1. Surgical Technician for Canine Spay
Michelle Hervey
Tarleton State University

2. Case Introduction
When I was in veterinary technician school my class assisted in the spay/neuter program at the Texas A&M Veterinary Teaching Hospital. In this program we were to be the surgical nurse for the assigned third year veterinary student performing the spay/neuter procedure.

3. Definition
Surgical Nurse - A “sterile person who assists with surgical duties such as passing instruments, retracting tissue, and maintaining homeostasis” (Tear, p. 310).

4. Patient History
Stella is a 1 year old, female, Labrador Retriever Mix. She is from the Aggieland Humane Society, and is here at the Texas A&M Veterinary Teaching Hospital to be spayed. Stella is current on all vaccinations, Heartworm medication, and flea/tick medications provided by the animal shelter 3 weeks prior to the overiohistorectomy (OHE). A heartworm test was performed at that time as well. Stella tested negative on her heartworm test. Once Stella has recovered from her OHE procedure the Aggieland Humane Society will place her up for adoption.

5. Physical Exam/Blood Work
Body Condition Score is 5/9, and the patient is bright alert and responsive (BAR).
Skin condition is within normal limits.
Hydration within normal limits.
Heart Rate = 120 bpm
Heart Rhythm = Normal Sinus Rhythm
ECG within normal limits.
Respiratory Rate = 20 bpm, and no abnormalities ausculted.
Temperature = 101ᵒF
Complete Blood Count (CBC) within normal limits.
Chemistry Panel with Electrolytes within normal limits.

6. Patient Preparation
Stella is prepped for HOE procedure in the anesthesia prep area. This area is where the veterinary technicians, and veterinary students prepare the patient. Stella will have an intravenous catheter placed, induction medications will be given, intubation will be performed, and anesthesia will begin. Once the patient is stable under general anesthesia the abdomen is clipped, and wet prepped for surgery.

7. Operating Room Preparation
As the surgical nurse in this situation I am required to set up the surgical table with the instruments, and suture needed for the OHE procedure. I will also prepare the surgical table as well.

8. Hand washing
Once the surgical area is prepared I am required to surgically wash my hands and arms in preparation for sterile gowning and gloving. I will put on a bouffant, booties, and surgical mask before I wash my hands. Surgical Hand Washing – Is “The process of removing as many microorganisms as possible from nails, hands, and arms by medical washing and chemical antisepsis before a person participates in a surgical procedure” (Tear, p. 88).

9. Patient preparation in the Operating Room
The anesthesia team brings the patient into the operating room on a gurney and places her to the surgical table in dorsal recumbency.
Anesthesia will also restrain the patient to the surgical table.
I must dry off my hands with the sterile towels provided, and sterilely gown and glove up.
I will surgically scrub the patient for the OHE procedure.
I must remove my sterile gloves after surgical scrubbing the patient, and re-glove sterilely.
Once I am sterilely re-gloved I will assist the third year veterinary student drape in the patient.

10. Draping in the patient
Sterile towels are used as the bottom drape, and then a fenestrated drape is placed over the sterile towels.
The corners are held in place by Backhaus Towel Clamps.
Fenestrated Drape
Backhaus Towel Clamps
Placing the Backhaus Towel Clamps

11. Surgical nursing duties
Passing surgical instruments
Blotting blood from surgical site with sterile gauze.
Kept count of sterile gauze used, and surgical instruments.
Assisted with holding surgical instruments while the third year veterinary student performed ligations of certain areas in preparation to remove the reproductive organs.

12. Surgical Nursing Duties Continued
Assisted the third year veterinary student with running the suture for closing of the surgical site.
Cut the ends of the suture once the suture were in place.
Blotted the patient’s surgical site clean after the closure sutures were in place.
Removed the Backhaus Towel Clamps and removed the draping material.

13. Transportation to Recovery
Once the procedure is finished the patient is transported by the anesthesia team to the recovery area.

14. Surgery room clean up
After the patient is removed from the operating room I clean up. I will need to remove the blankets on the surgical table, and place them in the surgical laundry. I will clean the surgical table top, and the base with Snap ‘N’ Go cleaner. The sharps are removed from the instrument table into the sharps container. All surgical instruments are placed into the enzymatic cleaner. The sterile drapes and gauze are removed from the instrument table and placed into the biohazard trash bags. The Instrument table top and base are cleaned with Snap ‘N’ Go cleaner. The entire operating room is then completely swept and mopped before leaving the room.

15. Cleaning surgical instruments in preparation for sterilization
The surgical instruments are cleaned after they have soaked for at least 10 minutes in the enzymatic cleaner.
The instruments are rinsed with water.
The instruments are dipped into instrument milk. This will keep the instrument hinges lubricated, and the instruments will not rust.
Then the instruments will be allowed to dry before they are placed in the pack to be sterilized.

16. Sterilization Process
Once the instruments are dry they are placed into the pack for sterilization. There will be a label placed on the outside of the pack with indicator tape. This will note what the instrument pack is for, the date, and my initials.

17. Conclusion
Stella had a great recovery from anesthesia. The recovery from her OHE procedure was a success and she was later adopted by the third year veterinary student that performed the procedure. This story all the way around was a great experience as a surgical nurse, and the patient had a happy ending with her adoption.

18. Reference
Tear, M.. (2012). Small Animal Surgical Nursing Skills and Concepts (Second Edition).Elsevier Mosby. St. Louis, MO. Thomas, J. A., and Lerche, P.. (2011). Anesthesia and Analgesia for Veterinary Technicians (Fourth Edition). Elsevier Mosby. St. Louis, MO.