Veterinary Surgical Nursing

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Veterinary Surgical Nursing

• PRE-OPERATIVE
• ASSISTANCE

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Pre-op

• Bath (day before)
• Food withheld for 12hours
• Withhold water 2-3hours prior to surgery
• Allow urination defecation
• Enema - if required
• Placement of intravenous catheter (facilitates
  smoother induction, reduces risk of accidental
  perivascular injection, allows intravenous fluid
  administration ensures a route for drugs in the
  event of an anaesthetic emergency)

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General Preparations

• Dietary restrictions
• Excretions
• Diagnostics
• Bathing
• Anaesthetic pre-medication
• Antibiotics
• Intravenous fluids
• Stabilisation if disease or injury
• Skin preparation, check sex,
• Patient positioning

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Surgical priorities

• Emergency
• Acute abdomen
• Necessary or urgent
• Fractures
• Elective non-urgent
• Desexing

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Surgery Schedules

• Timetable for efficiency
• Emergencies first
• Clean before contaminated
• Routines to go home same day
• Possible long surgeries after routines
• Some routines on some days e.g. dentals
• Rescheduling

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Dietary Restrictions

• No food 12 hour prior
• Water is usually ok
• Reduces risk of vomiting during GA
• But beware cooked bones can remain in stomach
  for days!
• May also help if gastrointestinal surgery
• No food several days prior
• colonic surgery

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Excretions

• Allow a dog a walk before Sx
• To void faeces and urine
• Male dogs abdominal surgery
• Urethral catheter placement
• Prevents urinating onto Sx field
• Use stay sutures or towel clamp
• To move prepuce laterallyaway from Sx field

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Excretions

• Anal purse-string suture
• If surgical field is near anus
• hip and tail surgery etc
• Dont forget to remove! (like throat packs)

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Diagnostics

• Clinical pathology etc
• Hospital may suggest routine tests
• Blood
• Urine
• Faeces
• Radiography
• Ultrasonography

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Bathing

• May be required if grossly soiled
• e.g. if an enema was given
• Care with handling
• Use muzzle whenever risk of biting

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Anaesthetic Pre-med

• According to hospital protocols
• Routinely might be
• acp/atropine
• methadone/acepromazine/atropine
• diazepam/ketamine
• Acp/buprenorphine
• what other?

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Antibiotics

• Not generally required for sterile surgery
• May be used prophylactically for certain clean
  major surgeries
• Orthopaedics
• Neurosurgery
• If used are best commenced before surgery or at
  induction of anaesthesia

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Fluids

• Often catheterised and fluids commenced before
  anaesthesia
• Gives ready access to a vein for GA
• Fluid rates
• If to keep catheter patent 5 ml/Animal/hr
• If maintenance see charts for weight
• If during surgery 10 mL/kg/hour

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Stabilisation

• May be required for
• Trauma
• Metabolic disease
• Respiratory disease

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Esmarchs Wrap

• To reduce blood in field
• Often used in equine limb Sx
• Squeezes most blood out of limb then maintains a
  tourniquet effect
• Empties the veins
• Compresses the arteries
• Time limit
• Rubber or silicone

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Skin Preparation

• Usually prepare skin for aseptic surgery

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Patient positioning

• For routine surgery
• As per practice policy
• Dorsal recumbency on its back
• Ventral recumbency on its belly
• Lateral recumbency on its side
• For non-routine surgery
• Ask surgeon

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The End
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