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Flashcards in Surgical Environment & Field Surgery Deck (23)
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1

Surgical Theatre...

Isolated from general traffic
- Has only one entry point
- Separate from, but close to the preparation room
- Adjacent to x-ray and pre- anaesthetic room

2

What are the surfaces and equipment like in theatre room?

- Easily cleaned surfaces
- Coved floors
- Flush fit cabinets
- Mobile equipment

3

What are some further aspects of theatre room design?

- Limit air entry
- Air filtration
- Laminar flow positive pressure ventilation
- Excellent lighting

4

What are the rules of theatre surgery?

- Prioritise the days caseload by sterility
- Clean procedures before contaminated ones
- Clean the theatre between patients
- Entry and exit from theatre during surgery must be minimised

5

What happens if the case is "too dirty" for the theatre?

- Not performed in theatre if possible
- Use prep area or wet bench for abscesses
- Last of the day

6

What is the difference in principle between field surgery and theatre surgery?

There is no difference

- Halsted's principles of surgery still apply

7

What is the difference in practice between field surgery and theatre surgery?

- Most will be factors irrelevant to the actual procedure
- these factors decide whether it is an in the field procedure or not

8

What will help you decide whether a procedure will be in the field?

Intrinsic:
- Technical difficulty

Extrinsic:
- Personal skill level
- Available infrastructure
- Available help
- Economics
- Client Education

9

What can decide the technical difficulty of a procedure?

- Length of procedure?
- Number of layers of closure?
- Requirement of skilled scrubbed assistant?
- Orthopedics (e.g. implants left in place)?

10

What encodes personal skill level?

- Experience
- Honesty

11

What available infrastructure is needed to perform field surgery?

- Large, dry field
- Clean, dust free area
- Covered facility
- Animal restraint devices
- Running hot water
- Facilities to clean instruments
- Twitch, ropes, tackles etc.

12

What is important about field surgery economics?

It often determines whether a procedure will be performed or not

13

What is important about client education in the field?

- A lot can be prepared and facilitated by the owner
- Client education is the vet's responsibility
- It will determine whether it will be pleasant between you and the owner

14

What should you think about before deciding whether a procedure can be done in the field or whether it should be referred?

- Procedure
- Personal skill
- Facilities
- Help
- Economics
- Client Education

15

How can a field procedure be safe and effective for the animal?

- Medicated pre-op with antimicrobials and analgesics
- Well restrained
- Local and/ or general anaesthesia
- Cleaned properly, clipped and aseptically prepared
- With post-op care organised

16

How can a field procedure be safe and effective for the vet?

- Non-vet work can be performed by non-vets
-- Prep of surgery area
-- Handling and restraining of the animal
-- Clipping and cleaning of the surgery site
-- Moving the animal back to housing

- Assistants: scrubbed assistant and anaesthesia support

17

How can a field procedure be safe and effective for the client?

- Vet is responsible for everyone's safety
- Well-organised means safer, better, faster, cheaper

18

What are some commonly performed procedures on horses standing?

- Castration
- Wound repair
- Caslick's procedure
- Rectovaginal lacertation
- Fistula repair
- Perineal Urethrostomy

19

What are some commonly performed procedures on cattle standing?

- Castration
- Wound repair
- Rectovaginal lacertation
- Fistula repair
- Perineal Urethrostomy
- Dehorning
- Caesarian
- Explorative laparotomy
- Rumenotomy
- Pyloropexy
- Abomasopexy
- Vasectomy

20

What are some commonly performed procedures on small ruminants standing?

Dehorning

21

What are some commonly performed procedures on cattle recumbent and restrained?

- Disbudding
- Abomasopexy
- Claw amputation
- Caesarian
- Teat laceration repair

22

What are some commonly performed procedures on Small ruminants recumbent and restrained?

- Disbudding
- Vasectomy
- Tail Docking
- Caesarian

23

What are some commonly performed procedures on Horses under general anaesthesia?

- Castration
- Wound repair