Anaesthesia for Veterinary Nurses PDF
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Anaesthesia for Veterinary Nurses Edited by Elizabeth Welsh Blackwell Science © 2003 Blackwell Science Ltd, a Blackwell First published 2003 by Blackwell Science Ltd Publishing Company Editorial Offi ces: Library of Congress 9600 Garsington Road, Oxford OX4 2DQ, UK Cataloging-in-Publication Data Tel: +44 (0)1865 776868 Anaesthesia for veterinary nurses / edited by Blackwell Science, Inc., 350 Main Street, Elizabeth Welsh. Malden, MA 02148-5020, USA p. cm. Tel: +1 781 388 8250 Includes bibliographical references (p. ). Iowa State Press, a Blackwell Publishing ISBN 0-632-05061-6 (pbk.) Company, 2121 State Avenue, Ames, Iowa 1. Veterinary anesthesia. I. Welsh, Elizabeth. 50014-8300, USA Tel: +1 515 292 0140 SF914.A48 2003 Blackwell Publishing Asia Pty Ltd, 636.089′796--dc21 550 Swanston Street,Carlton South, 2002155057 Victoria 3053, Australia Tel: +61 (0)3 9347 0300 ISBN 0-632-05061-6 Blackwell Verlag, Kurfürstendamm 57, 10707 Berlin, Germany A catalogue record for this title is available Tel: +49 (0)30 32 79 060 from the B ritish Library The right of the Author to be identifi ed as Set in 10/13 pt Sabon the Author of this Work has been asserted in by Sparks Computer Solutions Ltd, Oxford accordance with theCopyright, Designs and http://www.sparks.co.uk Patents Act 1988. Printed and bound in Great Britain by TJ International, Padstow All rights reserved. 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Contents Contributors v Preface vii Acknowledgements viii 1 The Role of the Veterinary Nurse in Anaesthesia 1 Joan Freeman 2 Physiology Relevant to Anaesthesia 15 Mary Fraser 3 Preoperative Assessment and Preparation of the Patient 34 Joan Duncan 4 Anaesthetic Machines and Ventilators 55 Craig Johnson 5 Breathing Circuits and Airway Management 83 Craig Johnson 6 Anaesthetic Drugs 113 Derek Flaherty 7 Analgesia 157 Derek Flaherty and Janice MacGillivray iii iv Contents 8 Intravenous Access and Fluid Therapy 179 Kirstin Beard and Elizabeth Welsh 9 Monitoring the Anaesthetised Patient 219 Louise Clark 10 Nursing the Patient in Recovery 247 Janis Hamilton 11 Cardiopulmonary Resuscitation and Other Emergencies 271 Kirstin Beard 12 Rabbit, Ferret and Rodent Anaesthesia 290 Simon Girling 13 Avian Anaesthesia 307 Simon Girling 14 Reptile Anaesthesia 323 Simon Girling 15 Large Animal Anaesthesia 340 Elizabeth Welsh Index 353 Contributors Kirstin Beard VN, DipAVN(Surg) University of Edinburgh Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EG25 9RG Louise Clark BVMS, CertVA, MRCVS University of Edinburgh Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EG25 9RG Joan Duncan BVMS, PhD, CertVR, MRCVS Idexx Laboratories, Grange House, Sandbeck Way, Wetherby LS22 4DN Derek Flaherty BVMS, DipECVA, DVA, MRCVS University of Glasgow Veterinary School, Bearsden Road, Bearsden, Glasgow G61 1QH Mary Fraser BVMS, PhD, CBiol, MIBiol, CertVD, MRCVS No 9 Edderston Ridge Crescent, Peebles EH45 9ND Simon Girling BVMS, CBiol, MIBiol, CertZooMed, MRCVS 171 Mayfi eld Road, Edinburgh EH9 3AZ Janis Hamilton VN, DipAVN(Surg) University of Glasgow Veterinary School, Bearsden Road, Bearsden, Glasgow G61 1QH v vi Contributors Craig Johnson BVSc, PhD, DVA, DipECVA, MRCA, MRCVS Comparative Physiology and Anatomy, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Private Bag 11-222, Palmerston North, New Zealand Janice MacGillivray VN, DipAVN(Surg) PDSA, 211 Hawkhill, Dundee DD1 5LA Joan Freeman VN, DipAVN(Surg) University of Edinburgh Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EG25 9RG Elizabeth Welsh BVMS, PhD, CertVA, CertSAS, MRCVS University of Edinburgh Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EG25 9RG Preface In every small animal veterinary surgery, on every day, pet owners entrust their animals into our care. Many of these pets are sedated or anaesthetised and veterinary nurse trainees and listed veterinary nurses play a central role in this process. They are often the people who admit the patient to the clinic, are central to the care of the patient before, during and after anaesthesia, and will frequently discharge the patient into the care of its owner at the end of the day. Thus, it is vitally important that veterinary nurses at all stages of their career are familiar with the physiological, pharmacological and physical principles that