Anesthesia/Surgery Tech

Veterinary Surgery/anesthesia technician on-boarding training:

  1. New employees will receive an employee handbook upon starting employment at ASCM. Be aware that modifications to the employee handbook will be made on occasion and employees will be informed of the changes. Our Safety Manual is at the back of the handbook. This guides you through security and accident reporting.
  2. Fill out tax forms provided by Dr. Lisa. You need 2 forms of ID such as a drivers license, passport, social security card, etc.
  3. Set up direct deposits of paychecks. Dr. Lisa will need an account number and routing number.
  4. A key fob for entry into the building will be provided. Dr. Lisa to review entry into building when hospital is closed.
  5. A login will be provided for Swipeclock.com for punching in and out of work. You will also punch out for lunch/break periods. Discuss PTO time.
  6. Staff Introduction: Doctors- Dr. Dan/Lisa Degner – owners of the practiceSurgeons- Dr. Noah Bander, Dr. Charlie DeCamp, Dr.Jennifer Godfrey, Dr. Brayden Stanley, Dr. Erik Zellner
  7. Internal Medicine- Dr. Jennifer Pearson
  8. Interns- Dr. Jordan Pieczynski, Dr. Tim Lin.
  9. Managers- Susan Holland, Sarah Haggerty
  10. Your department: Brandi, Corrine, Danielle, Emily, Kate, Morgan, Rhonni, Rob, Samantha, Sarah J, Swan.
  11. A job description for your position will be provided. A signature will be required once you have read through it,
  12. A review of your schedule will be discussed. If you need to call in please notify Dr. Lisa AND Susan. Their numbers will be provided to you.
  13. Dress Code is navy blue scrubs. Please see the employee handbook for more detail.
  14. Parking for employees is behind the building. The front parking lot if for clients.
  15. OSHA/Safety classes are on-line. You will receive an e-mail with a link through AVMA-PLIT. Please complete these on your first day.
  16. Emergency contact information given to Susan Holland.
  17. Hills food professional discount program- hillsprofeeding.com.   Account # 830493

  • SpecVet –our medical records system
    • Login – please see Dr. Dan for login profile
    • Dash board and how to navigate to various patients
      • Understand visit level versus global level for patient
    • Entering diagnosis, referral letter, surgery report and discharge instructions; applying a template to the referral letter, discharge instruction sheet, surgery report
    • Creating a treatment plan (estimate); how to apply an estimate to an invoice
      • Understand that not all items are automatically transferred from an estimate to invoice
      • Basic charges per day – day hosp, night hosp, fluid therapy, analgesia per day, any injections
      • Checking invoices to make sure that they are complete – compare to services rendered on the flow sheet in Smartflow program on ipads.
    • Creating an order – primary for labs
      • Always fill out history sheet in detail for pathologist
      • Always click button to make sure it indicates that it has been submitted so that it will appear on the invoice
    • How to make a new client/patient profile
    • How to schedule an appointment
    • Resources – educational videos are 
  • Smartflow
    • Login – please see Sarah H or Susan for login profile
    • Onboarding videos and educational material – provided by Sarah H or Susan
    • How to make a treatment flow sheet
      • Using templates
    • How to make an anesthesia sheet
  • Radiographs
    • Use of the Heska Cuattro x-ray machine
    • Use of portable radiographs
    • Proper positioned radiographs
    • Using appropriate settings
    • Radiation monitoring badge – obtain from Susan Holland
      • You must turn your badge in when requested for processing and you will receive a new one 
      • If there is an alert to high radiation exposure, you will be notified
  • CT scans
    • How to position patient for various scans
    • Selecting settings for CT
    • How to administer IV contrast
    • How to set up CT machine and execute a scan
    • How to transfer scan
    • How to load contrast in machine
    • Radiation safety
      • CT has much greater radiation, always stay in the operator booth during CT acquisition
      • Never stand in the gantry room during acquisition of scan
      • Wear your radiation badge at all times whenever performing, radiographs or CT scan; you must hand the badge into Susan Holland. Lost badges cost $40 which will be the responsibility of the employee (cost of lost badge will be taken off any bonuses provided to employee).
  • Ultrasound
    • How to enter a patient profile in the machine for surgeon to complete study
    • This can be demonstrated to you by one of the surgery technicians
  • CBC machine – how to order test, how to use machine, which blood tube to use
    •  
  • Chemistry machine – how to order test, how to use machine, which blood tube to use
    • Note: sample ID is the order number from SpecVet
  • Epoc – how to order test, how to use machine, which blood tube to use
    • NOTE: sample ID is order number from SpecVet
  • Coagulation profile – how to order test, how to use machine, which blood tube to use
    • Note: sample ID is order number from SpecVet
  • Buccal mucosal bleeding time – how to do
  • Transfusions –
    • Cross-matching –how to do test
    • How to administer blood and monitoring involved
    • Understand when reaction to blood transfusion is seen
    • Premedicating the patient for transfusion
    • Transfusion overview
  • How to set up Heska fluid pump
  • How to use Baxter fluid pump
  • How to use our syringe pumps
  • How to use the Hover Heat to keep your patient warm
  • Tasks During surgery
    • Put in surgery report, discharge instructions, referral letter, diagnosis in SpecVet.  Ask questions of surgeon during surgery to fill out as much as possible
    • Monitor anesthesia and document vitals on Smartflow anesthesia sheet
    • Open additional instruments and supplies as requested by surgeon
    • Discuss post-op medications and any special patient treatments on treatment flow sheet for patient with surgeon
    • Tissue samples- place in formalin after inking margins if applicable. 
    • Formalin Safety-Formalin and PPE
  • Recovery of patient
    • What needs to be done
      • Check list –
        • treatment sheets done 
        • medical records done
        • medications put in pill vials and make an internal medical note that this has been completed
        • temp patient
        • connect fluids to patient
        • connect CRI narcotics like fentanyl etc if indicated
        • have heating device on patient with towel barrier between heating device and patient (safe against burns),
          • Bair Hugger
          • heating blanket (medical grade only)
          • Hotdog
            • Please know how to safely use these to avoid patient burns
        • round with patient care team to transfer the case to them
  • Use of oxygen cage
    • How to turn machine on, connect oxygen line to machine
    • How to calibrate machine
    • How to make sure that soda sorb is fresh, especially if patient is staying in O2 cage for a prolonged period of time
    • Adjusting temp, humidity, oxygen level of chamber

