Organize IV cath supplies (catheter, tape, heparin saline, antiseptics for sterile skin prep)

Organize equip for intubation(different sized tubes, laryngoscope, stylet, topical anesth spray, gauze, syringe to inflate cuff)

Organize crash cart/emergency drugs for emergency situations

Prepare machine and select breathing system accord to animal's size:

CIRCLE BREATHING SYSTEM(RE-BREATHING)

Pediatric -- less than 7kg
Adult -- 7 to 135kg
Y-piece, breathing tubes and connectors
1 way valves
Rebrebreathing bags < 135kg (< 300#) use sizes 1, 2, 3, 5, 6 L bags; >135kg (> 300#) use sizes 15, 20, 30 L bags
**Bag selection should be based on patient's tidal volume (10ml/kg) multiplied by 6 (Ex. 20kg canine = a tidal volume of 200 multiplied by 6 = 1200ml or a 1.2 Liter bag)

NONREBREATHING SYSTEM - for patients less than 7kg

Fill vaporizer and check O2 supply

Evaluate soda lime absorbent-refill if 2/3 color

Turn on flowmeter to check for free movement indicator

Close pop-up valve and pressurize breathing system to 40 cm H2O on pressure manometer using O2 flush valve-place thumb over patient connection

Connect machine to waste gas scavenging system

Calculate O2 flow rate according to patient size and breathing system used

Organize fluids administration and calculate appropriate admin rate

Calculate dosage for induction drugs. Withdraw drugs from bottles into syringes and label properly

Inject air into intubation tube cuff to check ability to hold volume

With animal in sternal recumbency intubate and check for proper tube placement by palpation and coughing

Inflate cuff to a soft pillow and secure tube by tying w/gauze

Turn on O2 flow a few minutes prior to connecting patient to fill system with O2

Connect ET tube to system and turn vaporizer on to appropriate induction setting

Apply eye ointment to Ketamine cats and assess pulse rate and quality and respiration

Reduce vaporizer settings to appropriate maintenance conc as indicated by patient's anesth depth

Begin IV fluid admin and begin monitoring

Take reading of vital signs every 5 minutes-check mm, hp, rr, bp, pulse, color, ekg, ventilation rate, anesth depth and every 10 min inflate lungs to prevent atelectasis

Upon completion of procedure, flush breathing system w/pure O2 and continue O2 delivery for 5-10 min and kick machine off when you get to the sewing part

Deflate cuff and position in sternal recumbency w/head extended

Extubate only after swallowing reflex occurs

Vigorously rub and move animal's legs, call animal's name to hasten recovery and observe animal

Jodi Lynn Dziedzic, VSPN member