Nursing Anaesthesia

The anaesthetic machine is an essential tool for inhalation anaesthesia. A good working knowledge of both the machine and breathing circuit is essential to ensure the safety of the patient.

This module will cover the different types of machines available and will review available breathing circuits. The range of monitoring equipment in veterinary practice has increased significantly over the last few years and the latest thinking on this topic will be presented. Key learning objectives:

• Understand the anaesthetic machine
• Know how anaesthetic breathing circuits work and how to choose them
• Understand the use of low flow anaesthesia with circle circuits
• Be able to fill in the anaesthetic record correctly
• Have an overview from basic through to advanced monitoring
• Understand equipment - how it works and what to choose
• Be able to anticipate potential problems and avoid pitfalls
• Adopt minimal monitoring in ‘general practice’
• Have an overview of ventilators and artificial ventilation

This module will cover how to assess the patient before anaesthesia and the different drugs available for pre-medication. General anaesthesia may be induced by injectable drugs or inhalational agents. These will be reviewed along with methods of maintaining anaesthesia. Key learning objectives:

• The role of pre-anaesthetic assessment
• Understand the reasons and ways to use pre-medication and sedation
• Have an overview of injectable anaesthetics
• Have an overview of the inhalation anaesthetics
• Be able to review the principles and practical use of the newer agents
• Explain the use of anaesthetic checklists and be able to implement them in clinical practice

The causes of cardiopulmonary arrest (CPA) will be covered as will how to recognise ‘at risk’ patients. The aim of cardiopulmonary resuscitation (CPR) is to support ventilation and circulation until natural functions can be restored and maintained. Equipment and resources needed for CPR will be included and a step-by-step ‘how’ to’ guide. Key learning objectives:

• Be able to identify common complications in anaesthesia
• Know the causes, identify and the treatment of arrest
• A practical step-by-step guide as to how to manage an arrest, basic CPCR, ventilation and artificial circulation

Fluid therapy is often seen as complicated by both nurses and vets. This module aims to demystify the subject and explain the reasons why every nurse should understand the basics of fluid balance, fluid therapy and fluid administration. 

How to calculate fluid requirements, rates of administration, and monitoring techniques will be covered. Nutritional support for the anaesthetised patient will also be included. 

Key learning objectives: 

• Know about the types and uses of different fluids, including colloids, HBOCS 

• Be able to devise a fluid therapy plan and monitor patients 

• Understand the principles of transfusion medicine 

• The importance of nutrition in the critical patient 

There are naturally some important differences when planning anaesthesia in both equine and exotic species. This module will cover the different drugs and techniques available for both the horse and also common ‘exotic’ species. 

Key learning objectives: 

• Have an overview of equine anaesthesia: the horse as an anaesthetic candidate 

• Understand drugs and anaesthetic techniques including monitoring and complications in equine anaesthesia 

• Know of special considerations, techniques and advice for anaesthesia in other species including birds, reptiles, ferrets, rabbits and other small mammals 

• Have an awareness of some considerations specific to farm animal anaesthesia 

This module will cover the pathophysiology of pain and how to recognise and assess pain in the different species. 

The different types of drugs available for analgesia will be reviewed for short, medium and long term use. The concept of pre-emptive analgesia will be covered along with multi-modal analgesia. 

Key learning objectives: 

• Have an overview of the pathophysiology of pain 

• Recognise pain in different species 

• Have an understanding of pain scoring 

• Understand the many analgesia options, including opioids, non-steroidal anti-inflammatory agents, local anaesthesia and other agents such as alpha 2 agonists 

• Local blocks and epidurals 

• Know how to use constant rate infusions 

• Consider long term pain management and chronic pain 

• Be aware of adjuncts to pain control, new and novel drugs 

Certain conditions require the anaesthetist to employ different techniques from those routinely used. The use of neuromuscular blocking agents will be covered in this course as well as planning anaesthesia for thoracic surgery, head and neck surgery, patients with cardiopulmonary disease and those with neurological problems. 

Key learning objectives: 

• Know about muscle relaxants – indications, current use, new drugs and monitoring 

• How to plan an anaesthetic for: 

  • Thoracic surgery 

  • Head and neck surgery 

  • Patients with cardiopulmonary disease 

  • Patients with neurological disease 

This module will cover how to plan an anaesthetic for both the patient undergoing a caesarean operation, the paediatric and geriatric patient. In addition, considerations for anaesthesia for patients with renal or liver failure and for particular endocrinopathies will be discussed. All of these situations place particular demands on the anaesthetist and the importance of patient assessment, drug selection, induction/maintenance techniques and monitoring will be covered.

Key learning objectives:

• Plan an anaesthetic for Caesarean section
• Be able to plan an anaesthetic for paediatric patients
• Understand anaesthesia for patients with kidney, liver disease and endocrinopathies