Onboarding – getting you ready to work and get paid
SpecVet – our electronic medical records system
Standard patient processing – summary of activity with a patient from start to finish
Overview of hospital maintenance- cleaning/laundry
Familiarization with common surgical abbreviations and terminology
Familiarization with common drugs and side effects
Radiology- entering patient information, PPE, acquiring images
Location of supplies- IV catheters, bandage material, blood supplies, drugs, syringes, etc.
Filling prescriptions and printing prescription labels
Cubex and emergency drugs
Admitting patients: bedding, cage locations, proper labeling, personal belongings, own medications
Entering visit information into Spec Vet- communications, labs, procedures, estimates, invoicing
Introduction to lab equipment: ordering tests, entering patient information, location of supplies, transferring results to medical records, outside labs
SmartFlow – overview and training, creating flowsheets
Give SQ, IM, IV injections, draw blood
Anesthetizing patients for procedures- CT, scope, PRP, etc
Choosing the correct ETT, hoses, breathing bag
Fluid pumps- troubleshooting alarms, connecting and disconnecting the patient
Familiarization with anesthesia monitoring equipment- storage, operation, cleaning
Patient recovery- usage of sedatives, keeping patients
Oxygen therapy – O2 cage operation
Patient restraint – physical and chemical
IV catheter placement and injections
Anesthesia 101 for outpatient
Analgesia following procedures
Patient recovery
Orthobiologics
Bandages, casts and splints
Outpatient onboarding and ongoing training to make you the best of the best
- 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.
- Fill out tax forms provided by Dr. Lisa. You need 2 forms of ID such as a drivers license, passport, social security card, etc.
- Set up direct deposits of paychecks. Dr. Lisa will need an account number and routing number.
- A key fob for entry into the building will be provided. Dr. Lisa to review entry into building when hospital is closed.
- 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.
- Staff Introduction: Doctors- Dr. Dan/Lisa Degner – owners of the practice
- Surgeons- Dr. Noah Bander, Dr. Charlie DeCamp, Dr. Jennifer Godfrey, Dr. Brayden Stanley, Dr. Erik Zellner
- Internal Medicine- Dr. Jennifer Pearson
- Interns- Dr. Tim Lin, Dr. Jordan Pieczynski
- Managers- Susan Holland, Sarah Haggerty
- Your department: Amanda, Andrea, Chrystee, Courtney, Jami, Jerrid, Liz, Melissa , Sydnei and Tiffany
- A job description for your position will be provided. A signature will be required once you have read through it,
- 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.
- Dress Code is navy blue scrubs. Please see the employee handbook for more detail.
- Parking for employees is behind the building. The front parking lot if for clients.
- 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.
- Emergency contact information given to Susan Holland.
- Hills food professional discount program- hillsprofeeding.com
- SpecVet –our medical records system
- Login – please see Dr. Dan for login profile
- Dash board and how to navigate to various patients
- Visit level versus global level
- 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 hospitilizaton, night hospitilization, 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
- Smartflow
- Login – please see Sarah Haggerty or Susan Holland for login profile
- Onboarding videos and educational material – same as above
- How to make a treatment flow sheet
- How to make an anesthesia sheet
- Cubex
- Login- please see Susan Holland for login profile
- X-rays
- Use of the Heska Cuattro x-ray machine
- Proper positioned radiographsUsing appropriate settingsRadiation monitoring badge – obtain from Susan Holland
- You must turn your badge in when Susan requests it for analysis and you will receive a new one If there is an alert to high radiation exposure, you will be notified
- Radiation safety
- Always wear a lead apron with thyroid shield
- CT scans
- How to position patient for various scans
- Selecting settings for CT
- How to administer IV contrast with contrast injector
- How to set up CT machine and execute a 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.
- Ultrasound
- How to enter a patient profile in the machine for surgeon to complete study
- This is 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
- Biopsy- how to order test, how to save the sample, FORMALIN SAFETY, where to leave the sample
- 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
- How to set up Heska fluid pump
- How to use Baxter fluid pump
- How to use our syringe pumps
- Tasks During Outpatient:
- Take history – make sure that client has filled out appropriate history sheet; the correct history sheets are being uploaded on www.animalsurgicalcenter.com on each “Pet condition” webpage on the site. This needs to be downloaded and filled out by the client or by the outpatient tech. Interns can also help out with this especially on new cases. If we are getting behind, techs must jump in. Recheck histories can be done by interns if they are available. Techs need to keep in mind that interns have a tremendous amount of entry of medical records to complete referral letters, so please help out when needed.
