Dental Clinic Observation Paper

• When I came into the clinic I was greeted by Patrick and Monica. They showed me around the clinic. I was also introduced to Liah, Antinique, and the rest of the team. With no hesitation I started to help Antinique with a patient that came in for a dental and a mass removal; it was a schnauzer named Jackpot. Antinique was filling out some information in the records and asked me if I can pull up 0. 5ml of hydromorphone and 3. 0ml of penicillin. The patient’s records were written on index cards and were taped together in order from oldest being first and most resent being last.

After pulling up the medication | went to go get Jackpot from his kennel and took his TPR. His temperature was 101. 9, heart rate was 160 and respiratory rate difficult to count because he was panting so hard from being nervous, I left it in the records as panting. After his TPRs were taken, I able to pull blood from his jugular vein and placed it in a red tube top and an EDTA tube. Before taking blood they like to heparinize the syringe. I thought this was a bit odd and asked if the blood is still able to clot in the red top tube even after pulling it up with the heparin in the syringe.

Liah ensured me that they are still able to spin it down to get the serum from the blood.. After the blood was pulled and placed in the proper tubes they were left in the lab for someone to finish the CBC work. They do not do PCVs at this clinic; everyone gets a CBC test run before they go into surgery. Older patients get the chemistry panel included. As soon as I was done pulling blood they asked me if I wanted to try to place a catheter. It was my first catheter and Jackpot was such a well behaved patient that I thought I should have a go at placing the catheter.

Antinique brought me all the necessary materials I needed for the catheter which was the clippers, alcohol, tape, vet rap, saline flush, two 22 gauge catheters, and one cap. Liah helped restrain Jackpot while Antinique guided me through the process. I first took the clippers and shaved the circumference of the right forearm. They didn’t use surgical scrub, they told me to just lather the area with alcohol. After applying the alcohol I went into the cephalic vein bevel up, going in as low as possible. My first attempt I ended up kinking the catheter, but my second attempt was a success.

I push the catheter and pulled the needle out. I immediately placed my cap and twisted it in place. Then I took my first strip of tape and raped it around the arm to secure the catheter in place. After I took the second piece of tape and placed it under the cap and raped it around the hub in a crisscross position. Lastly I flushed the catheter with some saline and raped the catheter with vet rap and Jackpot was ready to go into the surgery room. I also got to administer the penicillin subcutaneously in the rear leg and administered the hydromorphone IM into the semitendinosus.

Liah showed me which muscle to feel for and told me she usually gives this injection in the semitendinosus. I was nervous because I didn’t want to hit the sciatic nerve. But I prep the area with some alcohol and tried to inject as caudal as possible. Holding the syringe in a stab like position I went in, pulled my syringe to see if any blood will draw back. No blood was seen so I slowly administered the hydromorphone and massaged the area. • | went with Antinique into the surgery room where they go and prep their patients.

Antinique had 3mls of propofol premade and had already picked a couple of endotracheal tubes picked out for jackpot. She asks me if I’ve ever intubated before and I told her ounce before at Camillas house but I still need to practice more. She tells me to try this time, so I have my laryngoscope and stethoscope ready in hand, waiting as Antinique low gives Jackpot one ml of the propofol. One of the other vet techs named Ziad comes in to help with the prepping Jackpot for surgery. He checks the jaw tone for me and tells me I’m good to go. Antinique holds the jaw open for me as I attempt to intubate the dog.

With gauze in hand I gently pull back on the tongue and with my right hand I hold the endotracheal tube in place with the laryngoscope and tried to locate the glottis. I see the epiglottis open and see the glottis entry into the trachea. I immediately stick my tube through the whole. For some reason something happened where I was unsuccessful this time around in intubating the dog. Antinique gave one more milliliter of propofol and stepped in to place the endotracheal tube. • Jackpot was intubated and was connected to the anesthesia machine.

While Ziad clipped the surgical site, Antinique decided to show me how to set up the EKG and how to set up the leads to the patient. She shows me that all you need to enter in the EKG machine is the weight of the patient and the species. This machine had multiple leads for multiple functions. It had a pulse ox, capnograph, blood pressure cuff, thermometer lead and the electrode leads. First we placed the BP cuff; the cuffs are set based on the dog’s weight and are placed on the lateral saphenous vein. Second we placed the pulse ox on the prepuce, we wet the prepuce with some water before placing it.

Then wel lubricated the thermometer and place it into the anus making sure not to force it in the anus. Next we placed the electrodes slightly proximal to the elbow and the knee, making sure to wet the contact points with alcohol. Lastly the capnograph was already preset onto the end of the rebreathing circuit. With all the leads connected and the area clipped and scrubbed Jackpot was ready for surgery.. Antinique monitor the surgery and Ziad was assistant Dr. Pegelow with the surgery. I stay with Antiniqe and she showed me how to properly fill out the monitoring form.

She told me to watch the reservoir bag and listen to the cricket of their breath safe apnea monitor. Every time the patient takes a breath the breath safe will go off making a cricket noise, this is connected to the end of the rebreathing circuit. Antinique would fill out the monitoring sheet every five minutes. I also got to help with the doctor by passing him a pair of 3-Osutures. I opened the pack of sutures making sure not to touch the inside and had out out for the doctor to pick up with a pair of forceps. After the surgery on Jackpot was done they prepped an area for him to move into to have a dental done.

I helped monitor Jackpot as Ziad did the dental, half way they asked me if I would like to do the other side of Jackpots teeth and I was happy to do it. As Ziad finished one side I did the right side of his mouth. With the scaler set to a fine mist I went ahead and cleaned each tooth making sure to remove all the tartar build up. After, 1 polished each tooth with the polisher and rinsed out the mouth with water. Lastly I applied some fluoride and left it on to sit for five minutes before rinsing it out. Jackpots teeth were very healthy, there was no sign of any periodontal disease just some tartar build up.

At the end of the dentall gave a subcutaneous injection of carprofen on the rear leg. • Later on I got to help set up another surgery this time on an 11 year old yorkie named Copper. I got to place the endotracheal tube on this patient and was successful at it! After I helped set up the leads the same way I did with Jack pot and helped a vet tech named Jules monitor Copper while he was in surgery.. In the afternoon it was very slow and there was only one appointment. But someone had dropped off three Yorkies to be left for boarding. They all needed DA2P, Rabies, Flu shots, and intranasal bordetella.

I helped Jules pull up all the vaccines and with the doctors supervision I went ahead and administered the vaccines in the appropriate spots on the front and rear legs. • Lastly at the end of the day I did a fecal float on a Chihuahua named Oscar. I was able to collect a large sample of fecal since Oscar pooped himself on the table. I set up the fecal float and waited 10 minutes to read my slide. I look at the slide on 10x with low light and found nothing. I asked Jules if the doctor needed to take a look and she said no that they trusted me and told me to throw it out.