A 34kg 6 year old female entire Labrador is undergoing pyometra surgery.
The patient is in dorsal recumbency and the RVN has aided positioning with a cradle and pillow to ensure comfort as the patient is overweight.
Throughout the anaesthetic the patient has been taking long, slow, deep breaths and the RVN has noted hypercapnia via ETCO2 readings above 55mmHg. Capnography shows “wave forms which have increasing peaks”.
What could this suggest? How could the RVN resolve this?
The wave form would suggest increasing ETC02 or hypoventilation. This could be due to several reasons such as a decrease in respiratory rate, a decrease in tidal volume, an increase in metabolic rate or a rapid rise in body temperature.
To resolve this the RVN should first carry out patient checks such as heart rate, eye positions, reflexes, SPO2 and blood pressure. Ensure the ET tube has no obstruction and check for any exhausted CO2 absorbents such as ensuring soda lime is not exhausted. The RVN should begin IPPV to reduce the ETCO2 and increase the respiratory rate. Alternatively mechanical ventilation can be used to assist with resolving hypercapnia.
Furthermore, the patient’s body weight and positioning could be a cause of this so it’s important for the RVN to aid positioning and comfort and ensure the thorax is able to move adequately.
How did you get on?
This question and answer is from the tutor on the upcoming Online Mini Series Course “Anaesthesia for Vet Nurses: From Fundamentals to Emergency Expertise.” For very practical help with your small animal anaesthesia patients, read on…..
Online Mini Series Course
I found the information easy to understand and the information was delivered clearly. I will be able to apply the knowledge to my day to day activities.
Foundations of Anaesthesia: Patient-Centric Preparation and Pre-op Insights
Unlocking the Power of Anaesthesia Monitoring and Equipment in Veterinary Nursing
Critical Insights: Veterinary Emergency Preparedness and Patient Recovery
I have six years of experience as a qualified Registered Veterinary Nurse (RVN), with a diverse background encompassing referral anaesthesia, Emergency and Critical Care (ECC), and diagnostic imaging. My unwavering passion lies in the field of anaesthesia and analgesia, as I firmly believe that RVNs play a pivotal role in ensuring the well-being of our animal patients during these critical procedures. Over the past six years, I’ve dedicated myself to continuous learning and professional development, earning two significant certifications: CertVNECC (Certificate in Veterinary Nursing of Emergency and Critical Care) and CertAVN (Certificate in Advanced Veterinary Nursing) with a specialisation in Anaesthesia, Analgesia, and Pain Management.
The mini-series is clearly structured and very informative.
Session 1 - Wednesday 31st July 2024 2pm-4pm UK time
Session 2 - Wednesday 14th August 2024 2pm-4pm UK time
Session 3 - Wednesday 28th August 2024 2pm-4pm UK time
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Very thorough and comprehensive courses. The course notes are a great addition too.
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