suite and had a circulating nurse sterilely open the surgical pack.
Once Dipper was scrubbed, he was moved into the surgical suite and hooked up to the anesthesia machine and monitors, as well as tied to the table.
Then the surgery began, with one surgical assistant passing instruments, and the other helping Dr. Young. They switched half way through. The anesthetists monitored Dipper throughout the surgery, adapting the anesthesia according to what was going on with Dipper.
After the surgery was over, everyone cleaned up and the anesthetists recovered Dipper, giving him his pain medication; Buprenex; when his temperature was up to 97. They also decided who was going to give the rest of the pain medication.
A recovery sign was put up and the catheter was removed. The surgical packs get cleaned and repacked to be autoclaved for tomorrow’s lab, along with the gowns and drapes. The surgery suite is cleaned and mopped and the monitors are cleaned as well.
*please see procedure section for a more in depth description of all of these tasks
While this is going on, the surgical assistants are preparing the surgical suite by turning the table and heating pad on, setting up all of the monitoring machines and getting out their gowns and gloves for after they scrub.
I then changed the scrub containers according to the correct procedure.
When Dipper was sedated enough, the circulating nurses attempted to place a catheter. They tried three times, so I had to put the catheter in.
Once the catheter was placed, the anesthetists induced him with the Propofol over 60-90 seconds. Then they intubated him, connected the tubes, inflated the cuff and turned on the oxygen and Isoflurane. Then they clipped the surgical area and scrubbed him.
While Dipper was being prepared for surgery, the surgical assistants scrubbed, gowned and gloved. Then they moved into the surgery suite and had a circulating nurse sterilely open the surgical pack.
Once Dipper was scrubbed, he was moved into the surgical suite and hooked up to the anesthesia machine and monitors, as well as tied to the table.
Then the surgery began, with one surgical assistant passing instruments, and the other helping Dr. Young. They switched half way through. The anesthetists monitored Dipper throughout the surgery, adapting the anesthesia according to what was going on with Dipper.
After the surgery was over, everyone cleaned up and the anesthetists recovered Dipper, giving him his pain medication; Buprenex; when his temperature was up to 97. They also decided who was going to give the rest of the pain medication.
A recovery sign was put up and the catheter was removed. The surgical packs get cleaned and repacked to be autoclaved for tomorrow’s lab, along with the gowns and drapes. The surgery suite is cleaned and mopped and the monitors are cleaned as well.
*please see procedure section for a more in depth description of all of these tasks
Sunday, October 7, 2007
Thursday, October 4, 2007
Maura was sick for the first lab, so I did all of the same things as before, and hers as well. This included wrapping gowns and packs, folding gowns, assembling packs and how to clean certain parts of the anesthesia machine and tubes. For the second lab, Maura was there so I just did the tasks I had done yesterday and Tuesday. I was done early so I started fixing the spay packs to prepare them to be autoclaved before surgery starts on Tuesday. Maura and I also put the surgical gowns and hand towels into the laundry to prepare them as well.
Tuesday, October 2, 2007
The second part of the lab practical started this week. We split up the 20 tasks up between Dr. Young, Kim, Maura and I. My tasks are using the autoclave, scrubbing, gowning, and closed and open gloving.
To use the autoclave, the students have to turn it on in the back, and with the power button. Then they have to select the correct mode depending on what they are autoclaving. Then they have to check the water level and tell me where to fill it too and with distilled water. Then they have to show me what button starts the cycle, and then how to unload it without burning themselves.
To scrub, they have to tell me what they would be wearing before they started to scrub; cap, gown and mask; show me where the scrub is kept and then they can start scrubbing. First they need to rinse their hand with water, and then get a general lather with the scrub. Then they use the nail pick to clean out their nails. They have to show me how many plains are on each arm, and how many strokes to scrub, 20. I have them demonstrate on a few fingers and their hand and arm how they would scrub, making sure they did not touch any part of the sink. Then they rinse by keeping their hands above their elbows so the water runs down their arms.
To gown, they first need to dry their hands with the towel. Then they need to pick up the folded gown and step away from the table. Letting the bottom drop and unrolling the arms until you find the holes is the next step. Then they put their arms in the gown, without letting their fingers out of the cuffs. I then tie them in on the back of the gown.
To closed glove, I open the gloves for them. Then they pick up whichever glove they are picking up first, and line it up with that hand. Cuff to cuff, and the thumb down. Next, they use their fingers through the cuff to fold the top part of the glove over the hand. Once the fingers are in the fingers of the glove, they can start the next glove. They line this one up the same way, and flip it over as well. Then they pull the folded up cuff down over the arm of the gown, and go back and pull the opposite cuff down as well.
