Schedule 3 and Veterinary Nursing

The Veterinary Surgeons Act 1966
1. 1991 Listed VN amendment
2. 2002 SVN amendment
"the priviledge of giving any medical treatment or carrying out minor surgery, not involving entry into a body cavity"
1. Administer medication
2. Wound closure
3. Skin mass removal & biopsies
4. Dental scaling and polishing
5. Treatment of abscesses
6. Treatment of aural haematomas
7. Placing iv medication
"Registered or Listed VNs under the direction of their VS employer to animals under their employer's care. The directing VS must be satisfied that the VN is qualified to carry out the medical treatment or minor surgery"
1. 'direction' means that the VS instructs the VN or SVN as to the tasks to be performed, but is not necc present
2. 'SVN under the direction of their VS employer to animals under their employer's care. In addition, medical treatment or minor surgery must be supervised by a VS or RVN/LVN and, in the case of minor surgery, the supervision must be direct, continuous and personal. The medical or minor surgery must be carried out in the course of the SVNs training
  1. 'Supervision' means that he VS is present on the premises and able to repsond to a request for assistance if needed
    1. 'Direct, continuous and personal supervision' means the VS or VN is present and giving the SVN undivided personal attention
  2. Locum SVN cannt perform Schedule 3
Aural haematoma surgery
1. Common causes
  1. Self-inflicted trauma
  2. Head shaking
  3. Scratching
  4. Rubbing ear against objects
2. External causes
  1. Poor ear conformations
  2. Immune mediated
  3. Food allergies
  4. Ear mites
  5. Hypersensitivities
  6. MUST TREAT UNDERLYING CAUSE!
3. Surgical technique
  1. Clip hair and surgically prepare skin
    1. Suture less technique: 1. Make elliptical incision in skin, curette and lavage. 2. Tape either side of wound and reflect pinna into over some padding on top of head. 3. Place absorbent dressing over top of incision for 3 weeks
  2. 1. Make a longitudinal, S-shaped incision
    1. 2. Remove blood and fibrin clot
      1. 3. Curette cavity
        4. Flush with sterile saline
  3. 2.0/3.0/4.0 nylon/polypropylene suture material & swaged on striaght cutting needle
    1. Place horizontal mattress suture (incl. all layers of pinna) in 2-5 rows parallel to incision
      1. Sutures tied on convex side
  4. Complications
    1. Irreversible cosmetic alterations (delay in tx/sutures too tight), recurrence (inadequate suture no's, underlying cause not tx)
    2. Pinna necrosis is blood supply diminised
4. Draining technique
  1. Draining haematoma with needle & syringe and instilling steroid
  2. Usually fills again
5. Permanent damage & pinna deformity
Skin mass removal & biopsies
1. Pre-excisional biopsy
  1. Cannot be excised simply
2. Post-excisional biopsy
  1. Simple excision without construction
3. Fine Needle Aspirate Biopsy
  1. Involves using needle & syringe, cells aspirated into needle hub, blown onto slide and smeared
    1. Performed without sed/GA
    2. 10-20ml syringe, 20-25G needle
  2. Clip & scrub skin, immobilise mass, insert needle and apply -ve pressure, redirect needle 2-5x, released plunger & removed needle
    1. Expel contents onto slide & smear
4. Core needle biopsy
  1. LA/sed required
  2. Obtains a cylinder of tissue from solid mass
5. Insional biopsy
  1. Removing slice of tissue
Abscess management
1. Diagnosis from FNAB
2. Pointing encouraged by warm compress
3. Lancing
  1. Stab incision, express pus, flush cavity until fluid clear, insert drain if necc
  2. Daily flushing, incision kept open to allow drainage

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