Volume 10 Issue 3

Ethical dilemmas surrounding 24-hour nursing provision for patients in veterinary practice

Providing suitable 24-hour patient care is a difficult topic for many veterinary practices (VP) and involves many ethical dilemmas to ensure that the patient's, staff's and clients' needs are met. Following rules and regulations to prevent litigation, providing care for good patient outcomes and upholding client expectations at an affordable price, alongside the provision for staff wellbeing makes this a difficult task. Evidence-based research, technology and effective communication skills may help to solve these dilemmas.

Initial management of the burn wound patient

Wounds are a common occurrence in veterinary medicine, ranging from traumatic injuries to surgical complications, but most of these wounds will not require as comprehensive multimodal management as the severe burn patient. A burn wound is defined as thermal damage to the two main skin layers which causes coagulation and microvascular reactions. This leads to increased capillary and extravascular permeability and vasodilation, subsequently these reactions can cause numerous complications including burn shock, sepsis, severe oedema, multisystem organ failure and death. If appropriate management is initiated from when the patient is first presented, then an attempt can be made to prevent these adverse events from occurring. This article aims to cover the initial emergency stabilisation of the burn patient and some of the wound management options available.

Canine and feline blood transfusions

Despite the various blood products for dogs made available by Pet Blood Bank UK, there is currently no system available for cats in the UK. It is crucial that veterinary nurses and surgeons know how to collect blood in emergency situations and how to administer blood and blood products safely.This article focuses on the importance of blood typing and cross matching to try and minimise potential reactions. It also highlights the criteria for appropriate canine and feline donors and how to collect blood safely.

Rehabilitating the canine cruciate patient: part two

Surgery to correct cranial cruciate ligament rupture is commonly performed in both first opinion and referral practice. Following on from part one of this article which discusses the background aetiology, diagnosis and conservative management of cruciate disease, this article looks at the three most commonly performed surgical procedures as treatment options, and rehabilitation of the canine patient post surgery.

Don't forget the foal: the nursing requirements of hospitalised foals when the mare is the primary patient

In the post-partum period, there are a range of factors that could result in the hospitalisation of the mare. To minimise the long-term impact that the hospitalisation period has on the physical and behavioural development of the foal veterinary practices should have a protocol in place to care for a foal even though the mare is the primary patient. When patients are admitted detailed information should be gathered from the owner about both the mare and the foal. This provides valuable information necessary to plan appropriate nursing care. Important factors that need to be considered when planning care include the nutritional needs of the foal, the development of the selective bond between the mare and the foal and the handling of them as patients.Where possible the owner should be encouraged to participate in the care of their mare and the foal during the hospitalisation period. This will help the owner feel more involved in the provision of care and have a better understanding of the mare and foal's care requirements post discharge. This is a technique used in human paediatric nursing and is known as parent participation in care.

Gastric dilatation volvulus in guinea pigs (Cavia porcellus)

Gastric dilatation volvulus (GDV) is a known acute abdominal emergency in dogs. The condition is life threatening and without corrective surgery results in the death of the patient. GDV in guinea pigs has been documented in literature but is not well known to many of the general small animal veterinary practices. This is probably due to the species' sudden death from this condition, absence of specific clinical signs, a lack of experience in this species, and a high mortality rate known with this condition in guinea pigs. This article explains the signs and care of this condition in these animals and discusses a case of GDV in the author's own guinea pig in the hope that awareness of this condition can be raised.

Which skin preparation technique is most effective to minimise bacterial contamination?

Background: The risk of surgical site infections (SSI) can be addressed by removing organic matter which contains transient and resident flora from the patient's skin prior to surgical incision. Using correct techniques when applying skin preparation solution can significantly reduce bacterial load. Historically the circular technique has been used within veterinary practice for skin preparation prior to surgery; however there has been a recent promotion within the veterinary industry using the back-and-forth technique which has historically been used in human medicine. Aim: The move towards evidence-based medicine suggested testing both skin preparation techniques to determine if either technique was more effective than the other at reducing bacterial load. Method: Five felines undergoing flank ovariohysterectomy surgery were randomly selected for each skin preparation technique with a total sample size of ten felines. Samples of bacterial load were taken before and after the skin was prepared using each technique and cultured in sealed agar plates at a temperature of 38.5°C for 48 hours. Bacterial colonies were then counted and compared pre and post skin preparation. Statistical analysis was performed using ‘Minitab’. Results: There was no statistically significant difference between either skin preparation technique at reducing the number of colony forming units (Mann-Whitney U test: W=27.0, N=5, <i>p</i>=1.000). Conclusion: The limited sample size indicated that either technique was as beneficial as the other at preparing the skin for surgery, giving the veterinary nurse confidence in choosing either technique for skin preparation for flank ovariohysterectomy.

Dog-Friendly Practice and how to become one

Most veterinary professionals are aware of the Cat Friendly Clinic initiative, but did you know that it is now possible to become a Dog-Friendly Practice? Rachel Malkani from the British Veterinary Behaviour Association explains why this new certification programme is necessary.

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