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
