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Vet care 2 (xray and anesthes)
rad and anesthesia and lrg animal...
17
Other
Undergraduate 1
03/04/2008

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Cards

Term

 

 

 

 

 

Large animal nursing

TPR

Definition
Normal body Temperature
 
Horse 36-38.5 degrees C
 
Cow 38.6 degrees C (lower in the morning, higher in the evening 37.5 - 39.2) 
...... 
Pulse
 
Horses 30-40 bmp usual, 25-50 acceptable
 
cows 50-70 bpm 
.....
 
Respiratory rate 
 
horses 8-12 breaths per minute 
 
Cow 20-30 breaths per minute 
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Large animal nursing

Horses 

Definition
flight or fight respons instinct strong
 
body language to ward off predators - horse will turn its hind quarters as a threat or even charge with head down
 
strong memories - this can influence training quite a bit 
 
Herd animals:
 
enjoy company of other horses. If isolated, behaviour problems that are stress related may occur.
 
grooming can be very social for them 
 
Senses 
 
Unique eyesight - blind spot  (directly in front of nose and directly behind them)
unable to manage rapid changes in light intensity, position of eye on either side of the head allows for grazing while watching for predators - small binocular vision feild because of this, so depth perception may not be good.
 
smell - the important social signal - feces; mare in estrus etc.  (Jacobsen's organ on roof of mouth) curl lip like cat opening mouth
 
ears - quite mobile for locating sound. Not as good as dogs, but pretty good, limited voice range  - relatively simple
 
Stay apparatus - horses can sleep while standing
 -historically, allows a quick response to predators
 
Digestion 
 - hindgut fermentation in the cecum - need poorly digestible or low grade hay and grasses at a constant rate. No gallbladder (no need)
 
-like rabbits they are designed to graze for a large portion of the day so if unable to do so they develop behaviour probs eg)cribbing and weaving
 
Behaviour 
steriotypical behaviours- repetitive actions for no obvious reason usually stress-related
 
ex) cribbing  or wind sucking (aerophagia)
 
crib-woodchewing: increase in fiber in diet helps; also husbandry. toys, companions
 
weaving - transferring wt from one front leg to the other, swaying head and neck.
 
self-mutilation has many causes, often in young stallions (who normally groom a lot anyway) anxiety release
 
breed of the horse influences the behaviour
eg) Thorougbreds generally enjoy speed, draft horses are often more laid back 
 
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Surgical instruments, AHT's role 

Definition
AHT's role in surgery is primarily to ensure that all instruments are available and ready, and that the patient is prepped correctly.
 
pre-surgery: prep the patient, prep the room, prep the instruments and equipment
 
during surgery: monitor patient, responsible for general anesthetic, assists surgeon by scrubbing in or by opening surgical packs, suture and needed supplies
 
Post surgery: monitor patient, post-op care, client education when patient goes home, remove sutures
 
Aseptic technique: prevents contamination, and thus infection of the surgical wound; ensures no delay in healing
 

 
 
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what are some precautions that we take to minimize contamination ?

Definition

-sterile instruments
-pack handling
-clip/clean - patients - formal prep
-gowns, gloves, scrubbing
-ensure scrub material ok
-in date materials
-mask, hair covered
-separate cleaning materials for surgery room
-minimizing traffic
-beards covered
-insect control
-cleaning room often (daily) 
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Surgical Instruments 

Definition
operating room rules:
-as few people as possible in the room, minimizes movement to decrease air currents
 
-all personnel must know what is sterile and what is not (think green or blue...)
 
 - ask if not sure! 
 
-sterile equipment kept separate from non-sterile items
 
-only sterile items should touch patient tissues!
 
-if unsure if an item is sterile, consider it contaminated (clothing, gloves... etc)
 
-sterilization= destruction of all microorganisms on an object or surface 
 
Care of Instruments 
-unused, improperly cared for instruments have shorter life span, and are more likely to rust or corrode, pit and discolour.
 
-AHT's role is to keep instruments in peak condition
 
-ALL equipment that comes into contact with patients or sterile instruments must be cleansed and disinfected before being re-used!
 
-Instrument cleaning is done in many ways: manually, using cleaning solutions or enzymatic solutions and /or using ultrasonic cleaner
 
- autoclave
 
 
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Surgical Instruments - Cleaning 

Definition
-cool water rinse off all instruments ASAP after procedure then clean and sterilize
 
-rinse in distilled water or de-ionized water to prevent staining 
 
-open clamps, take apart instruments if applicable before cleaning
 
-fine and delicate instruments should be cleaned separately
 
-manual clean before ultrasonic cleaning using nylon brushes (scrub brushes) or wire for serrated clamps and such
 
-pH 7 will avoid staining; can use surgical milk - helps lubricate instruments
 
-enzymatic solutions help remove proteins.
 
