Plus-Hex CLINICAL

Conclusion

Methods may be selected for a range of reasons : for the objective reasons mentioned , as well as the level of practitioner experience , familiarity with the technique and availability of equipment – to name a few .

Literature has been outlined as the gold standard and has been benchmarked by Robertson et al . ^{[ 7 ]} and Bednarski et al . ^{[ 8 ]} , but it is still not known which methods are currently used in practice , if the benchmarks are being followed or the reasons behind the choices being made . It is also not known if inadequate airway management methods are being utilised , if existing protocols require review and if further education should be supplied .

With a recent shift towards evidence-based veterinary medicine ^{[ 18 ]} , it is important to know if veterinary professionals are making choices for their patients that align with the best available evidence . This applies to both veterinary nurses ( VNs ) and veterinary surgeons , as both have involvement in the management of patients under anaesthetic , and the equipment and techniques used in the placement of airway devices .

Additionally , the RCVS legislative reforms ^{[ 19 ]} may increase the VN ' s role in , for example , cat castrations . This is a key area in which opinions on airway management differ , so further study into this is prudent and is explored in Part 2 .

REFERENCES

1 Johnson C . Breathing systems and airway management . In : Welsh E . ( ed .) Anaesthesia for Veterinary Nurses . 2nd ed . Chichester : Wiley-Blackwell ; 2009 . p . 90 – 120 .

2 Sheppard D . Understanding and improving airway management in companion animals – part 1 . Veterinary Nursing Journal . 2018 ; 33 ( 8 ): 233 – 237 . Available from : https :// www . tandfonline . com / doi / abs / 10.1080 / 17415349.2018.1476 196 [ Accessed 7 November 2020 ].

3 Sheppard D . Understanding and improving airway management in companion animals – part 2 . Veterinary Nursing Journal . 2018 ; 33 ( 9 ): 262 – 265 . Available from : https :// www . tandfonline . com / doi / abs / 10.1080 / 17415349.2018.1490 677 [ Accessed 7 November 2020 ].

4 Oostrom H , Krauss M , Sap R . A comparison between the v-gel supraglottic airway device and the cuffed endotracheal tube for airway management in spontaneously breathing cats during isoflurane anaesthesia . Veterinary Anaesthesia and Analgesia . 2013 ; 40 ( 3 ): 265 – 271 . Available from : https :// www . sciencedirect . com / science / article / abs / pii / S1467298716302318 [ Accessed 9 January 2021 ].

5 Prasse S , Schrack J , Wenger S , Mosing M . Clinical evaluation of the v-gel supraglottic airway device in comparison with a classical laryngeal mask and endotracheal intubation in cats during spontaneous and controlled mechanical ventilation . Veterinary Anaesthesia and Analgesia . 2016 ; 43 ( 1 ): 55 – 62 . Available from : https :// www . sciencedirect . com / science / article / abs / pii / S146729871630037X [ Accessed 9 January 2021 ].

6 Clancy N , Hoy C . How to manage a difficult airway . The Veterinary Nurse . 2016 ; 7 ( 8 ): 478 – 484 . Available from : https :// www . magonlinelibrary . com / doi / pdf / 10.12968 / vetn . 2016.7.8.478 [ Accessed 9 January 2021 ].

7 Robertson SA , Gogolski SM , Pascoe P , Shafford HL , Sager J , Griffenhagen GM . AAFP Feline Anaesthesia Guidelines . Journal of Feline Medicine and Surgery . 2018 ;( 20 ): 602 – 634 . Available from : https :// journals . sagepub . com / doi / pdf / 10.1177 / 1098612X18781391 [ Accessed 7 November 2020 ].

8 Grubb T , Sager J , Gaynor JS , Montgomery E , Parker JA , Shafford H , et al . 2020 AAHA Anesthesia Guidelines for Dogs and Cats . Available from : https :// www . aaha . org / aaha-guidelines / 2020-aaha-anesthesia-and-monitoringguidelines-for-dogs-and-cats / anesthesia-and-monitoring-home [ Accessed 9 January 2021 ].

