Intl Field Spay & Neuter Guidelines

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Intl Field Spay & Neuter Guidelines

  1. 1. International Spay Neuter Field Clinic Guidelines<br /><ul><li>Introduction
  2. 2. Planning
  3. 3. Community organization
  4. 4. Local veterinary community
  5. 5. Community outreach
  6. 6. Cultural sensitivity
  7. 7. Language skills available throughout clinic
  8. 8. Permit acquisition
  9. 9. Clinic location
  10. 10. Caseload
  11. 11. How caseload is acquired/decided
  12. 12. Identification and records
  13. 13. Transport
  14. 14. Clinic housing
  15. 15. Volunteers
  16. 16. Adequate numbers and expertise to ensure standard of care and safety
  17. 17. Veterinarians
  18. 18. Veterinary Technicians and/or assistants
  19. 19. Others
  20. 20. Medical supplies
  21. 21. Budget constraints
  22. 22. Manifest
  23. 23. What needs to be imported
  24. 24. What can be acquired locally
  25. 25. Methods of sterilizing
  26. 26. Prior to clinic
  27. 27. drapes, instruments, etc
  28. 28. Throughout clinic
  29. 29. Sterilizing machines
  30. 30. autoclave or pressure cooker
  31. 31. Kills all viable organisms including spores using pressure
  32. 32. Instruments must be open for adequate sterilization
  33. 33. Pressure cooker is relatively cheap and easy to maintain
  34. 34. Autoclave
  35. 35. Expensive pressure cooker
  36. 36. Expensive to operate and maintain
  37. 37. Ease of use if available and working correctly
  38. 38. Dry oven
  39. 39. Requires the use of steribags for appropriate sterilization
  40. 40. Cloth wrapped instruments and drapes will burn if sterilized at the appropriate temperature for the appropriate amount of time
  41. 41. Requires specific indicator strips for dry ovens to assure adequate sterilization
  42. 42. Sterilizing solutions
  43. 43. Kills most microorganisms except spores when done correctly
  44. 44. Requires minimal time in solution for adequate sterilization. Minimum of 15 minutes. Instruments must be open for adequate surface contact.
  45. 45. Instruments need to be clean prior to immersion in sterilizing liquid
  46. 46. Examples Benz-all, Dermacrit
  47. 47. Miscellaneous supplies
  48. 48. Laundry, biohazard materials, cleaning supplies, trash collection and disposal, cages
  49. 49. Preoperative considerations
  50. 50. Disease awareness
  51. 51. Rabies
  52. 52. Local incidence
  53. 53. How to address bite cases that may occur during clinic
  54. 54. Infectious diseases
  55. 55. Incidence of tick borne diseases such as Erlichia and Babesia
  56. 56. Common pathogens, distemper, parvo etc.
  57. 57. Available vaccines
  58. 58. Clinic detail checklist
  59. 59. Equipment list
  60. 60. Medical supply list
  61. 61. Clinic flow
  62. 62. Clinical details
  63. 63. Records
  64. 64. Minimal data
  65. 65. Owner name, address, contact information, surgical release
  66. 66. Owner communication to assure understanding of procedures to be performed
  67. 67. Patient information
  68. 68. Name, species, breed, age, weight, physical exam
  69. 69. Medications administered
  70. 70. Anesthesia record
  71. 71. Surgical record
  72. 72. Recovery notes
  73. 73. Post operative instructions
  74. 74. Physical exam
  75. 75. Temperature, pulse rate and quality, respiration rate and lung sounds
  76. 76. CRT and mucous membrane color and texture
  77. 77. Exam of all other systems for clinically relevant findings
  78. 78. Reproductive tract
  79. 79. Verify sex
  80. 80. Males – Cryptorchid
  81. 81. Females – vaginal swelling or discharge, pregnant, in heat.
  82. 82. Presence of transmissible venereal tumors
  83. 83. Analgesia
  84. 84. Anesthetic protocols include analgesics. Every surgical case should receive analgesics.
  85. 85. Recognition of ability to acquire
  86. 86. Cost
  87. 87. Availablity
  88. 88. Premeptive analgesia
  89. 89. Mulitmodal analgesia
  90. 90. Common analgesics
  91. 91. Anesthesia
  92. 92. Minimally acceptable standards will vary based on the use of gas or injectable anesthesia and what analgesics and anesthetics are available.
  93. 93. Needs to be adequate and humane. A surgical plane of anesthesia must be maintained throughout procedure.
  94. 94. Primary reason analgesia and anesthesia are inadequate are:
  95. 95. Drugs used
  96. 96. Insufficient, inadequate, inappropriate
  97. 97. Surgical skill
  98. 98. Affects surgical time
  99. 99. Affects tissue handling. Rough tissue handling induces more post-operative pain.
  100. 100. What analgesics and anesthetics are available
  101. 101. Monitoring equipment and personnel
  102. 102. Anesthesia should be monitored to anticipate if/when more or less anesthesia may be required and to assist in identifying intra-op complications.
  103. 103. Must be prepared and have the ability to address rapid changes in the depth of anesthesia. “Top off” does and method of delivery should be determined prior to inducing anesthesia.
  104. 104. Adjuncts
  105. 105. Intubation
  106. 106. Ambu bag for injectable anesthesia
  107. 107. Catheters
  108. 108. Fluid therapy
  109. 109. Thermoregulation
  110. 110. Protocols
  111. 111. Adequate analgesia and anesthesia do not require the latest or most expensive analgesics, sedatives or anesthetics.
  112. 112. Protocols will vary based on what is available and affordable.
  113. 113. Cost
  114. 114. Ease of acquisition
  115. 115. Knowledge of drugs
  116. 116. Injectable vs. gas anesthesia
  117. 117. Must be able to address complications that may arise
  118. 118. Emergency drugs and procedures
  119. 119. Catheters
  120. 120. Fluid therapy
  121. 121. Additional analgesia and anesthesia
