User Guide

FIRST STEPS

PRE-ANAESTHETIC CONSULTATION

Once the decision has been made to carry out a surgical, diagnostic or other procedure requiring anaesthesia, a pre-anaesthetic consultation is conducted. During this consultation, a full physical examination of the animal is carried out, along with any additional tests deemed necessary. The owner is given a detailed explanation of the anaesthetic procedure and signs the consent form.

ANAESTHETIC STRATEGY

A set of specifications for the anaesthetic strategy is drawn up.

ANAESTHETIC PLAN

Finally, an anaesthetic plan is agreed and discussed with the entire team involved during a pre-procedure briefing.

On the day of the procedure, a pre-anaesthetic assessment provides the clinical baseline for the patient to be anaesthetised.

From that point onwards, a Safety Culture approach guides the practical delivery of the anaesthesia. This is where the SafeAnaesthesia.Vet app comes into play.

GENERAL STRUCTURE OF THE APP

It is divided into three sections: normal anaesthetic procedures, checklists and emergency procedures, each listed in its own column.

1. On the left, the normal anaesthetic procedures, step-by-step instructions to ensure nothing is overlooked. Where these are numbered, the order is important and must be followed.
2. In the middle, the checklists. These ensure that no vital or very important items have been overlooked. Once completed, the checklist allows the next step of anaesthesia to proceed with optimum safety and, consequently, greater peace of mind.
3. On the right, the emergency procedures, guidelines to follow in the event of a complication. The CPR procedure for cardiac arrest – the most serious complication – is listed separately from the other emergency procedures to allow for immediate access.

The checklists are presented in the chronological order in which they are used during anaesthesia and thus outline the steps of the anaesthetic process.

Normal anaesthetic procedures are grouped according to the stage of the anaesthetic process at which they will be carried out.

Emergency procedures are not listed in chronological order, as they may occur at any time.

For use on a mobile phone, the app is designed to be used in horizontal landscape orientation. On tablet, both vertical and horizontal orientation can be used.

HOW TO PERFORM A CHECKLIST

A checklist comprises a number of items, each summarised by a keyword on the left 1 and a descriptive term detailing the action to be checked on the right 2.

A checklist should contain no more than 8 items. A larger number may encourage routine actions without proper verification.

During the practical exercise, the person in charge of the anaesthesia reads out the keyword corresponding to the item. The person in charge of the preparation reads out the corresponding adjective or term. In the event of an anomaly, the necessary correction is made, and the checklist then continues.

If the same person is in charge of both the anaesthesia and the preparation, she/he carries out the checklist alone.

A checklist should be read aloud. This has the advantage of signalling to the whole team that we will move on to the next step once the checklist has been completed.

A checklist must not be recited from memory, as this risks introducing a new source of human error.

Concretly in the App, an item is verified when you click on it or touch it in case you use a tactile screen. Its color changes 1 and the next item becomes enabled.

The button lets you reset the checklist.

The button lets you go back to the main screen of the App. The state of the checklist will be lost.

When a checklist is finished, you can validate its completion by clicking on the special item which appears at the bottom of the screen. 1.

This action drives you back to the main screen, where the completed checklist is clearly identified giving the green light to proceed to the next step of the anaesthesia.

The button on the left 1 lets you reset the corresponding checklist.

The button in the header 2 lets you reset all the completed checklists.

USING THE LIGHT VERSION OF THE APP

In the free, light version, the available content is limited to the procedures and checklist based on the recommended requirements established by the AVA (Association of Veterinary Anaesthetists). The other sections are only accessible in the full version.

Use of the app in its light version therefore begins with the standard procedures corresponding to the recommended requirements of the AVA, which assist with preparation for induction 1 and with the cardiopulmonary resuscitation (CPR) procedure in the event of cardiac arrest 2.

Before proceeding with the induction of anaesthesia, the so-called <BEFORE INDUCTION> checklist 3 is carried out, and once completed gives the green light.

USING THE FULL VERSION OF THE APP

Use of the app begins with an initial checklist known as <BEFORE PREMEDICATION > 1. Once completed, it authorises premedication and thus the start of the anaesthetic procedure.

This is followed by a series of normal anaesthetic procedures to assist with preparation for induction 2. Before proceeding with induction, the so-called <BEFORE INDUCTION> checklist is completed, which gives the go-ahead 3.

Then are the procedures to assist with establishing the maintenance phase of anaesthesia and monitoring the patient 4. Before starting the surgery, the <BEFORE SURGERY> checklist 5 is completed, authorising the start of the intervention.

At the end of the surgery, a procedure assists with the preparation of patient recovery 6. Once again, the completion of the checklist known as <BEFORE RECOVERY> 7 authorises the patient to be woken. A procedure assists with carrying out the recovery 8.

The resuscitation procedure for cardiac arrest is displayed by clicking on CPR.

Other complications are displayed in a column by clicking on OTHER EMERGENCY PROCEDURES.