Tidig postoperativ övervakning av smådjur : förekomst av standardiserade rutiner

Abstract: Background. Anesthetic-related death in small animal anesthesia is about ten times more common than in human anesthesia. Recent research identifies the early postoperative period as particularly risky and highlights the need for regular and careful monitoring of the veterinary patient during this period. Objective. The aims of this study were to investigate whether there are standard procedures in terms of regulated routine patient observations and record-keeping during the early postoperative period at Swedish veterinary clinics, and if there are any guidelines for monitoring the veterinary patient during recovery. Methods. A small survey including ten Swedish veterinary clinics was carried out as well as a literature review. Results. The survey showed that 50 % of the veterinary clinics did not have standard procedures for monitoring the patient during the early postoperative period. Seven out of ten veterinary clinics stated that they during this same period of time only kept record in the event of incidents. Guidelines for monitoring the veterinary patient during anesthesia and recovery have been published by the American College of Veterinary Anesthesiologists (ACVA) in 1995 and in 2009 and by the American Animal Hospital Association (AHAA) in 2011. Both guidelines recommend frequent and careful monitoring and recording of vital signs by trained personnel during recovery which should include at the minimum assessment of pulse rate and quality, respiratory pattern, mucous membrane color, body temperature and signs of pain. No Swedish guidelines or recommendations for monitoring the veterinary patient during or after anesthesia were found in this study. Conclusions. A lack of standard procedures at the veterinary clinic may result in poor record-keeping and monitoring of the patient during the early postoperative period, which could compromise patient safety. This study highlights the need to enable the veterinary nurse to carry out her duties and nursing skills regarding patient monitoring in order to improve the quality of anesthesia care and match the increasing expectations of pet-owners.