It is true that anesthesia cannot be 100% risk free for people or pets but it is possible to make it a very controlled, very low risk event. We believe that the risks of the anesthetic procedure should never exceed the risks of the disease. In order to maintain maximum safety we have made several commitments. Most importantly, we recruit and train licensed veterinary technicians and doctors dedicated to anesthetic safety. We maintain an inventory of the best available anesthetic agents and we have assembled sophisticated equipment to provide the most thorough monitoring of our anesthetized patients.
- Technology plays a very large role in any anesthetic safety program. In-depth monitoring equipment is at the heart of our safety technology.
- There are no anesthetics that are perfectly tolerated by all patients.
- Anesthetic complications almost always start as small deviations from normal.
- Early detection and prompt correction of these deviations is how we consistently achieve a safe final outcome.
- There is no single monitor that covers all of the important issues facing an anesthetized patient.
- Complete, thorough monitoring requires a group of monitors, each specialized in a critical element of anesthetic safety, but most animals anesthetized in private practice today are lucky to have one monitor in place.
- The level of equipment at our hospital AND UTILIZED FOR EACH AND EVERY PATIENT UNDERGOING ANESTHESIA is normally found only at veterinary colleges:
- ECG Heart Monitors to assess heart rate and rhythm;
- Pulse Oximeters to measure the blood’s oxygen levels;
- Respiratory Monitors to monitor the respiratory rate;
- Blood Pressure Monitors to monitor the patient’s blood pressure (unmanaged blood pressure can cause many problems, including kidney failure later in life);
- a sophisticated End Tidal Carbon Dioxide Ventilation Monitor.
- We also have an assistant during each procedure whose sole responsibility is monitoring a patient’s vital signs during an anesthetic event.
- Our anesthetic protocols call for every patient to have Respiratory, Pulse Oximeter, ECG, and Blood Pressure Monitors regardless of the age of the patient or the procedure being performed.
- We also have emergency drugs drawn up and ready to use at the correct dosage for each patient – a box containing these drugs is labeled with each patient’s name, and this box accompanies each patient throughout their time at the hospital in case the emergency drugs are needed. Most hospitals stock at least some emergency drugs, but the difference in time from a problem being noted to the drug being administered to the patient can significantly affect the patient outcome. When the drugs are already drawn up at the correct dosage, it’s merely a matter of noting the issue, selecting the labeled syringe with the desired drug, and administering it, no time needed to up dosages, locate the medication, draw it up. Emergency drug sheets are printed the morning of the procedure, and are tailored to each patient’s special needs.
Each of our anesthetic patients has a preanesthetic examination. Preanesthetic medications are tailored to the needs of the patient to minimize distress and discomfort. IV catheters are planned for every anesthetized patient to maximize safety in the rare event that emergency medications are needed. Most veterinary practices do not use IV catheters during routine surgeries. An emergency drug sheet is customized for each individual patient. The most likely emergency drugs are drawn up and available for immediate use. In the event of an emergency, these steps save critical time. An anesthetic record is placed in the patient record with all the important information that we need when planning future anesthetic events. Most veterinary practices do not keep a separate, detailed, dedicated anesthetic record.
Some would say that there are no safe anesthetics, just safe anesthetists. Simply stated, anesthetic safety is based upon the skills of the anesthetist, the equipment, and the quality of the anesthetics available to them. Ongoing training is the key to becoming the safest possible anesthetist. It is Dr. Stein’s goal to spend 1 – 2 weeks out of every year training with the Board Certified Anesthesiologists at Michigan State University. The refinements we have made to our anesthetic program since he began this relationship have been both satisfying and rewarding. Working as a team, we have developed an anesthetic program that is among the strongest available in general veterinary practice. We will always continue to seek ways to build upon this outstanding practice strength.
We invite our clients with anesthetic interests (or fears) to spend a morning observing our anesthetic routines. The more our clients understand the distinct advantages of our program, the more comfortable they can feel.
If anesthetic safety worries you, you have come to the right hospital. Here is an article discussing a case where a patient suffered kidney damage from anesthesia, the sort of thing we all worry about when it comes to our pets being “put under” – the damage in this case could in all likelihood have been prevented with appropriate medication selection and if more effective patient-supportive measures had been applied – truly effective monitoring (like we use) should identify any concerning trends in vital signs early enough to allow for interventions to correct for that trend before it becomes remotely problematic. For more information on blood pressure monitoring during anesthesia (aimed at veterinary professionals), please see Dr. Stein’s Veterinary Anesthesia and Analgesia Support Group website here.