To open glove, their hands can be outside of the gown. They pick up one glove by the bottom of the folded part of the cuff with the opposite hand and slide your hand in the glove. The other glove is a little trickier; you need to slide the gloved fingers in between the cuff and fingers of the other glove to protect them, and then slide the ungloved hand into the opening. Then the cuffs can be unfolded down over the gown.
If the students miss any part of these tasks, I take off points accordingly.
To use the autoclave, the students have to turn it on in the back, and with the power button. Then they have to select the correct mode depending on what they are autoclaving. Then they have to check the water level and tell me where to fill it too and with distilled water. Then they have to show me what button starts the cycle, and then how to unload it without burning themselves.
To scrub, they have to tell me what they would be wearing before they started to scrub; cap, gown and mask; show me where the scrub is kept and then they can start scrubbing. First they need to rinse their hand with water, and then get a general lather with the scrub. Then they use the nail pick to clean out their nails. They have to show me how many plains are on each arm, and how many strokes to scrub, 20. I have them demonstrate on a few fingers and their hand and arm how they would scrub, making sure they did not touch any part of the sink. Then they rinse by keeping their hands above their elbows so the water runs down their arms.
To gown, they first need to dry their hands with the towel. Then they need to pick up the folded gown and step away from the table. Letting the bottom drop and unrolling the arms until you find the holes is the next step. Then they put their arms in the gown, without letting their fingers out of the cuffs. I then tie them in on the back of the gown.
To closed glove, I open the gloves for them. Then they pick up whichever glove they are picking up first, and line it up with that hand. Cuff to cuff, and the thumb down. Next, they use their fingers through the cuff to fold the top part of the glove over the hand. Once the fingers are in the fingers of the glove, they can start the next glove. They line this one up the same way, and flip it over as well. Then they pull the folded up cuff down over the arm of the gown, and go back and pull the opposite cuff down as well.
To open glove, their hands can be outside of the gown. They pick up one glove by the bottom of the folded part of the cuff with the opposite hand and slide your hand in the glove. The other glove is a little trickier; you need to slide the gloved fingers in between the cuff and fingers of the other glove to protect them, and then slide the ungloved hand into the opening. Then the cuffs can be unfolded down over the gown.
If the students miss any part of these tasks, I take off points accordingly.
Monday, October 1, 2007
Thursday, September 27, 2007
Today was our double lab. Maura and I arrived early to set up the instruments and anesthesia machine. The students took their practical and were done in about an hour and a half. We helped them practice for the next part of their practical. Then the next lab came in and they took their practical. Only one student stayed to practice, the rest of them wanted to leave to study for another test that day. After she left, we cleaned up and left ourselves.
Wednesday, September 26, 2007
It was the second day of the first week of practicals. Maura and I arrived half an hour early to start setting up. We laid out all of the instruments and numbered them along with parts on the anesthetic machine. Maura made another key and we monitored them. Someone from VCL came down to draw blood for their class, so Maura and I helped them since the students were having trouble. Then when everyone was done, we helped them practice the machines and other items to practice for the next part of the practical.
Tuesday, September 25, 2007
The students started their practical today. Maura and I showed up at 7:30 to set up, we laid out all of the instruments and numbered them, and labeled parts of the anesthetic machine. After the students came in, Maura and I made a key and then just monitored until they were ready for the more hands on part. We watched the students dispense liquid medication and reconstitute medication. When the students were done, we helped them practice for the second half of the practical next week.
Monday, September 24, 2007
Thursday, September 20, 2007
We had our double lab today, which was a bit more stressful; making sure the first lab was done in time for the next lab. However, it went very well, and both labs had enough time to get done with everything they needed. All of the labs this week went progressively smoother as we were able to help the students either multitask or help their group get things done instead of all doing the same thing at the same time. Also, each day I put up signs for the dogs to be fasted for the next day, as well as the recovery signs if the students forgot or did not have time to. Today we used Krypton, Leo and Moonbeam in the first lab; and Nash, Neptune and Ophelia in the second lab.
Wednesday, September 19, 2007
Today was pretty much the same as yesterday, we used three different dogs; Comet, Dipper and Draco. Then we had a mock practical and open lab at night, which was very well attended and we plan on having open lab as much as we can for the next few weeks while people are studying for their practical’s.
Tuesday, September 18, 2007
We taught the students how to intubate a dog for the first time today. We used three dogs, and didn’t end up with enough time to use the cats. The dogs we used were Andromeda, Cassiopeia and Callisto. This is what we had the students do to prepare to intubate.