underpin clinical anaesthesia. This is the fi rst book in the UK on the principles and practice of anaesthesia that has been aimed specifi cally at veterinary nurses. It has been written to help both veterinary nurse trainees and listed veterinary nurses, not only in their studies but also in navigating the daily challenges of anaesthesia more confi - dently. Throughout, we have aimed to provide the necessary information for this purpose at the right level and in the right detail, and, to refl ect the increas- ing importance of small mammals, birds and reptiles in small animal practice, separate chapters have been dedicated to them. vii Acknowledgements I would like to thank all my colleagues who contributed to this book. I would like especially to mention the veterinary nurses who readily agreed to contrib- ute to the content. The staff at Blackwell Publishing have been patient and sup- portive, and to them also I express my thanks. viii Anaesthesia for Veterinary Nurses Edited by Elizabeth Welsh Copyright © 2003 Blackwell Science Ltd 1 The Role of the Veterinary Nurse in Anaesthesia Joan Freeman Veterinary surgeons must work within the legal constraints of the Veterinary Surgeons Act (1966). They must also abide by the rules of conduct for veteri- nary surgeons (‘Guide to Professional Conduct’) set up by the Royal College of Veterinary Surgeons (RCVS), the professional body in the United Kingdom. Veterinary surgeons can be found negligent and guilty of malpractice, not only as a consequence of their own actions but also for the injurious actions of an employee, including veterinary nurses and student veterinary nurses. There- fore, veterinary nurses are not entitled to undertake either medical treatment or minor surgery independently. Nevertheless, veterinary nurses have a duty to safeguard the health and welfare of animals under veterinary care and, as an- aesthesia is a critical procedure, the need for knowledge and an understanding of the procedures involved in anaesthesia cannot be overestimated. LEGISLATION GOVERNING VETERINARY NURSES Student veterinary nurses who pass both Part II and Part III examinations for the veterinary nursing qualifi cation in the United Kingdom and fulfi l the practi- cal training requirements at an approved training practice are entitled to have their names entered on a list of veterinary nurses maintained by the RCVS and to describe themselves as listed veterinary nurses. The Veterinary Surgeons Act (1966) states that only a veterinary surgeon may practise veterinary surgery. Exceptions to this rule apply solely to listed veterinary nurses, and are covered under the 1991 amendment to Schedule 3 of the Act. 1 2 Anaesthesia for Veterinary Nurses The exceptions are: • Veterinary nurses (or any member of the public) may administer fi rst aid in an emergency as an interim measure until a veterinary surgeon’s assistance can be obtained. • A listed veterinary nurse may administer ‘any medical treatment or any minor surgery (not involving entry into a body cavity) to a companion ani- mal’ under veterinary direction. The animal undergoing medical treatment or minor surgery must be under the care of the veterinary surgeon and he or she must be the employer of the veterinary nurse. The Act does not defi ne ‘any medical treatment or any minor surgery’ but leaves it to the individual veterinary surgeon to interpret, using their profes- sional judgement. Thus veterinary nurses should only carry out procedures which they feel competent to perform under the direction of a veterinary sur- geon, and the veterinary surgeon should be available to respond if any problems arise. Recent changes to the Veterinary Surgeons Act 1966 (Schedule 3 amend- ment) Order 2002 now entitles listed veterinary nurses to perform nursing duties on all species of animal, not just companion animals, and in addition allows student veterinary nurses to perform Schedule 3 tasks during their train- ing, provided they are under the direct, continuous and personal supervision of either a listed veterinary nurse (Fig. 1.1) or veterinary surgeon. Currently there are moves towards a system of self-regulation within the veterinary nursing profession. In such a system the privilege of being listed Fig. 1.1 A listed veterinary nurse supervising a veterinary nurse trainee during a clinical procedure.
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