Urinary catheters

Anesthesia class

Please review the lecture material following the links provided.  You will need to set up your free login with think-anesthesia in order to have access to these lectures. Upon conclusion of the lecture, please ask Susan Holland for the examination that will need to be concluded.  A minimum grade of 80% will be needed to pass the module.  If you do not pass the module, please review the lecture again and retake the test (which will have different questions).

  1. How to properly set up an anesthetic machine
    1. http://thinkanesthesia.education/training-video/how-to-set-up-an-anesthetic-machine
    2. Changing soda-sorb safety
      1. Gloves
      2. Glasses
      3. Mask
      4. https://www.dispomed.com/did-you-know-how-and-when-to-replace-the-co2-absorbent-in-your-anesthesia-device/
  2. Trouble shooting anesthesia machines
    1. http://thinkanesthesia.education/on-demand-webinar/2022/02/think-anesthesia-machine-mishaps-troubleshooting-anesthetic-equipment
  3. Best practices in anesthesia
    1. https://www.thinkanesthesia.education/training-video/best-practice-in-anesthesia
  4. Understanding pain pathways
    1. http://thinkanesthesia.education/on-demand-webinar/2022/01/think-anesthesiar-understanding-pain-and-nociception-pathway-and
  5. IV catheter placement
    1. http://thinkanesthesia.education/training-video/percutaneous-iv-catheterization-training-video
  6. Multidose Alfaxone use
    1. http://thinkanesthesia.education/on-demand-webinar/2021/11/think-anesthesiar-clinical-use-of-alfaxan-multidose-idx
  7. Capnographyhttps://www.thinkanesthesia.education/on-demand-webinar/2021/08/think-anesthesia-reading-the-waves-of-capnography
  8. Pulse oximetry
    1. http://thinkanesthesia.education/training-video/optimizing-use-of-pulse-oximetry
  9. Interpreting ECGs
    1. http://thinkanesthesia.education/on-demand-webinar/2020/12/think-anesthesia-interpreting-ecgs
  10. How to measure blood pressure with ultrasonic doppler
    1. https://www.youtube.com/watch?v=xG8snMOKOVY
  11. Dealing with post-induction apnea
    1. http://thinkanesthesia.education/training-video/addressing-post-induction-apnea
  12. Importance of acute pain assessment during the peri-anesthetic period
    1. http://thinkanesthesia.education/training-video/importance-of-acute-pain-assessment-during-the-peri-anesthetic-period
  13. Smooth anesthetic recoveries
    1. http://thinkanesthesia.education/on-demand-webinar/2021/07/think-anesthesiar-optimizing-anesthetic-recoveries
  14. Intra-op hypotension and hypertension
    1. http://thinkanesthesia.education/on-demand-webinar/2021/05/the-low-down-on-getting-low-combating-intraoperative-hypotension
  15. Anesthesia of patients with respiratory disorders
    1. http://thinkanesthesia.education/on-demand-webinar/2021/05/dont-take-my-breath-away-anesthesia-for-patients-with-respiratory
  16. Minimizing feline stress prior to anesthesia
    1. http://thinkanesthesia.education/on-demand-webinar/2021/05/from-home-to-the-veterinary-clinic-and-back-minimizing-feline-stress-in
  17. Anesthesia for the emergency case
    1. http://thinkanesthesia.education/on-demand-webinar/2021/05/anesthesia-for-the-emergency-patient
  18. When not to panic during anesthesia
    1. http://thinkanesthesia.education/on-demand-webinar/2021/05/dont-sweat-the-small-stuff-when-not-to-panic-during-anesthesia
  19. Tricks of the trade: emergency anesthesia
    1. http://thinkanesthesia.education/on-demand-webinar/2021/05/tricks-of-the-trade-anesthesia-emergency
  20. Drug interactions
    1. http://thinkanesthesia.education/on-demand-webinar/2021/03/think-anesthesia-peri-anesthetic-drug-interactions
  21. Fluid therapy during anesthesia
    1. http://thinkanesthesia.education/on-demand-webinar/2020/12/think-anesthesia-fluid-therapy-for-the-surgical-patient
  22. The anesthesia process
    1. http://thinkanesthesia.education/on-demand-webinar/2020/10/think-anesthesia-the-anesthetic-process
  23. Anesthesia and the GI tract