-cleaning solutions need frequent cleaning!
 
-ultrasonic cleaning: manual first, leave instruments 'open' ie)ratchets open etc..
 
-prompt removal. When finished, rinse and pat dry 
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Surgical Instruments

Tissue Forceps and Hemostatic Forceps(hemostat)

Definition
Tissue forceps 
uses: to clamp and hold tissue or blood vessels
 
-thumb forceps are types of tissue forceps that are nonlocking, and tweezer like
 
-brown-adson common-serrations hold tissue firmly
 
-allis and babcock types - retract/grasp tissue
 
Hemostatic Forceps 
uses: blood vessel crushing or clamping
 
spay kit
 
straight of curved; multitude of sizes
 
mosquito hemostats
 
angiotribes
 
kelly curved or straight, crile, carmalt.... 
 
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Radiology

3 types of xray screens 

Definition
Intensifying screens 
 
Fast (high speed); exposure at mAS 2.5-10
- have large crystals, less detail, high___ -good to decrease exposure time on thick parts
 
Medium (par speed); exposure at mAs 5-12.5
 - good resolultion, relatively low exposure, common
 
Slow (ultradetail); exposure at mAs 30-40
-more detail, smaller crystals, used for high detail but need longer exposure time 
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Radiology

Definitions 

Definition
Millamperage: the amount of electrical energy being applied to the filament. It describes the number of xrays produced during exposure.
 
mAs:Milliamperage - seconds: number of xrays produced in a given period  (=mA x time)
 
Kilovoltage: the amount of electrical energy being applied to the anode and cathode to accelerate electrons from the cathode to the anode
(1 kilovolt (kV) = 1volt (V))
  
kVp:the peak energy of the xrays, which determines penetrating power of the beam.
 
Scatter Radiation: redirected radiation produced from the primary beam's interaction with structures in the patient's body; non image forming that goes in different directions due to objects in xray beam's path.
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Radiology

3 Major safety rules and examples 

Definition
Time - use the shortest possible time
ex) use short time when setting up exposure
-use good planning toe avoid retakes
 
Distance - keep as far from the primary beam as possible
ex) many, leave room, lean away; look away
 
Sheilding - adequate and proper must be worn
ex) lead protection-thyroid sheild, lead apron, lead gloves, goggles... 
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Radiology

7 properties of X-rays 

Definition
-extremely short wave-length
-causes fluorescence of certain materials
-affects photographic film
-travels in a straight line
-wave-length is variable (short range)
-ionizes matter
-causes biological changes 
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Radiology

3 sizes of film cassettes 

Definition
8" x 10" ( ~22cm  x 24cm)
 
10" x 12" (24cm X 30cm)
 
14" x 17" (35cm x 43cm)
 
note that these cannot be used interchangably (inches and cms) the correct film size must be ordered for the cassettes being used 
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Radiographic Density 

 

 

Definition
the degree of blackness
 
xrays make xray film black- more xrays reach film, the darker it is.
 
type of tissue and thickness of tissue will affect how many xrays reach the film 
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Radiographic Contrast 

Definition
density difference between 2 close areas on an xray
 
ex) white bone on black background - high contrast
 
lots of grey shading - lower contrast 
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 Radiology

ALARA

As Low As Reasonably Achievable 

Definition
1) how much of the body was exposed
-smaller area - less overall damage
-since the body has the ability to heal itself, the smaller the area, the less stress on the bodies repair mechanism
 
2) sensitivity of the tissues exposed
- tissues with high rate of cell turnover or division are most sensitive
- GI tract, lens and cornea of the eye, testes, skin
-those persons < 18 yrs of age should not be permitted in radiology suite since they are still growing and have a consequent higher cell turnover rate.
 
3) total dose recieved
-the larger the dose, the more damage
-exposure to the primary beam vs. scatter radiation for example
 
4) the time over which the dose was delivered
- a single massive does is more lethal than the equivalent total dose over an extended period of time
-body has time to repair itself 
 
 
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Radiology

sources of exposure 

Definition
leakage from tube (damaged housing)
 
primary beam
 
scatter radiation********* 
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Radiology

Other safety rules 

 

Definition
anyone not involved-out of the room
 
no one under 18 or pregnant in room during exposure
 
rotate personnel to decrease exposure to each
individual
 
no body parts(yours) is to be in the primary beam under any circumstances - shielded or not 
 
plan your views - avoid retakes and reduce total exposure
 
all personnel involved must wear dosimeters
 
never hold cassettes or portable machines by hand -use supports
 
perform routine safety checks of equipment - lead shielding, tube housing, collimeter
 
any views which require a horizontal beam - ensure that there are no personnel positioned behind the cassette and make sure the adjacent room is vacant
 
the machine is a serious electrical hazard - 120kVp  = 120000volts 
 
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