- TPR (temperature, pulse, respiration rate) and accurate weight must be obtained on each and every new patient unless the patient is highly aggressive…no exceptions. Small patients must be weighed on the table scale. Accurate body scoring is needed and should be consistent (don’t just guess, use standard “Body Scoring” guide)
- Physical examination is to be done by the specialist first, depending on the preference of the clinician. Interns can examine the patient while the clinician is discussing the plan with the client. While the clinician is doing the examination he/she will verbalize examination findings which should be documented in the medical record in SpecVet in the rDVM letter. Techs are to put in appropriate template for each and every patient (there should not be any blanks at the end of day!!!). Please chose a template which reflects the case better (example if it is a cruciate case, use the cruciate initial exam template, if it is a THR case, use the THR initial exam template). Please ensure that English is grammatically correct, without spelling errors and complete sentences when appropriate. See Link on common mistakes made in rDVM letters.
- Complete treatment plans should be completed while the clinician is discussing the plan with the client in the exam room. Charges are to be put in SpecVet. Fill prescriptions as directed by clinician. As soon as the clinician escorts the client to front desk for payment, the treatment plan is presented and date for procedure or surgery is scheduled.
- Clean exam room between clients
- If patient is admitted to the hospital, create a treatment sheet in Smartflow. Ask the doctor what needs to be on the treatment sheet and have him/her sign off on it.
- Recovery of patient following diagnostics
- What needs to be done
- Check list –
- treatment sheets done if patient is staying in hospital
- medications put in pill vials and make an internal medical note that this has been completed
- connect fluids to patient
- have heating device on patient with towel barrier between heating device and patient (safe against burns),
- heating blanket (medical grade only)
- Hotdog
- Please know how to safely use these to avoid patient burns
- round with patient care team if transferring the case to them
- Use of oxygen cage. This may be needed for patients that are hypoxic after a procedure or CT scan.
- How to turn machine on, connect oxygen line to 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
Anesthesia
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).
- How to properly set up an anesthetic machine
- http://thinkanesthesia.education/training-video/how-to-set-up-an-anesthetic-machine
- Trouble shooting anesthesia machines
- http://thinkanesthesia.education/on-demand-webinar/2022/02/think-anesthesia-machine-mishaps-troubleshooting-anesthetic-equipment
- Best practices in anesthesia
- http://thinkanesthesia.education/training-video/how-to-set-up-an-anesthetic-machine
- Understanding pain pathways
- http://thinkanesthesia.education/on-demand-webinar/2022/01/think-anesthesiar-understanding-pain-and-nociception-pathway-and
- IV catheter placement
- http://thinkanesthesia.education/training-video/percutaneous-iv-catheterization-training-video
- Multidose Alfaxone use
- http://thinkanesthesia.education/on-demand-webinar/2021/11/think-anesthesiar-clinical-use-of-alfaxan-multidose-idx
- Capnography
- http://thinkanesthesia.education/on-demand-webinar/2021/11/think-anesthesiar-clinical-use-of-alfaxan-multidose-idx
- Pulse oximetry
- http://thinkanesthesia.education/training-video/optimizing-use-of-pulse-oximetry
- Interpreting ECGs
- http://thinkanesthesia.education/on-demand-webinar/2020/12/think-anesthesia-interpreting-ecgs
- How to measure blood pressure with ultrasonic doppler
- https://www.youtube.com/watch?v=xG8snMOKOVY
- Dealing with post-induction apnea
- http://thinkanesthesia.education/training-video/addressing-post-induction-apnea
- Importance of acute pain assessment during the peri-anesthetic period
- http://thinkanesthesia.education/training-video/importance-of-acute-pain-assessment-during-the-peri-anesthetic-period
- Smooth anesthetic recoveries
- http://thinkanesthesia.education/on-demand-webinar/2021/07/think-anesthesiar-optimizing-anesthetic-recoveries
- Intra-op hypotension and hypertension
- http://thinkanesthesia.education/on-demand-webinar/2021/05/the-low-down-on-getting-low-combating-intraoperative-hypotension
- Anesthesia of patients with respiratory disorders
- http://thinkanesthesia.education/on-demand-webinar/2021/05/dont-take-my-breath-away-anesthesia-for-patients-with-respiratory
- Minimizing feline stress prior to anesthesia
- http://thinkanesthesia.education/on-demand-webinar/2021/05/from-home-to-the-veterinary-clinic-and-back-minimizing-feline-stress-in
- Anesthesia for the emergency case
- http://thinkanesthesia.education/on-demand-webinar/2021/05/anesthesia-for-the-emergency-patient
