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Speaking of valuable resources, remember to save the date on January 27, 2013, for our annual day-long CE event, “Cabin Fever.” We are planning a full day of technician CE for you, to include a total of six technician CE credit hours. Dog and cat bites are the most common risk we face in our practices because we handle painful and frightened animals every day. Because of their smooth teeth and strong jaws, dogs inflict injury primarily by crushing and tearing tissues below the skin, such as muscle, tendons and nerves. Should you be bitten by a dog or cat, you should wash the wound as soon as possible with soap and water.
There are currently no Occupational Safety and Health Administration (OSHA) policies regulating noise levels in dog kennels. Consider redesigning the facility to include noise cancelling construction materials and a floor plan that minimizes the propensity for dogs to bark. If you have ever gone to a rock concert or been exposed to a brief close loud noise such as a firecracker, you likely have experienced a period of ringing in your ears or a temporary hearing loss. You can’t say it has never happened to you or that you have never seen it happen to someone else. Note: The presence of a pop-off occlusion valve does not preclude the recommendations that the anesthesia machine be thoroughly checked before each use and that an individual be dedicated to monitoring the patient and the machine during the anesthetic procedure. Most glucometers use test strips that are designed to draw up a defined volume of blood by capillary action.
The AlphaTRAK (R) glucometer can also be used by pet owners to monitor their pet’s diabetes treatment at home.
A 2007 JAAHA study on catheter placement in dogs and cats demonstrated that one out of four intravenous catheters became colonized with harmful bacteria. What matters most are the precautions taken to protect the patient when the catheter is placed.
Shave a large region of hair around the venipuncture site, so that at no time will the catheter come in contact with the surrounding hair. Alternate scrubs of the venipuncture site three times with 2% chlorhexidine and 70% isopropyl alcohol. Wear gloves or thoroughly wash your hands with antibacterial soap for 2 minutes immediately prior to catheter insertion. Have you ever sent a patient home only to have the client call back asking if the IV catheter should be removed? We treat your pet as we treat our own pets, we treat you as we treat our family friends, and we treat your family veterinarians as our partner. OurScienceAs a part of our mission to provide the highest standard of care to patients, we participate in clinical trials to study the effectiveness of new drugs and treatments, which gives participating patients access to cutting-edge medicine not yet commercially available. The occupational exposure to anesthetic gasses is almost impossible to avoid in veterinary facilities where gas anesthesia is utilized.
Vaporizers can be fitted with adaptors that will minimize leakage of the anesthetic agent when being filled. The most common gas anesthetic agents used in the veterinary field include halothane, isoflurane and sevoflurane.
The risks associated with exposure to general gas anesthetics, especially the newer agents, have not been well studied.
The most common complaints from individuals exposed to anesthetic gases include transient nausea, dizziness, headaches, fatigue and irritability. Fill the vaporizer in a well ventilated area using one of the appropriate specialized spouts (integrated fused filling adaptor) produced for this purpose.
The vaporizer should be turned on only when the anesthetic circuit is connected to the patient. Use an appropriately sized endotracheal tube and make certain the cuff is adequately inflated. If using a mask, make certain it fits the patient’s face well to minimize gas leakage.  Minimize the time a mask is used, as they all leak.
Once the anesthetic procedure is complete, turn off the vaporizer and allow oxygen to continue to flow through the anesthetic circuit to flush anesthetic gases into the scavenging circuit before unhooking the patient. Note:  Because commonly used gas anesthetic agents do not have a strong odor at low concentrations, the absence of an odor does not mean you are not being exposed. Small volumes of liquid anesthetic agents will frequently evaporate before you have had the opportunity to attempt a clean-up.
Pop-off occlusion valves can be purchased from Webster Veterinary and other distributors.  Don’t risk your patient’s life again.
It’s impossible not to be exposed to radiation.  After all, radiation comes from the sun, from your computer monitor, from the fluorescent lights above you, from the ground below you (radon), and from the cell phone you hold against your ear. There is no way to know how much radiation you are being exposed to if you don’t wear your dosimeter badge. Radiation can take the form of atom particles (electrons, neutrons) that have escaped their orbits or the form of energy-containing waves. The most likely source for significant radiation exposure in your practice is the x-ray unit.

