Getting ready, being ready, and having fun doing it (Proceedings) - Veterinary Healthcare
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Getting ready, being ready, and having fun doing it (Proceedings)


CVC IN BALTIMORE PROCEEDINGS


9. 14 g IV catheter, 12 ml syringe and No. 3.0 mm endotracheal tube connector for rapid transtracheal or transcricothyroid cannula placement. The No.3 mm connector allows connection to a BVM for breathing of high frequency ventilations (>150-200 breaths per minute of very small volumes) 10. Tracheal suction catheters - (4.7.11 Fr Yankauer and Dental suction tubing 11 12. Suction units. This should include a rubber ear syringe and a portable suction device. These can be purchased from EMT-Paramedic suppliers. A mechanics hand-held and activated system used to create negative pressure for engine work also can be used for airway suctioning and costs less than a medical hand activated system.

Breathing drawer or module: Breathing assisting equipment such as Bag Valve Mask (BVM) AMBU bag w/ reservoir. oxygen w/ tubing. and masks (for positive ventilation breathing IPPB])

1. BVMs - should be each of three sizes: Adult (700 -900 ml), Pediatric (400-500 ml), and Infant (250 ml). Each must have a reservoir attached to provide 100 % oxygen. Without reservoir's the BVMs can only provide 45% oxygen concentrations. These are the best devices to be used for rescue breathing. The BVM's are attached to a source of oxygen such as an E cylinder and a regulator – flow meter combination.

2. PEEP valves - should be available and used to increase the functional residual capacity of the breaths because of the effect of the PEEP valve on exhalation. This is the best effective treatment for emergency treatment of cardiac congestive heart failure and other pulmonary conditions that decrease alveolar capacity and increase interstitial edema.

3. Y connector – to be used for connection into the anesthetic machine or other oxygen source after the flow meter, so that high flow oxygen can be provided.

4. Regulator and flow meter – to be used as an oxygen source to run the Ambu bag or other oxygen system

5. Oxygen Tank (E) Catty – not in the drawer but beside the crash cart – this allows oxygen to be taken anywhere in the hospital including the lobby – reception area.

Cardiovascular drawer or module

Atropine. Epinephrine. Lidocaine. Calcium chloride. Sodium bicarbonate. Hypertonic saline. DMSO. Desferoxamine. Dopamine, Dobutamine, Plasmalyte, Dextrose 50%, Diphenhydramine, one bottle of each should be considered as a minimum. Have each bottle of drug held within a space made in the foam rubber. This will keep the bottles from shifting. A space made next to each bottle should be filled with various sized syringes (1 ml-12 ml) loaded with 18 g and 22 g needles. Time will be saved. costs to those veterinarians that place order with them.

Defibrillator and monitoring equipment

This includes a doppler flow detector

and pediatric flat probe. ultrasound gel. blood pressure cuffs (at least 2.3.4.5.6. and 7 cm widths or at least a newborn and infant cuffs. and an aneroid sphygmomanometer.. ECG. temperature & pulse oximeter, end tidal CO2 monitors. oscillometric blood pressure monitors and monitors that measure direct BP. ECG. Temperature. respiratory rate, etc. and are made specifically for veterinary use

Equipment (miscellaneous) that is essential

Suction tips: Yankauer. for suctioning of the pharynx; Endotracheal tube as suction catheter for suctioning the pharynx and airway when large pieces of vomitus, clots, etc., are present. Tracheal suction catheters for aspiration of the trachea . Blankets and Plastic Bags are important to keep patients warm. A warm water circulation system is also recommended. ThermoGear Warm Blanket or Bair Huggar or Warm Touch patient warmer are very good units that keep patients warm or can be use to reverse hypothermia. On the other end of the temperature spectrum it is recommended to also have saline in liter bags in the refrigerator and in the frozen section as well. Simple ice bags are also recommended. New research has revealed that use of induced hypothermia to 31 degrees C to be life and heart and brain saving.

Surgical pack and sterile towels and laparotomy pads for emergency surgery

The towels are useful for packing. protecting and absorbing. Feeding tubes of various sizes and stop cocks are also needed to be used as IV catheters. and for vascular occlusion . Peritoneal dialysis catheters for diagnostic peritoneal lavage and for emergency dialysis. Thoracentesis sets made from an IV extension set with a stop cock attached on one side and an 18 gauge needed on the other side. A commercial centesis, mini chest drain can also be used and is recommended. 14 g IV catheters make very good mini chest tubes for small dogs and cats. Chest tubes with inner metal stylet for guidance into the chest cavity (size 12 to 32) (Kendall or other suppliers). You can use clear sterile disposable endotracheal tubes 2 mm to 10 mm OD as good substitutes for "chest "' tubes. A section of metal coat hanger or aluminum rod of small diameter than the ET tube can be used to guide the tube in place with care not to have them protruding from the end when using them. Anesthetic ventilator. Laboratory testing and imaging abilities (radiology and ultrasound) are also key as well as monitors for Doppler flow, BP. SpO2, ETCO3, temperature, etc.


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