Veterinary Specialists

Anaesthesia: Monitoring

ANAESTHESIA

The following guideline should be followed for the monitoring of animals under anaesthesia: The monitoring, maintenance and recovery from anaesthesia should be effected by registered personnel and or trained non registered personnel under supervision of a registered veterinarian who must be on the premises.  Surgery, monitoring and maintenance should not be done by the same person.

All animals should be monitored after surgery and not discharged unless adequately recovered from anaesthesia.   All animals must be fully conscious and ambulatory before discharging them from an animal facility.

Should it be necessary for a practitioner to deviate from the aforementioned the owner should be advised of the risks involved.

(Published -December 1997)

Refer to the guideline document under Guidelines titled " Recommendations for Monitoring of Anaesthesia" below.

Anaesthesia: Starving Patients

The delay or postponement of appropriate treatment of an emergency or other condition which, if not given timeous attention, could result in unwanted complications and lead to a veterinarian being found guilty at an inquiry.  Rule 4.1.2 of the Veterinary and Para-Veterinary Professions Act determines that a veterinarian is morally obliged to serve the public to the best of his/ her ability and in terms of the latest scientific knowledge. It is clear that there can be no grounds for defence on the basis of outdated information.  One example is the delay of general anaesthesia for fear that complications may develop in an animal who has recently eaten.

(Published - August 2000)

Anaesthetic Gas Scavenging

KE Joubert MMedVet (Anaes), BVSc

Anaesthesiology: Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria

Private Bag X04, Onderstepoort, 0110, RSA, (012) 529 8137 (Office), (012) 529 8307 (Fax), This email address is being protected from spambots. You need JavaScript enabled to view it.

A number of practitioners have disputed the relevance and practicality of scavenging of waste anaesthetic gas from operating theatres. In a recent survey of 161 practitioners in South Africa it came to light that only 11.8% of practitioners applied any form of scavenging to prevent contamination of the operating room environment. Volatile anaesthetic agents and some carrier gases may pose a significant health risk for staff. The welfare of animals, employees, and the clients are the concern of the veterinary profession and its governing institution.

The Occupational Health and Safety Act of RSA (Act 85 of 1993 as amended by Act 181 of 1993), requires that every employer instructs employees on the hazards to their health with regard to any substance they may use, handle, store or transport (Section 8, 9 and 12). As halothane or any of the other volatile anaesthetic agents are considered a potential health risk which is augmented by the fact that the European Union and the United Sates have established maximum exposure levels, we as employers are required to take the necessary precautions as described in Act 85 of 1993. The act requires that the employer instruct the employee on the appropriate methods to handle and use hazardous substances and it also states that an employer must take appropriate measures to prevent unnecessary exposure to any hazardous substance. Failure do so, is considered under the act to be an offence. Veterinarians are advised to take cognisance of this fact as litigation may result. The council by encouraging scavenging of anaesthetic agents wishes to protect veterinarians from potential legal consequences. The Occupational Health and Safety Act is administered by the Department of Labour.

Active scavenging devices are expensive and are not mandatory for veterinary facilities. Simple passive scavenging systems can be implemented as follows:

A pipe is connected to the pressure relief valve (pop-off valve) and another conduit through the outside wall of the room at a level below the height of the anaesthetic machine.
Installation of an activated charcoal container on the anaesthetic machine absorbs exhaled anaesthetic gasses. Companies specialising in this kind of equipment must install this. Like the soda-lime canister, the activated charcoal must be replaced from time to time. It is also a more costly system but convenient for mobile anaesthetic machines.
Alternative a plastic refuse bag (good quality) can also be attached to the pop-off valve and emptied outside after the procedure.
In cases where gas masks are used (like birds) anaesthetic gases escape into the room and there is an even greater potential for risk. In these cases it is recommended that a well-ventilated room be used, the masks fits a tightly as possible and if attached to breathing circuit scavenging is possible.

Acknowledgement

This article has been based on a previous publication by the author: Joubert KE 1999 The hidden dangers of the anaesthetic machine. Journal of the South African Veterinary Association: 70: 4: 140 – 141. Prof AM Lübbe is acknowledged for his input into the article. A list of references is available on request.

(Published - April 2003)