IV Fluid Support

 

"Be Prepared"    Boy Scout Motto

 

In medicine, the key to making a procedure safe is to know what the likely problems are and to then be prepared for them.

 

By far the most common problem we get into during anesthesia is low blood pressure. At Sunnyside Veterinary Clinic, we monitor blood pressure on every anesthetized patient, so we have a little different perspective than the clinics that don't monitor blood pressure.

Clinics that don't monitor blood pressure don't even know that many of their patients are getting into blood pressure problems during procedures. It's not something you can see of feel.  At least 40% of our surgical patients experience low blood pressure at some point during their anesthesia. 

Clearly, low blood pressure does not cause instant death, (although uncorrected it can be the beginning of a down-hill spiral.) However, just because low blood pressure doesn’t kill you doesn't mean it’s good for you. Low blood pressure:

• Can cause kidney damage that won’t show up until much later in life. 
• Can be the start of a down-hill spiral into serious anesthetic complications.
• Makes the post-op pain meds less safe.
• At the very best, low blood pressure makes the patient feel nauseous and headachy when they wake up.

Because low blood pressure is so common, it only makes sense to be prepared for it. This is why whenever any human is anesthetized, there is always an IV line in and there are always fluids running.  It is malpractice to not do so.  IV fluids help keep the pressure from going down in the first place, and if the pressure does go down anyway, we can give a big slug of fluids and bump it right back up again.

 

And then there is another huge safety issue 

Every two or three years, something happens during an anesthesia that meakes us reach for the Crash Kit.  Every Veterinary Clinic has one:  It's required by law.  If you open the Crash Kit up and look inside, you will find things like epinephrine, lidocaine, and atropine, all of which are most effective when given intravenously.

In the event that something goes wrong during anesthesia, how in the world are you going to give emergency drugs to a crashing patient if there is no IV line in place? The answer is "not very quickly if at all." Granted, this kind of problem does not happen very often, but in March of 2013 we had a cat under anesthesia whose blood pressure dropped from 120 to 60 just like that. Then she got pulmonary edema. She’s doing fine now, but if we had not had an IV line in and were not able to give rapid injections of life-saving medications, this case may not have ended up so well.

To help prevent episodes of low blood pressure, and to provide an important safety net, we recommend that your second upgrade be IV fluid support.

 

This upgrade is standard operating procedure at Sunnyside Veterinary CLinic, and we recommend it because of the increased safety and comfort it provides.



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