Patient Evaluation And Preparation PDF

Patient Evaluation and Preparation CVM 746 LISA EBNER, DVM, MS, DACVAA, CVA Learning Objectives : 1. Describe who, what, where, when, and why you should perform a thorough patient evaluation prior to an anesthetic episode. ◦ In Clinical Skills labs you will learn how to do a...

Patient Evaluation and Preparation CVM 746 LISA EBNER, DVM, MS, DACVAA, CVA Learning Objectives : 1. Describe who, what, where, when, and why you should perform a thorough patient evaluation prior to an anesthetic episode. ◦ In Clinical Skills labs you will learn how to do a patient evaluation 2. Describe the preparation for an anesthetic episode for a veterinary patient 3. Describe the general anesthetic concerns for a patient prior to performing anesthesia. Who should perform the pre-anesthetic evaluation? Ultimately the responsibility of the veterinarian in charge of the patient ◦ What about having a registered technician perform this? ◦ What happens on a rotation in your clinical year? ◦ Who performs the evaluation if there is both a surgeon and an anesthesiologist involved? What exactly is part of the pre-anesthetic evaluation?  Always start with the signalment (i.e. description) of the patient – required components: species, breed, age, sex, and reproductive status. History (including previous anesthesia events) ◦ If patient is ill, find out what symptoms are present, the severity and how long it has been going on. ◦ What about recent and current medications? Vaccination status? PE (including BW and BCS) · estimated lean bodyweight Blood and urine sampling Temperament/mentation and level of pain and stress Advanced diagnostics if indicated ◦ ECG, BP, radiographs, abd U/S, echo, endocrine testing, etc. Routine ECG screening? Patients with evidence of CV disease Geriatric patients Underlying disease that may lead to arrhythmias ◦ Hyperkalemia ◦ GDV ◦ Splenomegaly ◦ Traumatic myocarditis Telemedicine consults with boarded cardiologists KardiaMobile® Image; CardioPet ECG Plans | IDEXX Telemedicine Consultants - IDEXX US  Temp (know normal for each species) Pulse (rate, rhythm, and quality) Use stethoscope to auscultate for a murmur and use fingers to palpate a pulse simultaneously. Where can you place your fingers? What does pulse tell you about? Physical exam Respiration (describe what you hear…not just “WNL”) findings Why should you palpate the trachea? mm/CRT What does this tell you about hydration status? Hemodynamic status? Body wt lb vs. kg? Physical Findings in Dehydration Percent Dehydration (%) Clinical Signs