Every veterinary clinic is different and has various protocols for everything from answering the phones, to monitoring patients undergoing surgery. These protocols likely differ due to available resources (i.e. what equipment the clinic has in place), abundance and skill of veterinary assistants and nurses, and the number of surgeries performed.
Continuous monitoring of post-operative patients, for a minimum of three hours following surgery, allows earlier detection of problems and therefore intervention. This intervention can benefit patient outcomes while decreasing surgical complications and recovery time.
Monitoring is in the patient’s best interest, as over 50% of perianesthetic deaths (in dogs, cats, and rabbits) occur within 3 hours of the end of anesthesia according to the study, “Confidential Enquiry into Perioperative Small Animal Fatalities,” by David Brodbelt, MA, VetMB, Ph.D., DVA, DECVA, MRCVS.
Of the canine deaths included in the study, 74% were related to cardiorespiratory problems. This indicates that it is especially important to monitor metrics relating to the cardiovascular and respiratory systems. AAHA guidelines recommend heart rate, respiratory rate, body temperature, SpO2, and blood pressure continue to be closely monitored following the end of anesthesia.
Clinics have a variety of options for post-surgical monitoring of canine patients. With each option, several factors must be considered including:
- Labor/ skill required
- Cost of implementing a method
- Accuracy and reliability of the system
- Functionality of the approach
Due to the expense of most monitoring technology, its use in general practice, small animal veterinary clinics is often limited to patients currently undergoing surgery. However, emergency and specialty clinics often have portable cage-side monitoring equipment to use on critical care patients.
Without electronic monitoring technology, these clinics are typically left to record manual measurements and set time intervals. These check-ins can easily be overlooked on a busy day if a timer is not reset, leaving patients with no monitoring for an extended period. Additionally, manual measurements heavily rely on the skill of the veterinary nurse monitoring the patients and are subjective values. One benefit of this approach is the minimal cost of implementing a manual-measurements only protocol. Though the cost can be variable depending on if someone’s sole responsibility is monitoring, vs. if they are breaking away from completing other tasks to take a quick, peek, and TPR on several surgery patients.
While taking multiple sets of manual measurements does have clear benefits, it inherently allows for gaps between measurements in which a patient may not be closely monitored. This can be especially problematic if the time between a vitals check is unintentionally extended due to lack of labor.
However, these options are often costly, which can be a barrier to using on every patient. Instead, if clinics do have this capability, they may choose to only use this technology on the most invasive or complicated procedures. Additionally, these systems often include wires or probes which must remain attached to the animal. These attachments often come loose or fall off, especially as the patient continues to wake up and become increasingly active. This downfall can make the technology frustrating to use as it lacks functionality.
MeasureON! is a canine monitoring device capable of measuring a patient’s axillary temperature, respiratory rate (range), and heart rate. This data is automatically sent to the VetMeasure server and is immediately viewable on any mobile device or computer (logged into the corresponding account). MeasureON! also can stream a patient’s ECG for 2 minutes via Bluetooth, and reports relative activity level. This monitoring approach allows TPR data points to be recorded every minute, with patient reports available to download as a PDF for inclusion in the patient’s online medical record.
MeasureON! records objective vital metrics, and can be programmed to send alerts via email, text, and push notifications to a mobile device. MeasureON! Is a wireless system in a harness configuration that is comfortable for caged dogs to be wearing? In comparison to alternative monitoring technology, these harnesses are economically priced and affordable. Using MeasureON! allows staff to maximize their time for optimal efficiency. They can trust patients are being monitored, allowing them to focus on patients whose MeasureON!’s send alerts (due to vital parameters being out of range) or other patients who need additional monitoring. The MeasureON! technology automates 60% of the postoperative monitoring process and can expand a clinic’s current monitoring technology offerings.
Review the full AAHA Anesthetic Protocol Guidelines Check HERE.