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Veterinary dental nursing procedures

Veterinary dental nursing procedures

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Veterinary dental nursing procedures

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  1. Veterinary dental nursing procedures SAFETY, ANESTHESIA, POSITIONING

  2. Usual GA precautions • Appropriate monitoring equipment • IV catheter and fluids as required 5888H - Veterinary Dental Nursing

  3. Contaminated Surgery • Veterinarians should in general avoid performing “dirty” dentals on an individual animal at the same time as major sterile surgery • Bacteria entering the blood stream during dental work can lodge in the blood clots of the major surgery site. 5888H - Veterinary Dental Nursing

  4. Safety Considerations • Patient safety • Operator safety 5888H - Veterinary Dental Nursing

  5. Patient Safety • Head movement > endotracheal tube induced tracheal trauma; if tracheal trauma: • subcutaneous emphysema – if tracheal air escapes • tracheal stricture – can appear days or weeks later. • Head movement > tube twisting and kinking • Head tilted up > fluids, blood, blood clots, calculus easily enter trachea. • Cuffed tube > distal cuff still permits fluid to enter proximal trachea. • Wet face, cold table/grill > greater heat loss and hypothermia • Wet ET tube tie > loosens and falls out easily 5888H - Veterinary Dental Nursing

  6. Use Cuffed ET tube • Just enough to occlude air leakage 5888H - Veterinary Dental Nursing

  7. Good grip on ET tube • Ensure good grip on tube tie; might use • Rubber elastic band (not too tight on face) • Drip tubing (not too tight on face or tube) 5888H - Veterinary Dental Nursing

  8. Good grip on ET tube 5888H - Veterinary Dental Nursing

  9. Disconnect Tube • When turning or moving animal 5888H - Veterinary Dental Nursing

  10. Don’t turn over the back • Turn under belly • with legs kept underneath • reduces chance of fluid entering trachea 5888H - Veterinary Dental Nursing

  11. Slight incline for trachea • Tilt table, or • Use padding (eg bubble wrap) • More under shoulders, less under neck • Just think of airway position! 5888H - Veterinary Dental Nursing

  12. Patient Positioning • Options • Dorsal • Lateral 5888H - Veterinary Dental Nursing

  13. Dorsal Recumbency 5888H - Veterinary Dental Nursing

  14. Lateral Recumbency 5888H - Veterinary Dental Nursing

  15. Place absorbent wad in pharynx • eg swabs, throat pads • Past hump of tongue • REMEMBER TO REMOVE when finished • have a reminder check system – eg a marker on the ET tube when swab placed 5888H - Veterinary Dental Nursing

  16. Pharyngeal Packing · 5888H - Veterinary Dental Nursing

  17. Ocular lubricant • To protect eyes from aerosol • Artificial tears • Lacrilube 5888H - Veterinary Dental Nursing

  18. Care with Mouth Prop • Is used to protect operator and improve visibility • But not too wide! 5888H - Veterinary Dental Nursing

  19. Warmth • Consider • Heating mat • Bubble wrap • Warm water bottles • Some methods need care as may have risks of either scalding and/or electrocution 5888H - Veterinary Dental Nursing

  20. Head on a grill • To keep body and face drier 5888H - Veterinary Dental Nursing

  21. Monitor Temperature • Usually rectal temp measured 5888H - Veterinary Dental Nursing

  22. Recovery • Place in lateral or sternal recumbency with the head and neck extended, preferably head below thorax • Monitor temp, pulse, respiration, consciousness until able to maintain sternal recumbency • Keep orifices clear, clean and dry • Remove pharyngeal swabs • Remove endotracheal tube at appropriate time • Analgesics as indicated • Report recovery problems • Final grooming before discharge 5888H - Veterinary Dental Nursing

  23. What operator safety precautions shown here? Operator Safety 5888H - Veterinary Dental Nursing

  24. Risk of being bitten • Especially under light GA • Use a mouth prop 5888H - Veterinary Dental Nursing

  25. Eye protection . • Risks • Calculus flicked into eyes • Aerosol in eyes (possible conjunctivitis) • Protection • Full head visor • Goggles or glasses 5888H - Veterinary Dental Nursing

  26. Pneumonia • Large numbers of bacteria in aerosolised water droplets • These small droplets float deep into lungs • Possible bacterial pneumonia • Use face mask • Quality type, well fitted • But discard after use 5888H - Veterinary Dental Nursing

  27. General contamination • Build up of debris on the skin or under the fingernails • Moisture contaminates clothing (hospital hygiene) 5888H - Veterinary Dental Nursing

  28. Posture • Often a lengthy procedure in fixed posture • Use adjustable stool 5888H - Veterinary Dental Nursing

  29. Sharps • Discard of scalpel blades, needles, old burs into sharps container • Care with handling sharp instruments 5888H - Veterinary Dental Nursing

  30. Anaesthetic gases • Usual scavenging systems • Good fittings required if patient movement 5888H - Veterinary Dental Nursing

  31. Electrocution • Electric heating mats • Faulty electric dental equipment 5888H - Veterinary Dental Nursing

  32. Other protection • Gloves • Cap • Apron - waterproof 5888H - Veterinary Dental Nursing

  33. The End 5888H - Veterinary Dental Nursing