9 Yates D , Holgate A . Cuffed endotracheal tubes in cats . Companion Animal . 2020 ; 25 ( 3 ): 1 – 3 . Available from : https :// www . magonlinelibrary . com / doi / pdf / 10.12968 / coan . 2019.0070 [ Accessed 9 January 2021 ].

10 Hung W , Ko J , Weil A , Weng H . Evaluation of endotracheal tube cuff pressure and the use of three cuff inflation syringe devices in dogs . Frontiers in Veterinary Science . 2020 ; 7:39 . Available from : https :// www . ncbi . nlm . nih . gov / pmc / articles / PMC7015870 / [ Accessed 9 January 2021 ].

11 Brodbelt DC , Pfeiffer DU , Young LE , Wood JLM . Risk factors for anaesthetic-related deaths in cats : results from the confidential enquiry into perioperative small animal fatalities ( CEPSAF ). British Journal of Anaesthesia . 2007 ; 99 ( 5 ): 617 – 623 . Available from : https :// academic . oup . com / bja / article / 99 / 5 / 617 / 256314 [ Accessed 9 January 2021 ].

12 Mitchell SK , McCarthy R , Rudloff E , Pernell RT . Tracheal rupture associated with intubation in cats . Journal of the American Veterinary Medical Association . 2000 ; 216 ( 10 ): 1592 – 1595 . Available from : https :// pubmed . ncbi . nlm . nih . gov / 10825947 / [ Accessed 7 November 2020 ].

13 Brodbelt D . Feline anesthetic deaths in veterinary practice . Topics in Companion Animal Medicine . 2010 ; 25 ( 4 ): 189 – 194 . Available from : https :// www . sciencedirect . com / science / article / pii / S1938973610000723 [ Accessed 9 January 2021 ].

14 Crotaz IR . Initial feasibility investigation of the v-gel airway : an anatomically designed supraglottic airway device for use in companion animal veterinary anaesthesia . Veterinary Anaesthesia and Analgesia . 2010 ;( 37 ): 579 – 580 . Available from : https :// pubmed . ncbi . nlm . nih . gov / 21040382 / [ Accessed 9 January 2021 ].

15 O ' Dwyer L , Slade L , Pickup S . Safe delivery of anaesthetic agents in cats and rabbits . The Veterinary Nurse . 2013 ; 4 ( 7 ): 422 – 428 . Available from : https :// www . magonlinelibrary . com / doi / abs / 10.12968 / vetn . 2013.4.7.422 [ Accessed 9 January 2021 ].

16 Doyle E . Understanding tracheostomy tubes . The Veterinary Nurse . 2020 . Available from : https :// www . theveterinarynurse . com / review / article / understanding-tracheostomy-tubes [ 30 April 2021 ].

17 Hyndman P , Braym J . Temporary tracheostomy : a practical approach to the placement and management of a tracheostomy tube . Companion Animal . 2017 ; 22 ( 8 ): 471 – 479 . Available from : https :// www . magonlinelibrary . com / doi / abs / 10.12968 / coan . 2017.22.8.471 [ Accessed 30 April 2021 ].

18 RCVS . RCVS Position Paper on Evidence Based Veterinary Medicine ( EBVM ). Royal College of Veterinary Surgeons . 2013 . Available from : https :// knowledge . rcvs . org . uk / document-library / rcvs-position-on-ebvm / [ Accessed 30 April 2021 ].

19 RCVS Legislative Reform Consultation extended to April 2021 . Royal College of Veterinary Surgeons . 2021 . Available from : https :// www . rcvs . org . uk / news-andviews / news / legislative-reform-consultation-extended-toapril-2021 / [ Accessed 30 April 2021 ].

Need to make notes ?

We ’ re trialling an easier-to-navigate layout . Instead of having space for professional development notes at the end of articles , we ’ ve set aside a couple of pages at the end of the journal . Like it or loathe it ? Please let us know via vnj @ bvna . co . uk .

Volume 38 ( 1 ) • February 2023

39