The A.C.A.H. 11 Steps for Safe Anesthesia

1. Physical examination and History - We have to make sure that every patient is healthy enough to handle anesthesia. If an underlying problem is noted during the exam and/or history, we can then decide whether surgery is still an option, and what needs to be addressed to minimize the risk.
2. Breed Specific Predispositions - Some breeds are prone to certain diseases and adverse reactions to specific drugs. We therefore individualize their anesthetic protocol to make it as safe as possible.
3. Pre-anesthetic blood panel - This allows us to evaluate organ function and detect early problems that may not be apparent on physical examination. Adjustments with anesthesia and medication protocols can be used to minimize the risk of anesthesia if a problem is noted.
4. Modern anesthetic drugs - These are used for premedication, induction, gas maintenance, and the postoperative time frame. We utilize many of the same drugs used in human hospitals. For example, local anesthesia such as epidurals and bupivacaine, induction agents such as propofol, and systemic pain management drugs such as oxymorphone and buprenorphine are used on a daily basis.
5. Sterilization - After the appropriate clipping and scrubbing of the surgical site in the treatment room, we also perform a second 'sterile' room scrub after transport into the operation room.
6. Surgical Scrub Room - We have our own separate surgical prep room that allows the veterinarians and technicians to scrub and gown up in an extremely clean environment. This is where gowns, gloves, masks, and shoe covers are put on. Only then do we enter the operating room. All of the sterilization of instruments also occurs in this room.
7. Operation room - Our spacious operating room is thoroughly cleaned between surgeries, has modern surgical lighting, and positive-out ventilation to minimize air contamination.
8. Technician Monitoring - This is the most vital part of the entire anesthetic process. Anesthetic depth, pulse quality, heart rate, pain control, temperature, etc. are evaluated and recorded. Any problems or concerning trends are addressed immediately.
9. IV Fluids and Additives – Every major surgery receives an IV catheter and fluids during the procedure. This allows maintenance of blood pressure and tissue perfusion during long periods of anesthesia.
10. Advanced Monitoring Equipment - We have some of the most modern anesthetic monitoring equipment for your pet while they are under anesthesia. The following are parameters that are monitored while your pet is under anesthesia.
• Carbon Dioxide - A capnograph is used to measure CO2 levels as well as respiratory rate. If too high, we can give the patient extra breaths to help flush out the excessive CO2
• Oxygen Saturation - Lets us know the percentage of oxygen in the blood, and take corrective action if this becomes too low
• Ventilator - This machine breaths for the patient, which helps maintain appropriate oxygen and CO2 levels
• Blood Pressure - Anesthesia can subsequently lower a patient's blood pressure, which can result in inadequate tissue perfusion. If too low, we can take corrective action by increasing the fluid rate or by injecting a fast acting colloid such as hetastarch
• Electocardiogram - This monitors the heart for arrhythmias during anesthesia
• Temperature Display - An animal's core body temperature naturally decreases during surgical procedures, especially when the abdomen or chest is open. We therefore utilize water circulation heating pads and warm IV fluids. We also utilize Bair Hugger patient warmers postoperatively to hasten core body temperature to the appropriate level
11. Postoperative Care - Most anesthetic complications occur after the surgery is over. This is why we have treatment sheets and monitor your pet's vital signs closely during the recovery process. Many surgical procedures require overnight monitoring and hospitalization to ensure appropriate recovery before discharge.