Thursday, March 14, 2019

Snake Anesthesia before Surgery


Henry Cabrera, MD
You must be wondering why and how snakes are given anesthesia? Generally, what we’ve seen on Nat Geo, Austin Stevens – a veteran snake charmer approaches a snake swiftly from the rear and, barehanded (gloves make him clumsy), squeeze just behind the snake’s jawbone using his thumb and forefinger. Control the writhing body. And BOOM he gets a hold of it and extracts venom pinching softly and gently as if he is caressing it. 

Each snake charmer has its own quality but ever wondered what leads to a case when snakes need anesthesia? This is why I have formed a blog where I would discuss what quantities of anesthesia does a snake requires. So without further ado, let’s get into this.

Generally speaking, performing anesthesia and medical procedure on a snake ought to be drawn closer with indistinguishable standards from those utilized for domestic creatures. In any case, there is clear anatomic contemplation, just as unique parts (especially a snake) of patient readiness, situating, and equipment with which the reptile clinician should be familiar.

Reptiles make good anesthetic patients because of their physiologic resilience. In the simplest words, reptiles are very resilient and capable of surviving physiological changes. Furthermore, these species frequently undergo potentially painful surgical procedures.  New drugs that are not only safe and efficacious but also result in relatively short recovery times have greatly enhanced the design of anesthetic regimens. Further studies are required to quantitatively evaluate the physiologic effects of drugs used and validate available monitoring modalities for use in a wide variety of reptiles.

Wound Treatment 

Wounds, more often than not horribly tainted, are a successive introduction, and given the caseous idea of the reptilian incendiary reaction, careful debridement is frequently constantly essential. Sharp dissection is utilized to expel all follower necrotic and contaminated tissue that should then be submitted for histopathology and microbiology.

Surgical Procedures

Snake integument is composed of keratinized scales and thinner interscaler skin. Incisions should be made between the scales, thus making most surgical wounds scalloped. When reptile skin is incised, it has a tendency to invert. Therefore, everting suture patterns (eg, horizontal or vertical mattress) using polydioxanone or nylon are recommended to ensure opposition of tissue without future dysecdysis. Fine polydioxanone causes less reaction than polyglactin and is preferred for internal sutures. Skin sutures are typically removed after 6 to 8 weeks.

Whatever it takes, reptiles are a dangerous creature and not to be messed around. 


Wednesday, January 30, 2019

Enhancing Your Business Budget


Henry Cabrera, MD
Every successful business needs a budget

It’s a basic tenet of business – before you can make money you have to figure out how to spend it. Drafting a budget is a key way to help you turn your dreams for business success into reality. Using this vital tool, you can track cash on hand, business expenses, and how much revenue you need to keep your business growing – or at least afloat. By committing these numbers to paper, your chances of succeeding with your business are helped by anticipating future needs, spending, profits, and cash flow. It also may let you spot problems before they mushroom so that you can switch gears.

Purpose and perception– the purpose of healthcare professional education is to educate learners to a high standard and keep them up to date – not to make a profit. Hence, while budgeting is important, you should always remember that it is a means of achieving an end and not a goal in itself.

Get involved –The earlier that you get involved in budgetary planning, the more likely you will be able to influence outcomes. Planning will involve deciding upon strategic goals, reviewing options, and deciding upon the best one.

Thorough communication between teams –The budget must be able to capture this complexity and must be communicated to the team in a format that they will understand.

Adherence –If there is going to be an over- or under-spend of the budget, then the time to know about it is as soon as possible. A small over-spend on say simulation equipment in the first quarter may turn into a massive over-spend by the end of the financial year. Corrective action taken into the first quarter may well be effective; action taken in the last quarter is unlikely to have much effect. The difference between actual spend and planned spend is called the variance. 

Consider Cutting Costs in Non-traditional Areas

Salaries and benefits come from one side of the budget while capital expenditures come from another. But, it doesn’t have to be that way. When you consider where to find the money for the increase in health insurance, keep all options on the table. Do you need all the space you rent now? Could you save money by allowing staff members to telecommute? Could travel be replaced with video conferencing in most cases? Look at everything, keeping in mind that your people are the most important aspect of your business.

-Henry Cabrera Anesthesiologist