Five VM 568 Animal Restraint and Orientation objectives:
VM 568
Animal Handling &
Orientation
1. Introduce the VTH and VCS clinical faculty and staff
2. Training in safe handling and restraint in the clinical
environment
3. Start clinical skill training:
2013 Introduction
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•
•
John Gay, DVM PhD DACVPM
2005 ADBF
AAHP Field Disease Investigation Unit
Veterinary Clinical Sciences
Diagnostic process
Physical exam procedures
Basic treatment procedures
4. Introduce broader aspects of clinical practice
5. Begin engagement with intended career path information and resources
http://www.veehof.co.nz/
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Philosophy is that of Professional Continuing Education
All VM 568 Animal Restraint and Orientation details are on‐line
• Grading
VM 568 Website ‐ key
– Pass/Fail, no ranking
– Show up and complete the labs, you pass
http://courses.vetmed.wsu.edu/vm568/
• Syllabus
• Course objectives and official policies
• Goal is "comfortable competence"
• Class Notes, Resources, & Websites
– Judged by lab faculty and staff
– If you feel you need more “hands on” time, ask the lab instructors how to arrange it
– Students not reaching goal by semester’s end can receive an Incomplete
• Links to required readings & additional information
• Lecture & Lab Schedule
• Lecture & lab reading assignments
• Lab equipment and attire
• Directions to locations
• Based on clinician and VTH Section schedules
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– Will change so please check it!
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Safe animal handling and restraint in the clinical environment is unique
Clinical Environment is full of:
• Unfamiliar Surroundings
• Unfamiliar Smells
• Unfamiliar Noises
• Unfamiliar Animals
• Unfamiliar People
• Unfamiliar Procedures
Understand what critters are telling you
Safety for all parties:
• The animal being handled
• Other animals
• Others involved
• Bystanders •
You
Trigger Aggression & Fear Responses!
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Learn to recognize risky situations!
Could this behavior be predicted?
Behavior types:
• Protection of young
• Aggression
• Fear
• Socialization
Each species has:
• Characteristic reactions
• Clues of impending actions
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Know how to avoid the bad “wrecks” involving animals and animal handling
Know the bad "Wrecks“ for each species:
• What they are
• Why they happen
• What can result
• How to prevent
• Prepared for when they happen (to somebody else)
Know how to apply rope restraint correctly and efficiently
Constantly using ropes! Hard tied horse wreck happening
http://www2.ca.uky.edu/gluck/q_jul06.asp#Skull
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Prepare for clients with no restraint facilities
Veterinarians are expected to handle animals in unusual situations and emergencies
"Doc, we called you because he’s lame"
http://www.travelblog.org/Photos/2331214.html
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Note size of those horns
Do you see any restraint facilities anywhere?
Remember: CVM restraint facilities are better than those of many of your future clients!
http://www.naturalhorsetrim.com/Trailer_esape.htm
Trailer wrecks
http://www.dailymail.co.uk/news/article-2016923/
Trapped animals
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Know the common animal restraint devices and how to apply them properly
Learn to tie restraint knots quickly and correctly!
Practice, Practice, Practice
• Know how to tie each
– Know how to keep from loosing fingers or limbs!
• Know why and when to use each
– Nonslip but quick release
– Prevent choke
– Prevent Wrecks
Clients will spot when it’s on backwards!
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Practice useful knots until you can tie them while talking without looking! (automaticity)
Ex: Clove Hitches on Stocks
Quick Release Versions!
Practice!
Practice!
Practice!
You will soon use clove hitches in:
LA Anatomy Stocks, Equine Clinic Stocks
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Even little horses can kick harder than you ever want to be kicked
Know how not to be stupid in the clinics
Clinical handling phases:
• Approach in a stall or cage
• Halter
• Move
• Perform procedure
• Hold for others
• Return to stall or cage
• Release
• Not transmitting disease!
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Lack of respect for animal’s natural instincts can bring disaster!
Develop excellent personal biosafety habits to avoid transmitting infectious agents!
• ~1,400 communicable infectious agents infect humans
• 2/3's are zoonotic
Social obligation of all veterinarians to be alert for these circumstances
– transmitted between man and animal
• Examples of big ones for reading about:
– Salmonellosis
– MRSA (Staph. aureus)
– Cryptosporidiosis
Little girl putting name tags on horse's body
Very dangerous even with the gentlest horse! 20
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Due to the infectious disease "Iceberg,“ most infected animals cannot be detected visually!
Most important is cleaning hands frequently and effectively
• Most infections are subclinical • Typically > 10:1
• Can't identify every infected animal without lab testing
• Important because some animals are more susceptible than normal
To wash hands:
• Wet hands (avoid HOT water –
dries skin ‐> cracking)
• Apply soap
• Rub hands together for at least 15 seconds
• Cover all hand surfaces • Rinse with water and dry thoroughly
– Neonates
– Animals with other diseases
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• Use a paper towel to turn off faucet
Goal: Handle all animals as if they are subclinically infected
When hands are not visibly soiled, alcohol‐based rubs are more effective than soap and water
Segue – Buddy, the family dog
Bacterial Reduction
Time After Application
% log
99.9 3.0
99.0 2.0
90.0 1.0
Alcohol-based
handrub
(62% ethanol)
Antimicrobial soap
(4% Chlorhexidine)
0.0 0.0
0
60
180 Plain soap
log minutes
Packed for college
Adapted from: Hosp Epidemiol Infect Control, 2nd ed., 1999.