First they performed a physical exam on the dog their group was assigned to. Next, they drew blood for a big four, which consists of blood glucose, total solids, BUN level and a PCV. Then they calculated the drug dosages of Butorphanol, acepromizine and Glycopyrrolate as a premedication. (See drug dosages section) After Maura, Kim, Dr. Young or I checked the calculations; they drew up the drugs and wrote them in the controlled drug log. We checked that the students drew up the correct amount, then showed them how to combine all of the drugs into one syringe by pulling the plunger of one syringe back enough to fit the other two, and adding the other two.
They then gave their dog the premedication intramuscularly and waited for the dog to become sleepy. While they waited, we checked their propofol calculation if they hadn’t done them yet for the induction drug. They also got supplies ready to place a catheter as well as check the anesthesia machines.
Once their dog was sedated enough, the students placed a catheter. Up until now, most of the dogs had been fine, and the students had been able to get everything done, but Maura ended up placing a catheter in Andromeda and Callisto was not sedate enough to place one, so we didn’t use her.
Dr. Young talked to them about how to give the propofol, slowly to effect over 60-90 seconds; and also how to intubate and inflate the cuff once they are induced.
Kim took one group, while Dr. Young took the other, and Maura and I split up as well, and helped the students intubate.
To intubate, an assistant holds the dog’s mouth with one hand, and the tongue with the other. Then the person intubating takes the endotracheal tube which has a sterile lubrication on the end, along with the laryngoscope and places them in the dog’s mouth. The laryngoscope has a light source to help see the back of the throat. Using the laryngoscope and the endotracheal tube, you can then move the epiglottis down to see the trachea and esophagus. You then glide the tube on roof of the mouth so as to go over the epiglottis and then don into the trachea which is on the bottom. To make sure the tube is in the correct place, the animal should cough while it is going down, and also, you should be able to feel breath coming out of the end of the tube.
Next, we hook up the animal to the anesthesia machine and turn the flow meter on. For surgery, the Isoflurane would also be turned on, but since we are just practicing today, only the oxygen is turned on. Then we showed the students how to inflate the cuff so no air or gas leaks into the room. To do this, a syringe with a few mL’s of air is attached to the cuff inflator, the pop-off valve is closed, and we give a small breath and listen while we push the air into the cuff. When we hear no more air coming through the outside, it is inflated enough, and the pop off valve is reopened.
To extubate, the cuff is deflated and the tube pulled out. After everyone in the group had intubated and extubated, the last tube was left in while the animal woke up enough as you would for a real surgery. Once they were swallowing, they were extubated, wrapped in a blanket and could be put back in their cages with a recovery sign.
I fed the cats, since they were not used, and put up signs for three more dogs to be fasted in the morning.
*see procedure section for more detail on all procedures talked about
First they performed a physical exam on the dog their group was assigned to. Next, they drew blood for a big four, which consists of blood glucose, total solids, BUN level and a PCV. Then they calculated the drug dosages of Butorphanol, acepromizine and Glycopyrrolate as a premedication. (See drug dosages section) After Maura, Kim, Dr. Young or I checked the calculations; they drew up the drugs and wrote them in the controlled drug log. We checked that the students drew up the correct amount, then showed them how to combine all of the drugs into one syringe by pulling the plunger of one syringe back enough to fit the other two, and adding the other two.
They then gave their dog the premedication intramuscularly and waited for the dog to become sleepy. While they waited, we checked their propofol calculation if they hadn’t done them yet for the induction drug. They also got supplies ready to place a catheter as well as check the anesthesia machines.
Once their dog was sedated enough, the students placed a catheter. Up until now, most of the dogs had been fine, and the students had been able to get everything done, but Maura ended up placing a catheter in Andromeda and Callisto was not sedate enough to place one, so we didn’t use her.
Dr. Young talked to them about how to give the propofol, slowly to effect over 60-90 seconds; and also how to intubate and inflate the cuff once they are induced.
Kim took one group, while Dr. Young took the other, and Maura and I split up as well, and helped the students intubate.
To intubate, an assistant holds the dog’s mouth with one hand, and the tongue with the other. Then the person intubating takes the endotracheal tube which has a sterile lubrication on the end, along with the laryngoscope and places them in the dog’s mouth. The laryngoscope has a light source to help see the back of the throat. Using the laryngoscope and the endotracheal tube, you can then move the epiglottis down to see the trachea and esophagus. You then glide the tube on roof of the mouth so as to go over the epiglottis and then don into the trachea which is on the bottom. To make sure the tube is in the correct place, the animal should cough while it is going down, and also, you should be able to feel breath coming out of the end of the tube.
