penn foster externship 2 skill 11
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School
Penn Foster College *
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Course
EXTERNSHIP
Subject
Health Science
Date
Dec 6, 2023
Type
docx
Pages
4
Uploaded by vettechpip
Penn foster externship 2 skill 11
“shisha” Canine, 2 year old, Labrador Retriever, 56 pounds, Female. “shisha” presented to the clinic for an elective ovariohysterectomy on 9/26/2023.
Time
Temperatur
e
HR
RR
MM/CRT
Pain Scale (Colorado State Pain Scale)
11:25 AM
99.9
90
28
Pink/<2
2/4
11:40 AM
100.0
92
30
Pink/<2
2/4
11:55 AM
100.3
100
28
Pink/<2
2/4
12:10 PM
100.8
90
28
Pink/<2
1/4
12:25 PM
101.1
92
30
Pink/<2
1/4
When “shisha” was extubated, she was given her dose of Hydromorphone 0.22mL (0.1 mg/kg) via IV. Her pain level was a 2 out of 4 (Colorado Pain Scale) because she was whimpering and flinching while gently palpating her. At 11:40 AM, she was given a dose of Carprofen injection 2.2mL (4mg/kg) SQ, and her pain level was a 2 out of 4. She was still whimpering and was sensitive to palpation. At 11:55 AM, “shisha’s” pain level was a 2 out of 4 and was still whimpering and her eyes were looking back and forth; she flinched when I palpated
her. At 12:10 PM, her pain level was 1 out of 4 and “shisha” appeared to be a lot more comfortable, and I only heard her whimper just once, and she barely reacted to palpation of surgical site. At 12:25, her pain level score was a 1 out of 4, and she was ambulatory and sternal.
“coco” Canine, 8 years old, Bull Terrier, 45 pounds. “coco” presented to the clinic for a tail amputation on 9/2/2023.
Time
Temperature
HR
RR
MM/CRT
Pain Scale (Colorado State Pain Scale)
12:05 PM
99.7
80
20
Pink/<2
1/4
12:20 PM
99.9
80
22
Pink/<2
1/4
12:35 PM
100.3
90
26
Pink/<2
1/4
12:50 PM
100.4
98
28
Pink/<2
1/4
When “coco” was extubated, he was given his dose of Carprofen 1.8mL (4mg/kg) injection SQ. His pain level was a 1 out of 4 (Colorado Pain Score). He flinched to palpation of his surgical site. At 12:20 PM, “coco” seemed a little restless, and was reactive to palpation. At 12:35 PM, he was looking more relaxed, but would still flinch at palpation at his surgical site, and I heard him whimpering a little. At 12:50 PM, “coco” was sternal and ambulatory, he seemed
more content, but was still flinching at his surgical site.
At Vet Hospital, pain management is our top priority. Our goal is to make sure all patients
are comfortable during their stay, and even when they go home. The veterinarians rely heavily on
us technicians to report on a patient’s pain level. Signs of pain vary among patients, and it’s the technician’s responsibility to observe and advocate for their pain management, with the final say from the veterinarian. Since they cannot tell us, pain and stress is determined through patient behavior, physical exams, and exams after surgical procedures. Signs of pain in animals can be increased vocalization, increased heart rate and respiratory rate, decreased appetite, restlessness, aggression, and panting. In cats, hiding and aggression are common. In dogs, standing or sitting for long periods of time is common. At the hospital, we utilize the Colorado State Pain Scale as it
uses a 0-4 pain score assessment, image assessments and a descriptive summary of the 0-4 pain score. 0 means the patient is comfortable, happy and content; not tender to palpation. 1 means the patient is slightly restless and easily distracted by surroundings; reacts to palpation of surgical site. 2 means the patient is uncomfortable and might whimper, and not eager to react; flinches or cries at palpation. 3 means the patient is crying, groaning, or guards the surgery site; might be dramatic to palpation and pull away. 4 means screaming, not wanting to move at all, difficult to distract; cries at palpation and may act aggressively.
The drug protocols at the clinic are as follows: canine ovariohysterectomy patients will receive an injection of Carprofen 4mg/kg (50mg/mL) SQ post-op and the amount depends on their weight, and Hydromorphone 0.1mg/kg (2mg/mL or 10mg/mL) IV post-op, depending on their weight. Canine orchiectomy patients will receive an injection of Carprofen 4mg/kg (50mg/mL) SQ post-op, and the amount will depend on their weight. Feline ovariohysterectomy patients will receive an injection of Simbadol (buprenorphine) 0.24mg/kg (1.8 mg/mL) SQ pre-
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op, and the amount will depend on their weight, and a tablet of Onsior (Robenacoxib) 6mg orally
(>5.5 pounds and >4 months of age) pre-op, and they are anesthetized with DK (dexmedetomidine and ketamine 8mg/kg), which has pain control properties. Feline orchiectomy
patients will receive an injection of Simbadol (buprenorphine) 0.24mg/kg (1.8mg/mL) SQ pre-op
and a tablet of Onsior (Robenacoxib) 6mg orally pre-op. For canine patients that are having lumpectomies, an injection of Carprofen 4mg/ml (50mg/mL) SQ is administered post-op, and for
feline patients, Simbadol (buprenorphine) 0.24mg/kg (1.8mg/mL) SQ is administered for pain control pre-op. Even with our drug protocol in place, the veterinarian makes the final call before any medications are administered to the patient. This prevents any discrepancies with our technicians and assistants.