Skip to content

Improving Anaesthesia Monitoring

 
Improving anaesthesia monitoring in veterinary practice is mandatory for ensuring the safety and health of animal patients during surgical procedures. Veterinary teams have embraced advancements in monitoring technology to enhance patient care, optimize outcomes, and uphold high standards of practice. The integration of digital monitoring systems, such as pulse oximetry and capnography, has revolutionized the way veterinarians track anaesthesia parameters, record vital signs, and set timers for critical thresholds.
  
Types of Anaesthesia
-          Local anaesthesia numbs a small part of the body.
-          Regional anaesthesia affects larger areas.
-          General anaesthesia acts on the whole body, making the patient unconscious. 
 
Safety comes first
 
Monitoring the patient is the utmost priority, with equipment only being a secondary tool to help in the process. Advancements provide real-time feedback on anesthesia levels, respiratory rates, heart rates, temperature, blood pressure and other vital signs, enabling veterinarians to promptly address any deviations from the ordinary and safeguard the patient's health during surgeries.
 
Anesthesia plans should cover risk factors such as procedure risks, GA drugs, fluids and monitoring aids. Drug administration standards should be followed for the right patient, agent, dose, route, time, technique and documentation.
 
Patient support:
  • Warm blankets, heat pads
  • Fluid therapy
  • Appropriate drug administration
  • Ventilation
  • Every patient should have IV access, medication and emergency equipment available at all times.
 
Pre GA preparation may include:
 
  • Equipment preparation
  • Patient and client identification
  • Preoperative physical evaluation
  • Previous and current medications
  • Previous anesthetic episodes
  • Laboratory results
  • Drugs administered (dose, time, and route)
  • Endotracheal tube size and anesthetic circuit
  • Emergency drug kit
 
Surgery checklists
 
Surgery checklists have significantly improved post anesthetic outcomes, such as reduction in deaths and infections and reduction in post-op complications. Checking patient IDs and matching the patient to the respective surgical procedure should easily reduce complications. Checklists, now made digitally, provide better transparency and updates in real time.
 
Benefits:
 
  • Improve communication among the team
  • Provides a consistent standard
  • Reduces errors
  • Improves patient safety, morbidity and mortality rates.
 
Evidence suggests that surgery checklists have improved many outcomes, such as 47% reduced deaths, 36% reduced post-op complications and 48% reduced infections. (Bergström et al, 2016; Haynes et al, 2017; Mehta et al, 2018)
 
Monitoring Parameters
 
Monitoring equipment:
 
  • Stethoscope
  • Thermometer
  • Blood pressure monitor
  • Pulse oximeter
  • ECG
  • Capnography
  • Respiratory monitor
 
An important aspect of improving monitoring anesthesia lies in understanding and interpreting data from multi-parameter monitors. This knowledge is key to a successful anaesthetic procedure for both the patient and the veterinary team. Technicians also play a vital role in troubleshooting potential abnormalities related to the anaesthetic protocol, surgical procedure, or patient's medical condition, ensuring that patient and equipment-related issues are addressed promptly.
 
ECG
 
An electrocardiogram (ECG) is a valuable tool for monitoring cardiac activity during anesthesia, allowing to identify and treat common arrhythmias like sinus tachycardia, sinus bradycardia, AV blocks, and ventricular premature contractions.
 
Veta 3 Anesthesia Machine
 
Machines like the Veta 3 Anesthesia Machine with Iso Vaporizer have improved veterinary anesthesia practices to greater heights. This cutting-edge solution offers precision, reliability, and user-friendliness in delivering anesthesia care for animal patients. Features like high-precision vaporizers for accurate anaesthetic gas delivery, integrated breathing circuits for streamlined administration, and intelligent ventilation modes tailored to different patient sizes and conditions enhance safety and efficiency during procedures.
 
Record keeping
 
Important components of comprehensive record keeping include information elements, chronological details, details of practices or issues and the reasons for actions taken. Patient records should be clear, complete and compliant with the law. Digital record keeping eliminates the need for printing, scanning and using paper documents.
 
