Date:

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Anaesthesia & recovery record Sheet no.:

Name: History: Temperament: ASA classification

Owner: HR: RR:

I No organic disease
Patient ID: Pulse quality: II Mild systemic disease

Species: Clinical findings/results/medications: MM: CRT: Severe systemic disease

III
(not incapacitating)
Breed: Thoracic auscultation:
Severe disease
IV
(constant threat to life)
Age: Sex:
Moribund
V
Weight: (life expectancy < 24 h)
Add ‘E’ for emergencies
Anaesthetist:
ASA Grade:
Clinician: Temperature: °C
Procedure(s): Anticipated problems:

Pre-GA medication Dose Route Time Induction agent(s) Dose Route Time
Anaesthetic
…………………………………………. ……………….. ……….. ………... ……………………………………….… ……………….. ………... ………...
Safety
……………………………………….… ……………….. ……….. ………... ……………………………………….… ……………….. ……….. ………...
Checklist
……………………………………….… ……………….. ……….. ………... ……………………………………….… ……………….. ……….. ………...
completed
……………………………………….… ……………….. ……….. ………... IV catheter Position: Size:

ET tube / LMA / Mask Size: Eye(s) Breathing Patient position:

Cuffed / Uncuffed lubricated system: Patient warming:

Anaesthesia monitoring record overleaf

Recovery concerns & instructions:

Temperature: °C

Extubation time:

IV catheter Remove once recovered Post-op fluid

care Maintain & flush therapy

Monitoring during recovery

Post-op
T+0 T+15 T+30 T+45
analgesia
Time

Heart rate
Other
post-op Resp. rate
care MM & CRT

Temp.
Relevant information transferred to kennel sheet / patient
Pain score
record
Other
 Time Start procedure: Finish procedure:

Notes Throat pack Placed Removed

Total ……………..………ml Dog

10% 85ml/kg
……………..………ml

20% ……………..………ml Cat / Rabbit

Blood volume
30% ……………..………ml
55ml/kg

Notes

Key 240
230
HR ● 220
RR o 210
200
IPPV ø 190
SAP 180
˅
170
MAP – 160
150
DAP ˄
140
Doppler 130
120
Palpebral reflex
110
Jaw tone 100
90
- / + / ++ / +++ 80
70
Eye position 60
↓/→ 50
40
30
20
10

Iso / Sevo %

O2 / N2O / Air L/min

Palpebral reflex Swabs Sharps

Eye position In Out In Out

Jaw tone

Pulse quality

ETCO2 kPa/mmHg

SpO2 %

Temperature °C