    1. http://thinkanesthesia.education/on-demand-webinar/2020/09/think-anesthesiar-anesthesia-and-the-gi-tract
  24. Top 5 anesthetic complications
    1. http://thinkanesthesia.education/on-demand-webinar/2020/08/think-anesthesiar-the-top-five-anesthetic-complications
  25. Local anesthesia options
    1. http://thinkanesthesia.education/on-demand-webinar/2020/06/think-anesthesia-local-regional-analgesic-options
  26. Update on Alfaxone
    1. http://thinkanesthesia.education/on-demand-webinar/2020/06/alfaxalone-an-update-in-the-advancement-of-injectable-anesthesia
  27. Anesthesia for geriatrics
    1. http://thinkanesthesia.education/on-demand-webinar/2020/06/think-anesthesiar-anesthesia-for-geriatrics
  28. Nonschedule 2 opiods
    1. http://thinkanesthesia.education/on-demand-webinar/2020/06/think-anesthesia-non-schedule-ii-systemic-analgesic-options
  29. Balancing anesthesia and co-morbidities
    1. http://thinkanesthesia.education/on-demand-webinar/2020/05/balancing-anesthesia-and-common-co-morbidities
  30. Alfaxone for GDV, dystocia, urinary obstruction
    1. http://thinkanesthesia.education/on-demand-webinar/2020/04/alfaxalone-in-the-emergency-room
  31. Being the Boss of Feline Pain Control
      1. https://www.thinkanesthesia.education/on-demand-webinar/2022/06/be-the-boss-of-feline-pain-in-the-post-operative-period
  32. Local dental blocks
    1. http://thinkanesthesia.education/on-demand-webinar/2020/03/anesthesia-for-dentistry
  33. Capnography 2
    1. http://thinkanesthesia.education/on-demand-webinar/2020/01/respiratory-monitoring
  34. Cardiovascular monitoring during anesthesia
    1. http://thinkanesthesia.education/on-demand-webinar/2019/10/cardiovascular-monitoring
  35. Premedication
    1. http://thinkanesthesia.education/on-demand-webinar/2019/02/think-anesthesia-premedication
  36. Anesthesia monitoring
    1. http://thinkanesthesia.education/on-demand-webinar/2019/02/think-anesthesia-monitoring
  37. When a pet regurgitations while under anesthesia – steps to take
    1. http://thinkanesthesia.education/training-video/esophageal-lavage
  38. Use of ventilator and how to switch to standard manual bag ventilation
    1. https://www.youtube.com/watch?v=omikPcRJjBE
  39. Setting up and using Bains circuit
    1. Demonstration by technician
  40. CRI calculations
    1. http://thinkanesthesia.education/training-video/cri-calculations-for-administering-drugs-in-patient-fluids
  41. Gabapentin video – https://www.thinkanesthesia.education/on-demand-webinar/2022/06/gabapentin-wonder-drug-or-wonder-dud
  42. Feline pain control video – https://www.thinkanesthesia.education/on-demand-webinar/2022/06/whats-new-in-feline-pain-management-toolbox
  43. Orthobiologics video – https://www.thinkanesthesia.education/on-demand-webinar/2022/05/orthobiologics-for-osteoarthritis-and-joint-pain
    1. How to use our Angel system for PRP and stem cell
  44. Local anesthesia blocks
    1. Will include instruction with ultrasound guidance to inject around nerves and avoid blood vessels.  A Jello phantom will be used for the technician to learn how to aim a needle into olives embedded within the phantom
    1. Medications used for nerve blocks; also includes techniques for blocks
      1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196680/
    1. Femoral sciatic nerve blocks
      1. https://www.youtube.com/watch?v=d6majzKdGrs
      1. https://www.youtube.com/watch?v=pfowAwk0cQ0
    1. Dental nerve blocks
      1. https://www.youtube.com/watch?v=UtWUzkHnLTk
      1. https://www.youtube.com/watch?v=FzNPdKh3PaI
    1. Infraorbital nerve block
      1. http://thinkanesthesia.education/training-video/infraorbital-nerve-block
    1. Testicular blocks
      1. http://thinkanesthesia.education/training-video/intratesticular-blocks
    1. TAP blocks – for abdominal surgery
      1. http://thinkanesthesia.education/training-video/tap-block
    1. Brachial plexus block
      1. https://www.youtube.com/watch?v=OZwnjQm7TiI