Advantages of digital record keeping:
  • Autofills client and patient information
  • Real time updates 
  • Accessible remotely
  • Enables instant writing back to patient files
 
Charting
 
Anesthesia charts include patient details, procedures, staff involved in monitoring and recovery. Anesthetized animals should be checked every 5 minutes with a record document.
 
Veterinarians also benefit from digital charting that streamline practice workflows by digitizing treatment sheets and patient records. This digital transformation minimizes the challenges associated with paper-based systems, providing real-time updates on patient information from diagnosis to treatment. Digital records reduce errors in data entry and ensure that every member of the veterinary team has access to the latest patient information for informed decision-making. Secure data storage in the cloud enhances security by preventing misplacing or damage to physical documents.
 
Using anesthesia templates ensures consistency of care, improves overall nursing care quality and clinical effectiveness.
 
Some essential records:
  • Breathing systems
  • Patient position
  • Pre-GA medication
  • Induction agents
  • Swabs and sharps - in/ out
 
Recovery
 
Patients should be allowed to rest in a quiet, warm environment, with reduced exposure to bright light and within clear view of recovery staff. Checking vitals every 15 minutes is the standard for post operative monitoring.
 
Examples of the 20 Critical care vitals (Kirby and Linklater, 2016):
 
  • Fluid balance, colloidal osmotic pressure
  • Oxygenation and ventilation
  • Blood pressure
  • Heart rate, contractility, rhythm
  • Glucose
  • Body temperature
  • Albumin
  • Electrolytes
  • Mentation
 
Vitals should be checked regularly in order to guarantee a patient’s good health after anesthetic procedures.
 
Conclusion
 
The continuous advancements of monitoring anesthesia through technological innovations, advanced equipment, and digital solutions emphasize a commitment to excellence in veterinary care. By embracing these improvements and upholding rigorous monitoring standards, veterinarians can enhance patient safety, optimize surgical outcomes, and set new benchmarks for quality in veterinary anesthesia practices.
 
References:
 
Medline Plus, Anesthesia. (2023). National Library of Medicine. 8600 Rockville Pike, Bethesda, MD 20894. URL: https://medlineplus.gov/anesthesia.html
Cleveland Clinic, Anesthesia. (2024). Cleveland Clinic. 9500 Euclid Avenue, Cleveland, Ohio 44195. URL: https://my.clevelandclinic.org/health/treatments/15286-anesthesia
Burns S.  Anesthetic monitoring savvy. (2012). DVM360. MJH Life Sciences 2024. URL: https://www.dvm360.com/view/anesthetic-monitoring-savvy
NewVetEquipment. (2024) Elevate Your Veterinary Anesthesia Practices With The Veta 3 Anesthesia Machine. NewVetEquipment. URL: https://newvetequipment.com/blog/elevate-your-veterinary-anesthesia-practices-with-the-veta-3-anesthesia-machine
Bergstrom, A., & Dimopoulou, M., & Eldh, M. (2016). Reduction of Surgical Complications in Dogs and Cats by the Use of a Surgical Safety Checklist. Veterinary surgery, 45(5), 571-576. https://doi.org/10.1111/vsu.12482 
Hofmeister, E.H., Quandt, J., Braun, C., & Shepard, M. (2014). Development, implementation and impact of simple patient safety interventions in a university teaching hospital. Veterinary anaesthesia and analgesia, 41(3), 243-248. https://doi.org/10.1111/vaa.12124 
Hueffner, E. What is customer experience: strategies, importance & examples [Internet]. Zendesk Australia. 2022. URL: https://www.zendesk.com/au/blog/why-companies-should-invest-in-the-customer-experience/ 
Kirby, R., & Linklater, A. (2016). Monitoring and Intervention for the Critically Ill Small Animal: The Rule of 20. John Wiley & Sons, Incorporated. URL: https://ebookcentral.proquest.com/lib/monash/reader.action?docID=4709106&ppg=1