KEEP CALM OR I WILL BOLUS THE PROPOFOL

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Propofol is a very commonly used drug in the veterinary world. We use it to help patients fall asleep before surgery.

My last rotation of the year was spent in the anesthesia department at the university hospital. This was a rotation that my whole group wished had been scheduled earlier in the year. We were taught lots of valuable information about drugs that would have been very helpful during our placements–but better late than never!

The anesthesia department at the hospital runs almost all of the anesthetic protocols for any procedure going on in the hospital–so this means cats, dogs, horses, and occasionally other fun animals!  An anesthetic protocol is required for any patient that needs to be asleep for a procedure– like taking an x-ray or having a surgery done.

Each student was required to be ‘primary’ on a case for the day and read their patient’s file and then develop an anesthetic plan that would appropriately match the patient’s diseases and procedure. This is complicated. Especially when your patient has multiple diseases and you can’t give them certain drugs.

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Jessica reading up on her patient’s medical history. There is a TV in our student lounge connected to one of the surgical suites. On this day, I sat & ate my lunch and watched a thoracotomy. 

After doing a physical exam on our patients, creating an anesthetic protocol, and preparing all our equipment and machines we would draw up our drugs into syringes. The first step is then administering a pre-medication drug to the patient to make them a little sleepy. After that we would collect our patient from the wards, bring them to the prep room and place an IV catheter in their vein. We also placed an endotracheal tube (so we can control their breathing), and finished prepping them for their surgery or procedure. During surgery we monitor the patient’s vital signs to make sure their heart is beating properly, they are breathing correctly, and other important things. Once the surgery is finished we are in charge of making sure the patient wakes up smoothly and safely.

One day I monitored an anesthetic for 7 hours, one of my wonderful group mates brought me food from home and the rest of the team tagged me out for a break 🙂

During some of the afternoons we had tutorials where we learned about different stages of the anesthetic protocols and could ask any questions we needed to.

We all had to take complete charge of a patient (with no help from supervisors and nurses) and we were assessed to make sure we could do everything appropriately and safely. My patient was in hospital for a toe amputation. Everything went smoothly!

Some of the patients that I created anesthetic protocols and monitored for were getting CT scans, MRIs, spays, foreign body removal surgeries, etc.

Unfortunately, this post can’t be too much longer without talking about a lot of fancy drug names and anesthetic equipment. I found it helpful to practice using new drugs and talk about protocols with the experts!  At the end of the 2 weeks…we were done! But actually, DONE! No more rotations 🙂 next step…. graduation!

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Last day of DVM4! We are in the prep-room in front of some of the anesthetic machines we had been using during our rotation. 

 

 

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Eyeballs, ovaries, and anesthesia!

Its finally the start of our Easter break and its given me a chance to write another post. This has been a full on semester…the material is a lot more clinically relevant and interesting. I love that we get more hands on experience. This is the fun stuff, the stuff that counts, its what I’ve been looking forward to for years.

Recently I had a really good week of practical classes:

The first one was our Ophthalmology Practical class.  I’ve helped out with tons of eye examinations at work over the years, but only got to use the equipment myself a few times. I have never been overly interested in eye cases but this class was a lot of fun for me. We had our ophthalmology lectures a few days earlier which were full of different pictures and explanations of what to look for. Our lovely teaching greyhounds were present and we got to practice Schirmer Tear Tests (STT (measures tear production)), fluorescein eye stains (highlights wounds or ulcers in the eye), and examination of the eyeball with a focal light and an optivisor. I’m starting a clinical placement at a small animal clinic this week and I am really hoping to get a chance to practice my examination skills.

We had our second Bovine Reproduction Practical class where we practiced rectal palpation on female cattle. Our main objective was to attempt to find and palpate the cervix, bifurcation of the uterus, and both ovaries. I was able to find all the structures; one of our cows even had a cystic ovary. That ovary was a lot larger and easier to find than the normal healthy ovaries. The week before we had an Equine Reproductive Practical class where we felt for the same structures in horses. It was good practice to go between species and think about the differences in anatomy. Horse ovaries are bigger and you feel for them higher up than cow ovaries.

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We both found ovaries! Well on our way to diagnosing pregnancy…. 

Our Small Animal Reproductive Practical class finished off our clinical skills in our reproduction block. Unfortunately there was no dogs or cats present in our class so we mostly used microscopes to examine slides of swab samples. Cytology (the examination of cells) is one of the best ways to determine which stage of a cycle the bitch (female dog) is in. It is very important to know what stage she is in so that she can be bred on the right day and get pregnant with puppies. Looking through microscopes is definitely not my favorite part of vet med but after this class I understand a lot more what to look for in these cases.

My favorite practical class that week was our Equine Anesthesia class. We were split into 2 groups of students. Half of us were given a drug protocol and had to calculate drug doses and draw up our medications. The other half of the class had to complete a physical exam on our patient. My roommate and I were in the same group and we felt quite confident about how to start and complete a physical exam on a horse because of our time volunteering in the horse hospital. After we completed our exam we had to clean, prep, and insert a jugular catheter so we could administer the premedication drugs. Our group had a ‘Triple Drip’ drug protocol which is very common in horses. Then we proceeded to anesthetize our horse with our maintenance drugs. When the patient was asleep we were responsible for monitoring his vital signs and recording everything on the anesthetic record. We also practiced intubation. I’ve done intubations in cats and dogs before, horses are different because it is a ‘blind intubation’. That means that you cannot see exactly where you are placing the tube and instead have to rely fully on feel and knowledge of anatomy.

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I am holding the maintenance drugs we used for our TIVA (total intravenous anesthesia) Triple Drip protocol and equine intubation tubes. 

So vet school? Loving it!

After a full 9 weeks of class I’m ready for a 2 week break to catch up on lectures and complete some clinical placements…