Active temperature monitoring and temperature support, including preventative measures and active warming devices available and utilised.
Fluid therapy considered for every anaesthetic and goal directed administration provided where indicated. Availability of fluid pumps and/or syringe drivers to ensure accuracy.
Blood Pressure support considered from outset and managed where appropriate through anaesthetic drug selection, fluid therapy and appropriate drug administration.
Requirement of ventilation support considered from outset. Availability of manual or mechanical means of positive pressure ventilation utilised when necessary.
Discussion:
Two large-scale studies have reported a high incidence of post-operative hypothermia (83.6% in dogs and 96.7% in cats) (Redondo, Suesta, Gil, et al. 2012; Redondo, Suesta, Serra, et al. 2012).
Hypothermia disrupts homeostasis and has several detrimental effect on a patients wellbeing, preventative measures such as blankets and active warming therapies such as warm air blowers should be utilised (Armstrong et al. 2005).
Administration of fluid therapy has advantages for all anaesthetised patients. Consideration should be given to type and dose or whether it is appropriate to withhold. Careful administration using calibrated administration equipment and continued monitoring will minimise risks of adverse effects (Davis et al. 2013).
Blood pressure should be kept within normal ranges to protect vital organs and promote adequate tissue perfusion. Fluid therapy should not be solely relied upon to correct anaesthetic related hypotension – initial drug selection and dosage should be used preventively (i.e. reducing dependency on vasodilating drugs such as isoflurane), and appropriate supportive drugs should also be available as a treatment option.
Consideration of patient signalment and procedure can highlight risk of hypoventilation or apnoea during anaesthesia – plans for positive pressure ventilation of high risk patients should be made. Equipment should be available to allow endotracheal intubation and to apply positive pressure ventilation in all cases.
More Information: AAHA Fluid therapy guidelines.