- When not to panic during anesthesia
- http://thinkanesthesia.education/on-demand-webinar/2021/05/dont-sweat-the-small-stuff-when-not-to-panic-during-anesthesia
- Tricks of the trade: emergency anesthesia
- http://thinkanesthesia.education/on-demand-webinar/2021/05/tricks-of-the-trade-anesthesia-emergency
- Drug interactions
- http://thinkanesthesia.education/on-demand-webinar/2021/03/think-anesthesia-peri-anesthetic-drug-interactions
- Fluid therapy during anesthesia
- http://thinkanesthesia.education/on-demand-webinar/2020/12/think-anesthesia-fluid-therapy-for-the-surgical-patient
- The anesthesia process
- http://thinkanesthesia.education/on-demand-webinar/2020/10/think-anesthesia-the-anesthetic-process
- Anesthesia and the GI tract
- http://thinkanesthesia.education/on-demand-webinar/2020/09/think-anesthesiar-anesthesia-and-the-gi-tract
- Top 5 anesthetic complications
- http://thinkanesthesia.education/on-demand-webinar/2020/08/think-anesthesiar-the-top-five-anesthetic-complications
- Local anesthesia options
- http://thinkanesthesia.education/on-demand-webinar/2020/06/think-anesthesia-local-regional-analgesic-options
- Update on Alfaxone
- http://thinkanesthesia.education/on-demand-webinar/2020/06/alfaxalone-an-update-in-the-advancement-of-injectable-anesthesia
- Anesthesia for geriatrics
- http://thinkanesthesia.education/on-demand-webinar/2020/06/think-anesthesiar-anesthesia-for-geriatrics
- Nonschedule 2 opiods
- http://thinkanesthesia.education/on-demand-webinar/2020/06/think-anesthesia-non-schedule-ii-systemic-analgesic-options
- Balancing anesthesia and co-morbidities
- http://thinkanesthesia.education/on-demand-webinar/2020/05/balancing-anesthesia-and-common-co-morbidities
- Alfaxone for GDV, dystocia, urinary obstruction
- http://thinkanesthesia.education/on-demand-webinar/2020/04/alfaxalone-in-the-emergency-room
- Being the Boss of Feline Pain Control
- Coming next week on thinkanesthesia.com/education
- Local dental blocks
- http://thinkanesthesia.education/on-demand-webinar/2020/03/anesthesia-for-dentistry
- Capnography 2
- http://thinkanesthesia.education/on-demand-webinar/2020/01/respiratory-monitoring
- Cardiovascular monitoring during anesthesia
- http://thinkanesthesia.education/on-demand-webinar/2019/10/cardiovascular-monitoring
- Premedication
- http://thinkanesthesia.education/on-demand-webinar/2019/02/think-anesthesia-premedication
- Anesthesia monitoring
- http://thinkanesthesia.education/on-demand-webinar/2019/02/think-anesthesia-monitoring
- When a pet regurgitations while under anesthesia – steps to take
- http://thinkanesthesia.education/training-video/esophageal-lavage
- Use of ventilator and how to switch to standard manual bag ventilation
- https://www.youtube.com/watch?v=omikPcRJjBE
- Pressure checking barotrauma prevention unit (on CT scan anesthesia machine)
- Setting up and using Bains circuit
- Demonstration by technician
- CRI calculations
- http://thinkanesthesia.education/training-video/cri-calculations-for-administering-drugs-in-patient-fluids
- Gabapentin video – coming soon on thinkanesthesia/education.com
- Feline pain control video – coming soon on thinkanesthesia/education.com
- Orthobiologics video – coming soon on thinkanesthesia/education.com
- How to use our Angel system for PRP and stem cell – click her for instructional video from Arthrex
- Local anesthesia blocks
- 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
- Medications used for nerve blocks; also includes techniques for blocks
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196680/
- Femoral sciatic nerve blocks
- https://www.youtube.com/watch?v=d6majzKdGrs
- https://www.youtube.com/watch?v=pfowAwk0cQ0
- Dental nerve blocks
- https://www.youtube.com/watch?v=UtWUzkHnLTk
- https://www.youtube.com/watch?v=FzNPdKh3PaI
- Infraorbital nerve block
- http://thinkanesthesia.education/training-video/infraorbital-nerve-block
- Testicular blocks
- http://thinkanesthesia.education/training-video/intratesticular-blocks
- TAP blocks – for abdominal surgery
- http://thinkanesthesia.education/training-video/tap-block
- Brachial plexus block
- 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 (narcotic, sedative, antibiotic, non steroidal anti-inflammatory, etc)
- Contraindications for use
- Interactions with other drugs
- Dosage, frequency of administration, route of administration
- Acepromazine, atipamezole, Ancef
- Bupivacaine, buprenorphine, butorphanol, Baytril
- Carpofen, Cerenia, Convenia, Clavamox, Clindamycin
- Deracoxib, dexmedetomidine, diphenhydramine
- Fentanyl, flumazenil, ferocoxib
- Telazol, tramadol, Tylenol 4 (acetaminophen and codeine)
- Anatomy of the oral cavity, larynx, trachea
- Prevention of barotrauma – never leave a pop-off valve closed without monitoring; open immediately to prevent barotrauma; understanding the EMD safety valve (currently on the anesthesia machine in CT room)
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.
