April 24, 2018

Anesthesia Records are becoming required for AAHA

Our Vetgard+ monitoring system has non-invasive blood pressure, body temperature, respiratory rate, ECG, heart rate, and SpO2.  When we hook up our Bluetooth monitor for you, during our surgery, you get a large computer display of all the parameters. We send you a computer printout from our surgical procedure that lists 5 minute interval data for your records. Just another way we are trying to help your clinic have all the tools it needs.

Dog1Adapted from, AAHA Anesthesia Guidelines for Dogs and Cats

Anesthesia is typically maintained using inhalant anesthetics, although maintenance can also be achieved with continuous infusions or intermittent doses of injectable agents, or a combination of injectable and inhalant drugs. An O2-enriched gas mixture is necessary for the safe and effective administration of inhalant anesthesia.

O2 flow rates depend on the breathing circuit used. For a circle rebreathing system, use a relatively high flow rate when rapid changes in anesthetic depth are needed, such as during the transition from injectables to inhalants (induction), or when turning the vaporizer off at the end of the procedure. During the maintenance phase, total O2 flow rate should typically be between 200 and 500 mL. The system must be leak-free for these flow rates to be effective. These are, perhaps, lower O2 flow rates than many are accustomed to. The benefits of lower flow rates include decreased environmental contamination and the economy of decreased consumption of O2 and volatile anesthetic gases. Lower flow rates also conserve moisture and heat. Disadvantages of lower flow rates include increased time to change anesthetic depth. Administer an O2 flow of approximately 200 mL/kg/min to patients connected to a non-rebreathing circuit.

Guidelines for anesthesia monitoring are available from the American College of Veterinary Anesthesiologists (ACVA).

Continue the cardiovascular monitoring and physiologic support measures that began in the patient preparation and/or induction periods. Monitoring includes evaluation of oxygenation, ventilation, cardiac rate and rhythm, adequacy of anesthetic depth, muscle relaxation, body temperature, and analgesia. Blood pressure, heart rate and rhythm, mucous membrane color, and pulse oximetry provide the best indexes of cardiovascular function. Multiparameter electronic monitors are available and serve as tools to assess physiologic parameters during the perianesthetic period. One must always evaluate the data the monitor is conveying in light of all other parameters and make treatment decisions based on the whole picture. Vigilant monitoring, interpretation, and responding to patient physiologic status by well-trained and attentive staff are critical.

Provide thermal support and monitor body temperature throughout the perianesthetic period. Supplemental heat may include warm IV fluids, use of a fluid line warmer, insulation on the patient’s feet (e.g., bubble wrap), circulating warm-water blankets, and/or warm air circulation systems. Do not use supplemental heat sources that are not designed specifically for anesthetized patients, as they can cause severe thermal injury.