You should wear a radiation dosimeter badge whenever you have the potential to be exposed to avoidable radiation, most notably when taking radiographs. Two types of radiation dosimeters are commonly used, film badges and thermoluminescent badges. The current federal occupational limit of radiation exposure per year for an adult is 5,000 millirems (mrem) beyond background and medical exposure. The highest recommended limit for radiation exposure is for astronauts (25,000 mrem per mission).
Bites to the face also occur due to our proximity to the patient’s mouth when we lift, carry or reach for the pet. By contrast, cats have sharp canine teeth that produce punctures into deeper tissue, introducing bacteria into these tissues and the blood stream. A mix of anaerobic and aerobic bacteria from the animal’s oral cavity is frequently identified. Despite giving the impression that you may lack compassion, use a muzzle or other means to protect yourself from all trauma presentations and patients with uncertain dispositions.
The microbial population in the mouth of dogs and cats includes the resident population as well as transient micro-organisms introduced from what the cat or dog most recently ate or licked. Studies have shown that the noise level in a kennel of barking dogs can exceed 118 decibels (dBs). The force of these pressure waves within the ear indirectly damage the hair cells which are responsible for converting sound energy into the electrical signals that travel to the brain. Irritability, high blood pressure, sleep loss, heart disease, and immune compromise have all been associated with exposure to high noise levels. The blood reacts with enzymes embedded in the test strip that induce a color change or an electric charge. The AlphaTRAK (R) glucometer produced by Abbott Animal Health is presently our glucometer of choice. Home monitoring provides data more reflective of glucose values, which occur in pets while they participate in their regular daily routine. There was no association between the risk of a positive bacterial culture and the following factors: type of catheter used, blood sampling through the catheter, type of IV fluids administered, duration the catheter was in place, catheter location, complications with the catheter, and final patient outcome. Gas can escape from the anesthesia machine itself due to poor, misaligned or loose fitting connections between its various components as well as from worn seals and gaskets. The Occupational Safety and Health Administration (OSHA) has not set permissible exposure limits regulating these agents. The available information comes from studies performed using animal models, as well as from surveys of individuals who routinely work with anesthetic gases. This means checking all connections, inspecting all the hoses for damage, making certain the gas scavenging system is operating and determining the ability of the circuit to maintain a constant pressure, i.e. The presence of an odor suggests that you are being exposed to higher concentrations of the agent. For small spills, the best solution may be to leave the room for a short period and ensure that the room is subsequently well ventilated.  For large spills, the recommendations noted on the material safety data sheet for the anesthetic agent should be followed. The force of these pressure waves within the ear indirectly damages the hair cells which are responsible for converting sound energy into the electrical signals that travel to the brain. It’s called a ‘pop-off occlusion valve’.  A relatively simple device, the valve is placed on the exhaust side of the anesthetic circuit typically next to the pop-off valve.
It travels through the environment ‘knocking into’ and possibly altering the atoms present in the molecules that make up the cells of your body (kind of like a bowling ball banging into bowling pins). Atoms (carbon, hydrogen, oxygen, etc.) are components of molecules (like enzymes) which in turn have structural or functional responsibilities within cells. Other devices used in the veterinary field capable of giving off high doses of radiation include CT units, radiation treatment devices, and radiation emitting products such as technetium and I131 used for imaging purposes or to treat cancers.
Plan ahead and minimize the number of radiographs you are taking by doing it right the first time. Stand outside the radiograph room, or at least as far away from the radiation beam as possible. Wear the appropriate gloves, gown, thyroid shield and even eyeglasses recommended for the type of radiation you are working with.
Radiation dosimeter badges detect the amount of radiation you have been exposed to during the period it was worn. The damage caused by radiation is cumulative, and so it is important that we limit how much we are exposed to.
Many other things in life also present a risk:  crossing the street, eating too much fat, climbing a ladder. Without the atmosphere to protect them, astronauts are exposed to high levels of cosmic radiation.
Because cat bites create only small skin punctures, it is difficult for these deeper wounds to drain. Pasteurella multocida is one of the most common bacteria isolated from both dog and cat bites.
You should constantly be reading the patient’s appearance for signs that he or she may bite.

