We certainly spend a lot of time in surgery. We do lots of routine surgery for our own patients and we participate in spay / neuter programs with the local humane society. Since it's a long way to the nearest referral facility we take on most other kinds of surgery as needed. Since trauma seems to be very common in our area we do a ton of that type of work. I do enjoy orthopedics but wish it weren't necessary so often. We use a variety of inhalant and injectable anesthetics and work hard to provide good analgesia after the surgery. We monitor each case with EKG and have equipment for endoscopy, laparoscopy , microsurgery, ultrasound, cautery, suction, etc. . Our instrumentation has improved over the years and we are proud of our current quality. We are equipped for pinning, wire, screw fixation, external fixation and plating in orthopedics
Monitoring of surgical cases and "toys" for special procedures are built into the surgery room. We have use EKG monitoring of every surgery case for many years. This replaced the FM band esophageal stethoscope in 1992 although we still use that from time to time. We use the pulse oximeter which measures actual blood flow (unlike EKG monitoring) and how well the blood is carrying oxygen to the tissues. In 1999 we were able to obtain a second pulse ox. machine and enough EKG monitors to have one in each exam room, surgery, ICU and the tech area. Each method of monitoring has it's own unique advantages. My personal preference is to have ALL of them and, most importantly, a qualified technician supervising the anesthesia for every surgery.
In September 1999 we added a new complex of monitors that we are trying out. The Datex monitors measure EKG, do pulse oximetry, pressures and do side stream spirometry. This allows us to measure the amount of oxygen, carbon dioxide and the level of anesthetic gas present in the anesthetic machines gas flow. We have a lot to learn about using this technology but it has a lot of potential and the machines are very "cutting edge" for us. I'll let you know what we think about it as we go forward.
Well, it's only October but I guess that we've got a feel for our new monitors. As you can see it does display a lot of information. It will warn you about all kinds of things. It'll warn you about a few TOO MANY things in some cases. We are figuring out how to set things up so that alarms don't go off too often. I would say that it will be most important in routine cases. It's best at warning you about the type of detail that you may simply fail to notice. It notices everything. For some our most complicated cases there may be times when it may be too MUCH information. For those cases will will probably stick with the EKG and regular pulse oximeter. The wave forms on the lower monitor include the pulse wave, the respiratory oxygen wave, the respiratory CO2 wave.
Over a year down the line and I've gotta' tell you that I hate to have an animal under anesthesia without the monitor running. They have definitely saved lives AND allowed me to let my mind wander a little! We have learned much about the problems with their use and how to adapt. We are able to calibrate the machines with special gas container and have found the machines to be more reliable than WE are!
I believe this is the only view of me on the home page. We do a wide variety of surgery. The mix has changed over the years. In a way it's good that I "grew up" in practice at a time when there were few choices for referral of surgical cases. We were forced to do new things. Today there are many more choices that are convenient for our clients.
The supplies cart in surgery allow quick access to most of the supplies that we may need in a hurry in an emergency situation. The storage area on the other side of the surgery table is common to both the surgery room and the "tech area" to allow pass through and common usage of equipment like catheters, chest tubes , packs, etc. between the two areas.
What in the world are all of those pictures on the wall all about? Well, believe it or not I don't remember EVERYTHING about anatomy. We are working on getting most of the pictures on the intranet but I do like to have a reference or two available for each surgery . . . especially orthopedics. It just made sense to leave the pics up all the time. Ya' never know when you'll have to change gears. However, it looks like were out of space!
One of the most important parts of the surgery room is the ability of the technicians. While Anna King is the only licensed Animal Health Technician we have at the hospital currently all of the technicians go through an extensive training program at the hospital. Here Tami (BS biology) and Summer (a high school student on the track to veterinary school) learn what the surgeons want by being the surgeon in a tightly controlled surgery involving Tami's personal pet. The many machines and protocols required are very important but sometimes the surgeon just needs the technician or the surgical assistant to simply KNOW what needs to be done. Procedures like this help with that type of training. In most of our clinical cases the veterinarian is scrubbed in by his or herself. However, there are some procedures that simply require more than one pair of hands. All of the technicians are trained in sterile procedures so they can help if needed.