This document provides guidance to veterinarians on anaesthetic monitoring.
It is not possible to define a single standard in this area because of the large number of variables. As such, this document sets out an overarching principle with advice on how this applies in different scenarios. The application of the overarching principle always needs to be applied to the differing circumstances of each case.
All anaesthetised animals must be continuously attended by a person who is able to:
- Immediately identify chances in the physiological status of the animal, that are associated with the anaesthetic or the procedure
- Alter the way the animal is being managed in order to sustain it and achieve the best possible outcome in the circumstances.
This requirement extends through the period of recovery from the anaesthetic until the animal is sufficiently conscious and its condition is sufficiently stable that continuous nursing support is not required.
General anaesthesia carries inherent risks and can lead to potentially serious treatment outcomes or death.
An animal’s depth of anaesthesia can change quickly, sometimes in response to surgical stimulus. Cardiovascular and respiratory systems can fail in response to injury, disease or anaesthetic drugs.
Anaesthetic machines can also fail or run out of oxygen.
A safe anaesthetic requires someone who can take steps to prevent problems and diagnose and treat problems immediately.
While the veterinarian doing the surgery should be able to anticipate and prevent problems, particularly if a multifunction monitor is used, s/he is not able to physically response to problems without compromising sterility.
Therefore, another person must be able to act immediately when required and, in the absence of a multifunction monitor, be checking the animal’s status, at a frequency appropriate for that animal and the circumstances.
It is strongly recommended that anaesthetic monitoring records are kept. The monitoring parameters to be assessed and recorded should ideally include heart rate, respiratory rate, temperature, eye position, mucous membrane colour, blood pressure, oxygen saturation and medicine/anaesthetic given.
It is also strongly recommended that the person performing the anaesthetic monitoring is appropriately trained (i.e. either a veterinarian or an trained and experienced veterinary nurse).
In some situations, it may not be necessary for the person monitoring the animal to remain continuously at the animal’s side if they are available to respond immediately if required. For example, where the animal is healthy, the anaesthetic is stable, technological monitoring devices are used, the surgery is routine and low risk and/or where the anaesthetic is no prolonged. Veterinarians are expected to use their professional judgment in deciding whether safe anaesthesia can be maintained without the constant presence of someone to monitor the animals.
An additional person to the veterinarian performing the procedure is desirable but not always essential. If an additional person is not present, the veterinarian needs to be able to monitor the animal’s status and quickly implement any required changes to its management.
If a dedicated person is not available, the veterinarian must use their professional judgment in balancing the risks involved in delaying the surgery against the risks involved in anaesthetising an unstable animal. The overarching consideration should be the best welfare outcome for the animal.
The informed consent of the person in charge of the animal should be obtained and documented.
While this guidance applies to all animals undergoing general anaesthesia, the Council recognises that there will be some situations, particularly in production animal surgery, where the veterinarian does not have access to a dedicated person to monitor the animal or is constrained by the budget of the person in charge of the animal concerned.
In such circumstances, the veterinarian should:
- Use their professional judgment in deciding whether to proceed with the surgery, bearing in mind their overarching professional obligation to protect and promote animal welfare and alleviate unnecessary pain and distress
- Obtain and document the informed consent of the person in charge of the animal.
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