Emergency Splenectomy By Jennifer Hohle Tarleton State University

Patient History Max with a nine-year-old German Shepherd, intact male who presented on emergency due to collapsing at home. His mucous membranes were white upon admittance to the hospital. He had fluid in his abdomen. And effusion check via ultrasonography revealed hemoabdomen. A PCV of the blood in his abdomen was higher than a peripheral sample PCV, Indicative of and confirmed by ultrasonography, a bleeding splenic mass. Max was prepped for an emergency splenectomy.

Specialty Surgical Equipment For this particular surgery certain instruments and tools are needed Suction is needed in order to remove any free-floating fluid in the abdomen to keep the surgical site clear for visual purposes Ligature is also set up in order to cauterize at the same time as removing the spleen to avoid any issues with hemostasis A Cardell that performs ECG, thermometry, blood pressure, capnography was also utilized during the surgical procedure to monitor the patient's vitals every five minutes. An esophageal stethoscope and Doppler was also utilized during this procedure.

Uses of the Specialty Equipment ECG – monitors the rhythm of the heart and looks for any abnormalities such as VPCs, With the hopes of viewing a normal sinus rhythm throughout the entire procedure as well as postop Blood pressure cuff and Doppler- monitors blood pressure and a patient to avoid hypotension or hypertension and the Doppler monitors the heartbeat allows it to be audible Capnograph monitors expired carbon dioxide And the respiratory rate Pulse oximetry measures the O2 saturationEsophageal stethoscope also monitors heart rate via a tube placed through the esophagus of the pet

Uses of the Specialty Equipment Pictures of the vaporizer, Cardell, and suction

Uses of the Specialty Equipment Pictures of the Y tubing from the anesthetic machine, the capnography connected to the Y tubing and endotracheal tube, and a picture of the spleen riddled with cancer probably carcinoma per the doctor

How specific tests are performed Tests I performed prior to the surgical procedure was a pressure test on the anesthetic vaporizer, I made sure that there is sufficient isoflurane and check the pressure of oxygen to make sure that there was enough oxygen for the surgical procedure as well I inflated the pets endotracheal tube prior to placement to make sure that the cuff appropriately inflated My leak test allowed me to visualize that there were no holes in any of my equipment such as the Y tubing a reservoir bag There were no indications of any dysfunction in any of the surgical equipment prior to the surgical procedure

Quality control measures Routine maintenance of the anesthetic equipment allows for quality control measures The CO2 canisters checked and weigh daily to avoid buildup of carbon dioxide that could potentially harm the patient All endotracheal tubes, white tubing, and reservoir bags are checked for leaks on a regular basis for quality control measuresAll anesthetic and surgical equipment is disinfected in a particular way in our hospital the next slide will include a picture of our actual cleaning protocol

My specific job duties in this surgical procedure In this procedure my job was the runner I collected any materials or equipment needed for the surgery, performed quality control measures and equipment checks, handed the doctor any tools needed during the surgical procedure in an aseptic manner, and was ready to scrub and if needed I did not perform anesthesia monitoring in this particular surgical procedure

Quality control measures

Conclusion Once we had Max anesthetized, and open on the table it was determined that his prognosis was grave If you Refer back to the picture of his spleen it is easily visible to see what is most likely cancer spread throughout his entire spleen. There is also evidence of cancer looking areas on his liver Max's parents were contacted from a special phone and are surgical suite to notify them of his poor prognosis At that time his parents chose to euthanize on the table

References All pictures and information in this PowerPoint presentation were from personal stock.