Page 95 - BSAVA Guide to Pain Management in Small Animal Practice

BSAVA Guide to Pain Management in Small Animal Practice

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Sighthounds with little body fat are
particularly susceptible to urine scalding
and skin irritations when recumbent.
Use of a Comfy Collar™ and a towel to
absorb drool from the patient. Low-stress handling techniques, such as
those taught by the late veterinary behaviourist
A useful resource for further information Dr Sophia Yin (https://lowstresshandling.com/),
regarding preventing and treating pressure sores are increasingly embraced by veterinary sta to
is the guidelines document available from the improve patient welfare and comfort. However,
National Pressure Ulcer Advisory Panel. These many practices and individuals remain unaware
guidelines are available from their website of the handling techniques and behaviour
(www.npuap.org) and provide the most up-to- theory that this practice highlights. Many
date recommendations in human medicine. veterinary surgeons, veterinary nurses and
support sta receive very little training on subtle
Turning canine and feline body language and proper
handling of cats, for example. The practices of
Frequent turning is common practice in
recumbent patients. In human medical care, pinning patients down and scru ng cats are
recumbent patients are turned every to 4 outdated and should be superseded with far
hours. This frequency of turning developed more e ective and safe practices.
from historical nursing shortages: the time it Toileting
took for the nurses to rotate all patients on the
wards was hours Bansal et al., . urning Patients receiving intravenous uids and or
frequency should be increased for patients with diuretics, and any polydipsic patient, should
respiratory compromise or if the integument have more frequently scheduled toileting
had lost integrity with signs of ulceration and opportunities. Any patient that can be taken
infection. Decubitus ulcers, also known as bed outside to toilet should have this as a primary
sores and pressure sores, result from impaired option. Not only does going outside increase
blood supply and tissue malnutrition caused by patient activity levels but it also provides
prolonged pressure over skin, soft tissue, patients with stimulation and social interaction.
muscle, and bone. Patients with very little body Indwelling urinary catheters are often used
fat are at a higher risk igure 6.6 . he to assist with the management of recumbent
cornerstone of decubitus ulcer therapy is to veterinary patients. For inpatients with critical
reduce or eliminate pressure, through the illness, neurogenic bladder dysfunction,
provision of support surfaces, turning, padding, paraparesis or tetraparesis, close monitoring of
positioning, and, if possible, mobilization of the uids in and out is re uired. Indwelling urinary
patient Bansal et al., . catheters assist ease of patient care, assessing

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