Realizing that animals, especially dogs, will lick and chew most anything (dead animals, feces, etc.), it makes you second guess accepting their kisses.
It is believed to result when the metabolic pathways responsible for auditory function become fatigued from excessive stimulation.
Many human studies also have found no association between the length of time a catheter has been in place and the risk of catheter associated infection. But those are not the only dangers we face in our practices.  Let’s not forget the risks presented by radiation exposure, anesthetic exposure, needle sticks, falls and lifting injuries, bumped heads, splashing chemicals, possible infections, and even damage to our hearing from incessant barking (by the dogs and possibly your boss).
Anesthetic gas can also escape into the air from holes in the reservoir bag or the anesthetic tubing, a poorly fitted anesthetic bag, loose connections to the endotracheal tube or accessory devices such as a CO2 monitor, and from an inadequate inflation of the endotracheal tube cuff.
Their recommendation is merely to limit your exposure to anesthetic gas as much as possible.
These studies suggest that individuals exposed to gas anesthesia may be more likely to demonstrate reproductive problems such as abortions and difficulty conceiving children.  Exposure to gas anesthesia has not been strongly linked to developmental problems or a tendency for mutations.
Connect the chamber to the anesthetic gas scavenging system and evacuate the anesthetic gas prior to removing the patient by blowing oxygen alone (turn off the vaporizer) for a short period. This typically entails using an absorbent material to soak up the agent which should then be placed into a tight sealed container.
ALARA is an acronym for “as low as reasonably achievable.”  This is the principle recommended by the Nuclear Regulatory Commission for protecting yourself from radiation exposure. Damage to DNA or RNA molecules can result in the death of the cell or change how the cell operates or functions.
In many states, personnel are not allowed to be in the radiograph room when the radiograph is taken. A doubling of your distance from the radiation source will reduce your exposure to one-quarter of the dose.
By tracking the total amount of radiation you are being exposed to, steps can be taken to prevent overexposure. It is recommended that the lifetime exposure of someone working with radiation be limited to a person’s age multiplied by 1,000 mrem.
Less common, but of serious concern, would be the presence of methicillin-resistant Stapylococcus aureus, Bartonella henselae (the cause of cat scratch fever), and rabies virus. Don’t be afraid to ask for help with restraint of a patient even if you are not certain it is needed. Secondary infections from cat bites are very common, and can develop very quickly (within hours) into severe infections.
Both repeated exposure to short loud sound bursts and prolonged exposure to loud noises above 85 dBs can result in hearing loss or tinnitus (ringing in ears). The ability to hear typically returns within 12 to 48 hours after the exposure to the loud noise. Glucometers made for human use have been shown to be less accurate than the AlphaTRAK, (R) especially at lower blood glucose concentrations.
Poorly functioning waste gas scavenger systems,   poorly fitted face masks and leaking anesthetic chambers are also a source of exposure. Push down on the valve button and it occludes the escape of anesthetic gas similar to screwing closed the pop-off valve.
Thermoluminescent badges contain crystals which trap electrons freed by radiation exposure.
The maximum radiation exposure permitted for individuals under 18 years of age is 500 mrem beyond background and medical exposure.
And don’t be afraid to inform the clinician on duty that sedation may be needed to perform an exam or treatment.
This has been attributed to the higher plasma-to-red blood cell ratio of glucose molecules in dogs and cats compared to humans. And, let us not forget the anesthetic gas that is exhaled by the patient during recovery or the gas that escapes when we open the anesthetic chamber to retrieve the patient or when we fill the vaporizer with the liquid agent. Release the button and the valve springs back into the open position allowing exhaust gases to flow once again. Heating the badge releases these trapped electrons which creates light.  The amount of light released reflects the amount of radiation the badge was exposed to.
For pregnant woman, the maximum fetal exposure for the entire gestation period is 500 mrem to be accumulated at Iess than 55 mrem per month. A study comparing glucometers for use in 452 cats and dogs with and without diabetes mellitus found that glucose measurements from the AlphaTRAK (R) glucometer fell within 2% of Antech Diagnostics laboratory measurements when run on the same blood sample. After all, ask any veterinarian and they will tell you they don’t want their most valuable resource injured.

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