Next, we hook up the animal to the anesthesia machine and turn the flow meter on. For surgery, the Isoflurane would also be turned on, but since we are just practicing today, only the oxygen is turned on. Then we showed the students how to inflate the cuff so no air or gas leaks into the room. To do this, a syringe with a few mL’s of air is attached to the cuff inflator, the pop-off valve is closed, and we give a small breath and listen while we push the air into the cuff. When we hear no more air coming through the outside, it is inflated enough, and the pop off valve is reopened.
To extubate, the cuff is deflated and the tube pulled out. After everyone in the group had intubated and extubated, the last tube was left in while the animal woke up enough as you would for a real surgery. Once they were swallowing, they were extubated, wrapped in a blanket and could be put back in their cages with a recovery sign.
I fed the cats, since they were not used, and put up signs for three more dogs to be fasted in the morning.
*see procedure section for more detail on all procedures talked about
Monday, September 17, 2007
Today we went over the same things as last week and Maura and I put up NPO signs for three dogs and two cats so they can be sedated tomorrow. We also wrapped all of the gowns after the students practiced putting them on. Other than that, everything was the same. We also made up scrub and alcohol containers with chlorhexidine scrub and gauze, and alcohol and gauze (see procedures) which will get changed every Monday from now on.
Thursday, September 13, 2007
Today was the same as the past few days, only we had two labs. We went over scrubbing, gowning, gloving and CPR with Dr. Young and fluid rates, drug dosages, controlled drug logs, prepping, shaving, scrubbing of the patient and how to tie them onto the table with Kim. Also, the cats arrived today; Maura and I took them in and got them settled while Kim was teaching. We got to name them all as well.
Wednesday, September 12, 2007
Today we did the same things as yesterday and I had to go up to the office to get the drug box keys, but no one was there, so I had to go back down and get Kim’s keys to find the drug keys. Everything else was exactly the same. Then towards the end of the lab, the last 4 beagles arrived. I helped Kim bring them into the kennel and take them out of their crates. We then named them and cleaned out the crates. After I helped Kim clean up, we left.
Tuesday, September 11, 2007
Today we went over fluid rates and calculations, drug calculations, surgical site prep and the controlled drug logs with Kim. Then some of the Beagles arrived and Maura and I helped Kim bring them inside and get them all set up with water and we named them. Then we went back to the lab to help Dr. Young teach CPR, opened and closed gloving, scrubbing your hands and putting on a gown, both disposable and non-disposable.
Monday, September 10, 2007
Thursday, September 6, 2007
We had a double lab today and went over the same things with the students as we did yesterday and Tuesday. Maura and I helped out again in showing them everything and helping them learn the instruments and the techniques; other then that, everything was the same as the past two days. And at the end we cleaned the tables and helped to put away all of the instruments and packs.
Wednesday, September 5, 2007
Tuesday, September 4, 2007
Today we helped Kim teach the students how to unwrap surgery packs, gowns and drapes, how to clean instruments, how to wrap the packs and gowns and drapes, and how to fold gowns and drapes (see procedure section for all of these). Then Dr. Young taught them about all of the surgical instruments. We stayed after class for a bit to help the students go over a few things.
Wednesday, August 29, 2007
There was more cleaning and organizing to do today. We started the same way as yesterday, by taking out the anesthesia machines and then put away more supplies that had come in. Then I put away the ECG machines that were not being used. After that, I cleaned some of the food tubs for the beagles. Next week we should be able to help more, as there will be more for us to do with the class, and all of the cleaning and organizing is finished. At the end of lab, we helped put everything away again.
Tuesday, August 28, 2007
I started today by taking out the anesthesia machines and then I put away more supplies and helped Kim log in the controlled drugs into the log book. Then Maura and I cleaned and organized all of the cabinets in the surgery suite. The rest of the day was the same as yesterday; we helped go over the machines with the students. At the end of lab, we helped put all the machines away.
Monday, August 27, 2007
Today was the first day of school, and labs. As the surgery Teachers Assistant (TA) we could not do much the first day, as there were no surgeries. So we, the other TA, Maura, and I cleaned the surgery suite and helped put the order away, and brought a few items up to the rat lab. We cleaned the surgery suite by dusting off the lights and wiping down the counters and tables, also dusting off any other surface that looked dirty. We also cleaned and organized all of the cabinets and other supply areas. Towards the end of the lab we were able to help out by going over some of the machines with the students; the machines included the anesthesia machines, blood pressure, capnography, suction and ECG machines.
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