Howdy Friends! It's been a while, and I've been very busy. This quarter I have three classes: Anesthesia, Small Animal Surgical Assisting, and Advanced Hematology. I've been keeping very busy, to say the least. Let's do a little run through!
In this class, there are four of us and we get to draw blood on all nine animals every week, and we get to run a Complete Blood Count (CBC), Chemistry Panel, and Snap Tests (quick blood tests to check for certain diseases such as heartworm), and look at the blood under a microscope. We've done this stuff in the past, but never on a weekly basis such as this. It is really fun to hone my skills, and get better and faster at doing these routine things that I will be doing in the clinic in a few short months!
Surgery and Anesthesia
These two classes go hand in hand. In class, we learn about surgery and how the anesthesia machine works, on Tuesdays, we have surgery. As technicians, we cannot perform surgery, but we can assist. At school, we only do neuters and spays on dogs and cats.
There are three basic positions that we learn how to do things. As Scrub Nurse, we have to actually scrub in (surgical scrub, sterile gowning and gloving), and we have to sterilize instruments and everything else that needs to be sterilized for surgery in the Autoclave.
An autoclave sterilized instruments and other surgery equipment using pressurized steam at 121 degrees Celsius... that's about 250 degrees Fahrenheit!!
This is what we look like when we are scrubbed in... we cannot touch anything that is not sterile! I haven't worked in this position yet, but will do so next week.
As anesthetist, the animal under anesthesia's life is literally in your hands. Basically, when an animal is under anesthesia, just like a human, their heart rate and respiratory rate are depressed, among other things. If they go too far "Under" they could suffer serious complications including death. As anesthetist, you are responsible for doing a complete physical exam, pre-anesthetic blood work as outline above, lots and lots of charting, calculating and administering anesthetic medications, putting in an IV catheter and hooking up calculated fluids, putting in an endotracheal tube (see below) and hooking up anesthetic gases, and most importantly, monitoring the patient throughout surgery and recovery.
Once the patient is under anesthesia, there are lots of monitoring devices hooked up to them to measure heart rate, blood pressure, temperature, breathing and more. You also have to know the "stages of anesthesia" (depth of anesthesia), and be able to tell the doctor when he or she asks. You have to be able to adjust IV fluids and gas anesthesia to keep the patient in the correct plane suitable for surgery. We are lucky enough to have a third instructor on hand during surgery to help the anesthetist one on one.
The final position that we learn is the Circulating Nurse. Basically in this position, you do whatever you are told to do. This includes restraining for the anesthetist to put in the IV and endotracheal tube, scrubbing the patient for surgery, helping move the patient, charting everything that goes on during the surgery, cleaning the surgical suite from top to bottom, and assisting with getting things such as scalpel blades and sutures, and helping the scrub nurse and Doctor get into their gowns while remaining sterile. I was the position last week, and it was pretty fun, and very stressful trying to keep up with the Dr.'s notation during surgery!
My First Surgery
The first week of surgery, I was the anesthetist.. known to be the most time consuming and nerve wracking position of the three! I was nervous, but confident. My instructors are just wonderful! It was awesome to do all the things I mentioned above, including many things for my first time. It was the first time I placed an IV catheter that I actually USED (hooking it up to fluids) it, first time placing an ET tube and anesthetizing an animal, first time calculating and administering controlled drugs, first time recovering a patient... WHEW! I'm glad it's over because it was a lot to take on in one day!
BUT! I made it through :) My patient was a dog neuter. He was a sweetheart, and seeing a patient under anesthesia is always a little bit comical. First, they are stumbly and "drunk" looking, and then they are completely limp and you can move them anyway you want them to. Much easier to trim nails and stuff too ;) Oh, and their tongues almost ALWAYS hang out :P
Anyways, also as the anesthetists, you are responsible for recovering the patient, making sure it can eat and drink water without vomiting, and you are responsible for post-op medications and care twice a day for the rest of the week. This also includes discharge instructions for the humane society.
This quarter has been a whirlwind so far of emotion and knowledge, and putting both of those to the test. I have a few other things to post, but I will break those up into a few more posts.
I promise to try to write more, too. But we all know how that goes ;)