The Veterinary Nurse's Practical Guide to Small Animal Anaesthesia

402 Pages·2023·18.23 MB·English

by  Niamh Clancy

The Veterinary Nurse’s
Practical Guide
to Small Animal Anaesthesia

The Veterinary Nurse’s Practical Guide
to Small Animal Anaesthesia
Edited by
Niamh Clancy, Dip AVN (SA) DipHE CVN DipVN PGCert VetEd
FHEA RVN
Teaching Fellow, School of Veterinary Nursing,
Royal Veterinary College, UK
Deputy Co-course director,
Certificates in Advanced Veterinary Nursing,
Royal Veterinary College, UK
Anaesthesia Nurse, Queen Mother Hospital for Animals,
Royal Veterinary College, UK
This edition first published 2023
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Library of Congress Cataloging-in-Publication Data
Names: Clancy, Niamh, editor.
Title: The veterinary nurse’s practical guide to small animal anaesthesia /
edited by Niamh Clancy.
Description: First edition. | Chichester, West Sussex ; Hoboken, NJ :
Wiley-Blackwell, 2023. | Includes bibliographical references and index.
Identifiers: LCCN 2022049641 (print) | LCCN 2022049642 (ebook) | ISBN
9781119716921 (paperback) | ISBN 9781119716969 (adobe pdf) | ISBN
9781119717034 (epub)
Subjects: MESH: Anesthesia—veterinary | Anesthesia—nursing |
Analgesics—standards | Dog Diseases—nursing | Cat Diseases—nursing |
Animal Technicians—standards
Classification: LCC SF914 (print) | LCC SF914 (ebook) | NLM SF 914 | DDC
636.089/796 —dc23/eng/20221230
LC record available at https://lccn.loc.gov/2022049641
LC ebook record available at https://lccn.loc.gov/2022049642
Cover Images: © Ana Carina Costa, Carolina Palacios Jimenez, Niamh Clancy, Ioan Holban
Cover design by Wiley
Set in 9.5/12.5pt STIXTwoText by Straive, Chennai, India
v
Contents
List of Contributors xv
Preface xvii
1 Pre-Anaesthetic Assessment and Premedication 1
Niamh Clancy
Patient Assessment 3
History 3
Physical Examination 4
Cardiac and Thoracic Auscultation 4
Body Condition Scoring (BCS) 6
Hydration 7
Patient Temperament 7
Other Considerations 7
Premedication 9
Administration of Premedication 15
Acknowledgements 17
References 17
2 Interpreting Blood Results 19
Joanna Williams
Haematology 19
Red Blood Cell Count and Packed Cell Volume (RBC and PCV) 19
High PCV 19
Low PCV 20
White Blood Cell (WBC) and Neutrophil Count 20
High Count 20
Low Count 20
Lymphocytes and Monocytes 21
Eosinophils and Basophils 21
Platelets 21
High Count 21
Low Count 21
Biochemistry 23
Proteins (TP, ALB, GLOB) 24
vi Contents
High Levels (Hyperproteinaemia) 24
Low Levels (Hypoproteinaemia) 24
Hepatic Parameters (ALKP, ALT, BIL) 25
High Levels 25
Renal Parameters (CREA, BUN, InPHOS) 25
High Levels 25
Low Levels 26
Glucose (GLU) 26
High Levels (Hyperglycaemia) 26
Low Levels (Hypoglycaemia) 26
Electrolytes 26
Sodium (Na+) 26
High Levels 26
Low Levels 27
Potassium (K+) 27
High Levels 27
Low Levels 27
Calcium (Ca2+) 28
High Levels 28
Low Levels 28
Conclusion 29
References 29
3 Cardiovascular Physiology 31
Joanna Williams
Blood Flow Through the Heart 32
Conduction Through the Heart 33
Vascular System 34
Pulmonic Circulation 34
Systemic Circulation 35
Cardiac Output 36
Stroke Volume 36
Heart Rate 38
Anaesthetic Considerations for Patients with Cardiovascular Disease 39
References 41
4 Respiratory Physiology and Ventilation 42
Ioan Holbon
Respiratory Anatomy 42
Pulmonary Ventilation 43
Central Regulation of Respiration 44
Chemical Regulation of Respiration 44
Mechanics of Breathing 44
Inspiration 45
Expiration 45
Contents vii
The Effects of Anaesthesia on Normal Respiratory Physiology 45
Indications for Ventilation 46
Initiation of Ventilation 48
Manual Ventilation 49
Mechanical Ventilation 50
Volume Cycling Versus Pressure Cycling Ventilation 51
Positive End- expiratory Pressure (PEEP) and Alveolar Recruitment Manoeuvres
(ARM) 53
4.1 Possible Harmful Effects of Artificial Ventilation 54
Ventilation Strategies to Prevent Some of the Possible Negative Effects of IPPV 57
On the Lungs 57
On the Cardiovascular System 57
On the Intracranial Pressure 57
On Blood Gas and Acid–Base Disturbances 57
Troubleshooting During Mechanical Ventilation 58
Anaesthetic Machine and Breathing System 58
Ventilators 58
Patient 58
Weaning the Patient Off the Ventilator 58
References 60
5 Blood Pressure Regulation and Monitoring 63
Leanne Smith
What Factors Contribute to Blood Pressure 63
The Importance of Blood Pressure Regulation During Anaesthesia 64
How Do We Measure Blood Pressure? 66
Non-invasive/Indirect Blood Pressure Monitoring 66
Doppler 68
Oscillometric 69
High Definition Oscillometric (HDO) Devices 69
Invasive Blood Pressure Monitoring 70
Treatment of Hypotension Under General Anaesthesia 70
Drugs to Treat Hypotension 71
Positive Inotropes 73
Adrenaline/Epinephrine, Ephedrine, Dobutamine, Dopamine, Noradrenaline/
Norepinephrine 73
Vasopressors 73
Adrenaline/Epinephrine, Dopamine, Ephedrine, Noradrenaline/Norepinephrine,
Phenylephrine, Vasopressin 73
Anticholinergics 74
Glycopyrolate, Atropine 74
Treatment of Hypertension Under General Anaesthesia 74
Summary 75
Quick Reference Terminology and Definitions 75
References 76
viii Contents
6 Capnography and Spirometry 78
Lisa Angell
Capnography/Capnometry 78
Capnograph Device Options 79
Information Provided from a Capnograph 81
Carbon Dioxide 81
Interpretation of Carbon Dioxide Values 82
The Normal Capnogram 87
Analysis of the Capnogram 88
Common Abnormal Capnography Waveforms
and Their Interpretation 89
Spirometry 95
Acknowledgements 95
References 96
7 Pulse Oximetry 97
Ana Carina Costa
Introduction 97
How Does the Pulse Oximeter Work? 97
Data Interpretation 100
SpO and PaO 100
2 2
Hypoxaemia 102
Plethysmograph 104
Anaemia and Abnormal Haemoglobin Forms 107
Anaemia 107
Methaemoglobin 108
Carboxyhaemoglobin 108
Tips and Tricks 108
Advanced Technology – Masimo Pulse Co- Oximetry 111
References 111
8 Practical ECGs 113
Courtney Scales
ECG Fundamentals 114
Normal Conduction 114
The ECG Machine 115
The ECG Cables 117
The ECG Complex 119
Common ECG Complexes and Rhythms 121
Sinus Rhythms 121
Normal Sinus Rhythm 122
Sinus Arrhythmia 122
Sinus Tachycardia 123
Sinus Bradycardia 124