4 Steps To A Safer Pet C-SectionJuly 25, 2014 This article first appeared in the July 2013 issue of Veterinary Practice News A C-section can be a stressful and chaotic nightmare, or it can be a wonderful and uplifting experience. In this article, part one of three, we will share 10 steps to become better equipped for your next C-section. Our goal is to save the offspring—and of course keep the dam safe. 1) Preparation & Teamwork A successful C-section requires teamwork at its best. This should include pet owners, who should be educated during any pregnancy —especially those at risk — so they know what to expect and when veterinary assistance might be needed. What is normal? What is abnormal? When might a C-section be necessary? When should they call if they think a C-section is required, so you can be ready? Many late night or early morning emergency C-sections could be avoided if more time were spent educating clients. Understanding the client’s wishes is a critical part of the discussion. Does he want the pet spayed? Can she afford another C-section? Can he properly care for another 12 puppies while working two jobs? Does the world really need more hydrocephalic Chihuahuas …
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Scrub in or rub in?January 30, 2014 Dr. John Smith is getting ready for his first surgery of the day. He puts on his cap and mask, adjusts them methodically, and starts to rigorously prepare his hands for surgery. He grabs a brush soaked with chlorhexidine scrub and goes to work, as if it were a ritual: First his fingers, then the palm of each hand, then the back, then his wrists, then his forearms, for a full five minutes, just like he has been doing for the past 15 years as a surgeon. Sounds perfectly acceptable, doesn't it? What Dr. Smith doesn't know is that his surgical scrub routine is actually detrimental to the health of his hands, increases the likelihood of contamination, and puts him at risk of developing occupational dermatitis. Meanwhile, Dr. Denis Verwilghen of Copenhagen, Denmark, is getting ready for his first surgery of the day. He puts on his cap and mask, adjusts them methodically, and starts to rigorously prepare his hands for surgery. He first gently washes his hands with a mild, non-medicated soap, dries them with a non-sterile paper towel, and then meticulously rubs a hydroalcoholic solution on his hands and arms for a couple of minutes — until they are …
Surgical Insights: Care Of Neonates After A C-sectionSeptember 23, 2013 While rubbing babies and clearing their airways, we also should strive to prevent the three "hypos" in neonates: hypothermia, hypotension and hypoxia. We conclude our three-part article on C-sections with resuscitation and care of the neonates. It is time to change a few old habits and to embrace more modern techniques. Part 1 is here; Part 2 is here. 7. Resuscitation While rubbing babies and clearing their airways, we also should strive to prevent the three "hypos” in neonates: hypothermia, hypotension and hypoxia. Hypoxia is a constant battle during a C-section. The amniotic sac should be removed as soon as possible, and the mouth and airway must be cleared with a bulb syringe. "Don’t use too much suction,” reminds Margret Casal, DrMedVet, PhD, Dipl. European College of Animal Reproduction, University of Pennsylvania School of Veterinary Medicine, "as it could damage the delicate tissue of the pharynx and larynx.” Alternatively, a mucus suction device for human babies can be used, e.g., the poetically called "snotsucker nasal aspirator.” Hypothermia can be prevented by using warm towels straight out of the dryer, or a …
Two Simple Ways To Improve Patient CareNovember 1, 2011It's fascinating to me that every practice seems to have a different protocol to achieve similar results. For this column, we present better ways to intubate and scrub patients. Each doctor or technician probably has a different intubation protocol. I recently read a description of how we should probably all intubate. It was written by Sheilah Robertson, a board-certified anesthesiologist at the University of Florida College of Veterinary Medicine.1 Here's the idea: Most people test the cuff of a large endotracheal tube by inflating it with a syringe (aka "dry syringe," "air syringe" or "cuffer puffer"), waiting a few seconds, and deflating it. Then, some people lube the tip and the cuff of the tube with lubricating jelly (again, this specifically applies to large tubes). It seems that most do so on a deflated, folded cuff, which actually greatly decreases the benefits. Dr. Robertson suggests adding lube to an inflated cuff. Think about it. It wouldn't take any longer than doing both steps separately, but it would lubricate the cuff much more effectively—on 100 percent of its surface—instead of a few random spots. I have only witnessed one technician do that (surely there are more out there!) But …