  122. 122. Thermoregulation
  123. 123. Emergence delirium
  124. 124. Consequences of non-sterile technique
  125. 125. Specific protocols
  126. 126. Surgery
  127. 127. Location of surgery area
  128. 128. Location will vary depending on the logistics of the clinic site. Ideally it is a room or an area dedicated to surgery, covered and protected.
  129. 129. Asepsis
  130. 130. Fundamental to safe surgery and decreased post-op complications.
  131. 131. Always established and maintained throughout surgical procedure
  132. 132. The cost of establishing and maintaining are far cheaper and more humane than the lack of sterile technique and the consequences.
  133. 133. If sterile technique is broken, needs to be addressed, not ignored.
  134. 134. Consequences of non-sterile technique may not be visible, such as slow rate of healing or is in more pain.
  135. 135. Serious consequences of non-sterile technique may not be visible for a few days. Therefore post-op complications may go unaddressed unless post-op care is very good.
  136. 136. Surgical prep
  137. 137. Adequate surface for patient and equipment
  138. 138. Equipment necessary
  139. 139. Sterile gloves, drape, suture, blade, instruments, gauze
  140. 140. Cap and mask preferred but not always available
  141. 141. Method of sterilizing instruments
  142. 142. Autoclave
  143. 143. Cold sterile
  144. 144. Drape material
  145. 145. Adequate size to maintain asepsis
  146. 146. Should be resist ant to fluids in normal surgical conditions
  147. 147. Suture material
  148. 148. Approved for medical use
  149. 149. Pre-operative preparation
  150. 150. Clipping hair and hair removal
  151. 151. Patient prep
  152. 152. Solution and scrub technique
  153. 153. Surgeon prep
  154. 154. Recommended techniques
  155. 155. Adult dog or cat
  156. 156. Ventral midline or flank approach
  157. 157. Complete ovariohysterectomy
  158. 158. Closure
  159. 159. Body wall must include rectus fascia
  160. 160. simple interrupted, cruciate or continuous
  161. 161. Subcutaneous
  162. 162. Subcuticular
  163. 163. Adult male dog
  164. 164. Prescrotal approach
  165. 165. Complete removal of both testes
  166. 166. Closure
  167. 167. Subcuticular +/- subcutaneous
  168. 168. Cryptorchid
  169. 169. Must remove both testes
  170. 170. Approach and closure determined by location of testes.
  171. 171. Adult male cat
  172. 172. Scrotal approach
  173. 173. Complete removal of both testes
  174. 174. Incision left open to heal by second intention
  175. 175. Pediatric female dog or cat
  176. 176. As described above for adult dog and cat
  177. 177. Pediatric male dog or cat
  178. 178. Scrotal approach
  179. 179. Closure glued (dog) left open (cat)
  180. 180. Pediatric surgery
  181. 181. Hemostasis
  182. 182. Must be addressed throughout procedure
  183. 183. The common occurrence of tick borne diseases and their effects can contribute to pre, intra or post-op complications
  184. 184. Must be familiar with the diseases and how to address possible complications.
  185. 185. Thermoregulation
  186. 186. Produces significant and often avoidable complications, delays recovery
  187. 187. Temperatures should be monitored intro op if procedure is long, prolonged, complicated or one is operating in extreme environmental conditions.
  188. 188. Warm ambient temperatures are not conveyed to a table surface. Heat loss form an animal to the table surface can be significant. Always have something between anima and table surface such as a dry towel, bubble wrap, newspaper.
  189. 189. Keep patients dry and warm. Fluid soaked animals are much more prone to hypothermia as they lose heat on a surface colder than they are.
  190. 190. Keep heat sources such as socks filled with rice, warm water bottles, etc. available. Never put a heat source directly against an animal’s skin.
  191. 191. Minimize the use of water/cold prep solutions. Excess prep liquid should not be squeezed onto the surgical surface of the animal. Alcohol greatly and rapidly lowers body temperature.
  192. 192. If working in extremely hot environment with minimal to no ventilation, employ methods to keep body temperatures within normal parameters
  193. 193. Fans, cool floors, IV fluids, cool water bottles
  194. 194. Recovery
  195. 195. Needs to be monitored. Important to have experienced people so as to be able to identify normal vs. abnormal recovery and parameters.
  196. 196. Experienced personnel increase the ability to recognize and address possible complications as soon as possible.
  197. 197. Reference of normal recovery parameters available to assist volunteers
  198. 198. Any questions on parameters should be addressed by a veterinarian or experienced veterinary technician.
  199. 199. Most common area of the clinic where volunteers are bitten
  200. 200. Thermoregulation is the most common post-op complication.
  201. 201. Keep patients dry and warm. Fluid soaked animals are much more prone to hypothermia as they lose heat on a surface colder than they are.
  202. 202. Keep heat sources such as socks filled with rice, warm water bottles, etc. available. Never put a heat source directly against an animal’s skin.
  203. 203. Pediatrics
  204. 204. Are prone to hypothermia and hypoglycemia. Have heat sources as well as a concentrated glucose source such as honey, karo syrup available.
  205. 205. Post –op care and instructions
  206. 206. Must be provided and explained in a language the owner understands.
  207. 207. Must provide contact information for possible post-op issues or questions.

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