Apply full pump stroke, rub until dry
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Groups with effective hand sanitation programs had 50% as many respiratory and gi episodes as others!
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Flossing
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VM 568 Animal Restraint and Orientation starts the progression of “hands‐on“ clinical medicine
DVM
Practice recognizing the “normal”
4th Year Clinic Rotations
• You can't see the abnormal unless you know the normal
• Important diagnostic signs (clues) are often subtle
Advanced Procedures
Basic Clinical Procedures
– If they weren’t, clients would need us much less
Basic Physical Exam – Visual, TPR
Initial Restraint – Tying, Stocks
Initial Control – Haltering, Leashing
First Year
Approach & Contact – Kennel, Stall, Pen
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Learn a systematic approach to visual appraisal
For cattle, start practicing the bovine “RUMBA” visual appraisal
Routine
Start
Remember:
More is missed from not looking than from not knowing!
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See wrong anything here?
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Learn normal and abnormal appearances
Sick!
Feces
Routine End
RUMBA
Rumen – Uterus – Mastitis – Bronchial tree ‐ Abomasum
Learn normal and abnormal postures and gaits
Abnormal
Normal
Normal
Why? Her hind feet hurt
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Begin integrating “‐ologies” into clinical context now
4th Year Clinics
Integrate all into
Clinical
Diagnosis and
Treatment
Normal Function
• Anatomy
• Immunology
• Neurology
• Nutrition
• Physiology
1st Year
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Abnormal Function
• Bacteriology
• Clinical Pathology
• Parasitology
• Systemic Pathology
• Toxicology
• Virology
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•
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Professional curriculum is a marathon, not the hurdles
• First year medical students are said to double their vocabulary
Diagnosis &
Correction
Anesthesia
Clinical Nutrition
Medicine
Pharmacology
Radiology
Surgery
• Goal is building a deep understanding
• Don’t only use course notes!
• Read the relevant textbooks, dictionary in hand!
• Goals are automaticity and explanatory depth (non‐IOED)
3rd Year
• Don’t rely on looking it up!
2nd Year
Use evidence‐based practices to optimize your learning • Ericsson (2008). Deliberate Practice and Acquisition of Expert Performance: A general overview
• Dunlosky et al. (2013). Improving Student's Learning with Effective Learning Techniques: Promising directions from cognitive and educational psychology.
Maximize your learning by recording and critiquing your activities
• Seek to integrate coursework and clinic case problem solving
– Identify cases in rounds, clinic walk‐throughs, and clinic and WADDL records
– Review notes to improve retention
– Taking notes improves recall, even if never read again
• Maintain a clinical activities log (paper or electronic, images):
– Case signs, history, exam results, differentials, procedures, disposition
– Keep descriptions and tallies for group work
• Bjork et al. (2013). Self‐Regulated Learning: Beliefs, techniques, and illusions
• Preg checks, vaccinations, foot trimming
– Self‐assess on each log entry:
• Organizing Instruction and Study to Improve Student Learning (recommended by DT Willingham) http://ies.ed.gov/ncee/wwc/PracticeGuide.aspx?sid=1
• Identify what you learned
• Identify what you need to learn or practice further
The faintest pencil is stronger than the stongest mind!
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Begin learning on your own now about diseases and problems that interest you
Veterinary Clinics of North America are an excellent clinically‐oriented review series
Each issue has ~10-15 review papers by
invited authors focused on a theme
Google “Veterinary
Clinics of North America”
6 issues per yr
Google “Cornell Consultant”
http://www.vet.cornell.edu/consultant/consult.asp
3 issues per yr
http://www.merckvetmanual.com/mvm/index.jsp
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Make a habit of spending routine time every day reading up on something interesting that you’ve run across
Available on‐line through WSU Libraries!
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Actively pursue “practice readiness” in key skills
Fowler’s 3rd edition is the best single restraint textbook
• Insufficient hours to achieve in curriculum alone!
• Identify those skills that will make you most “practice ready” in your career pathway
Murray E. Fowler
• Restraint and Handling of Wild and Domestic Animals, 3rd ed (2008)
– Prioritized lists in under “Expected New Graduate Competencies” in VM 568 Notes & Resources
• Deliberately practice high priority ones
– Achieving entry level competency requires ~40 hours of deliberate practice for each key skill set
– To understand, read “Deliberate Practice and Acquisition of Expert Performance,” Ericsson KA (2008) Acad Emerg
Med, 15(11):988‐994.
http://onlinelibrary.wiley.com/doi/10.1111/j.1553-2712.2008.00227.x/pdf
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Remember: “Core” is the lowest common denominator!
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