Page 92 - BSAVA Guide to Pain Management in Small Animal Practice

6 | Physical methods used to alleviate pain: nursing considerations

VetBooks.ir positions, slipped or soiled dressings, or the Position Ideas
need to urinate. A veterinary nurse is typically
• Padding in the groin area to lift the
Sternal
responsible for documenting any interventions,
and the patient’s response to these pelvis in better alignment with the
spine
interventions, in medical records. Nurses then • Padding under the elbows or in the
ensure the intervention plan and patient’s axilla to reduce force through the
unique needs are communicated to all elbow
members of the team. • Padding under the chin/neck being
careful not to occlude jugular
vessels
Inpatient focus Dorsal • Vacuum positioning cushions
• Sandbags either side of the thorax
Many patients admitted for day procedures, or abdomen depending on surgical
such as imaging, dentals, and mass removals, access
will have concurrent disease. This disease may • Cradles with padding and the use of
foam wedges to minimize rotation
be diagnosed and clinically obvious or • Padding under each thigh (lateral
subclinical. Degenerative joint disease is a very side) to reduce the ‘spread’ of pelvis
common concurrent disease of veterinary
patients. First, it is important to consider Lateral • Vacuum positioning cushions
• Use of padded retainers to help
appropriate kennel size and adequate bedding secure limbs out of surgical elds
for the comfort of these patients. An arthritic • Padding between sti es
large-breed dog in a medium-sized kennel with Alternative ideas to achieve routine patient
only newspaper bedding is not appropriate. positioning for procedures.
Longer duration recumbent patient care will be
covered in more detail below, but an
anaesthetized patient is essentially a
recumbent patient. Although some procedures
are short, the total anaesthesia and recovery
time should be the emphasis for care. Particular
discomfort is caused by remaining in a single
position for prolonged periods, by the limbs
being tied in various positions for improved
surgical access, or by having the hips ‘frog
legged’ during dorsal recumbency. This
discomfort will contribute to a less settled
anaesthetic state and, furthermore, the patient
will have additional postoperative discomfort in
areas other than that associated with the
procedure just undertaken. Comfort and
padding are important to prevent pain from
positioning during anaesthesia igure 6.1 ; a
wide variety of aids are available through both
veterinary and human medical suppliers.
Vacuum positioning cushions allow a variety of
patient positions to be achieved while also
providing superior comfort and insulation
compared with solid cradles. A huge variety of
foam shapes, operating table accessories such Using a padded arm retainer. This keeps the
as padded arm retainers igure 6. , and front limbs out of the surgical eld without
anaesthetic tubing holders exist, which aid in the need for tying.

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