  • Know your drugs – reference https://www.vasg.org/a_drugs.htm
    • You must know the following about each drug
      • Type of medication (opioid, alpha 2, tranquilizer, etc)
      • Storage of medication (refrigerator vs room temp)
      • Indications for use
      • Contraindications for use
      • Interactions with other drugs
      • Dosage, frequency of administration, route of administration
    • Acepromazine, atipamezole, 
    • Bupivacaine, buprenorphine, butorphanol, baytril
    • Carpofen, Cerenia, Convenia, Clavamox, Clindamycin
    • Deracoxib, dexmedetomidine, diphenhydramine
    • Epinephrine
    • Fentanyl, flumazenil, ferocoxib
    • Gabapentin
    • Heparin, hydromorphone
    • Isoflurane
    • Ketamine
    • Lidocaine
    • Meloxicam, methadone
    • Midazolam
    • Naloxone, Nocita
    • Propofol
    • Telazol, tramadol, Tylenol 4 (acetaminophen and codeine)
    • Unasyn
    • Vasopressin (DDAVP)
  • Anatomy of the oral cavity, larynx, trachea
    • Proper intubation
    • Prevention of barotrauma – never leave a pop-off valve closed without monitoring; open immediately to prevent barotrauma

Disease conditions – please read the information on our website regarding these conditions.

Conditions related to oncology and cancer

 

 

Ear

Conditions related to the ears.

 

Gastrointestinal

Conditions related to gastrointestinal issues.

 

Liver and Biliary

Conditions related to the liver and biliary.

 

Oral cavity

 

Orthopedics

Conditions related to bones, joints, muscles, ligaments, and tendons.

Bone

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Elbow:

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Fractures:

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Hip:

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Shoulder:

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Stifle (knee):

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Tendon / Ligaments: 

 

 

Respiratory and Heart

Conditions related to the respiratory system and the heart.

 

Skin

Conditions related to a pet’s skin.

 

Spine and Brain

Conditions and information related to the spine.

 

Urinary and Genital System

Conditions and information relating to both the urinary and genital systems.