V-gel rabbits

Re: V-gel rabbits

Julie Innes — Sat, 23 Nov 2013 19:25:47 GMT

I've been toying with the idea for a while, and a client recently gave us a donation of £100, so sod it, I'm going to try it!

Mind you, just been to London Vet Show and now have a shopping/ wish list a mile long!!

Re: V-gel rabbits

Evelyn Barbour-Hill — Sat, 23 Nov 2013 19:07:08 GMT

[quote user="bob lehner"]Yes - I did point out to the Millpledge lady that I thought that a Chinese factory could probably produce these things for a few pence each....!

[/quote]

Probably make them out of dead babies.

Re: V-gel rabbits

bob lehner — Sat, 23 Nov 2013 07:20:11 GMT

Yes - I did point out to the Millpledge lady that I thought that a Chinese factory could probably produce these things for a few pence each....!

Re: V-gel rabbits

Michael Woodhouse — Sat, 23 Nov 2013 00:10:55 GMT

£7.95 for the human ones!

http://boundtree.co.uk/i-gel-supraglottic-airway

Then there's 6 different sizes available for rabbits, and then cat sizes too!

I'll wait until the price gets more reasonable!

Re: V-gel rabbits

bob lehner — Fri, 22 Nov 2013 22:56:52 GMT

[quote user="GrooveJet"]

Does anyone know how much they actually cost to buy?

[/quote] Just had a tutorial from a VN on the Millpledge stand at the L VS - they cost £120 each. You can use c. 40 times - so £3 a go. She told me many practices using them have increased their rabbit GA fee by this amount - but tell owners of the improved GA safety (at least compared to un-intubated rabbits - which is the case in many practices). Obviously she was trying to sell the V-gel - but made the point that a v small bunny with an e t tube in place has a vv narrow effective airway as compared to when a V-gel is used. Also said they were developed by a human anaesthetist and now widely used in hospitals - vet ones are a spin-off from the human ones.

Re: V-gel rabbits

Marie Kubiak — Fri, 22 Nov 2013 17:28:35 GMT

[quote user="Martin Atkinson"]

Groovejet might think I'm clever but I have to say I've never got to grips with a laryngoscope in a rabbit. Presumably you use the endoscope just to depress the tongue and light up the way Marie?

[/quote]

I find a laryngoscope a pain too! Not enough hands and still not good visualisation.

I use a 2.7mm 0 degree rigid scope - slide the ET tube over the scope then advance the scope tip into the desensitised glottis till it sits in the proximal trachea and then just slide the tube over the scope and into the trachea. Like placing an IV catheter but even smoother!

I have had quite a few that despite having a 1-2hr starve period pre-GA have a mouth with food (or caecotrophs) lodged at the back but the beauty is that you see this, can retract the scope, swab the mouth clear and then repeat scoping and place the tube once all is out of the way. If doing it blind then it is missed and some of this material must be forced into the trachea.

Marie

Re: V-gel rabbits

Rob Loxley — Fri, 22 Nov 2013 17:25:59 GMT

[quote user="Martin Atkinson"]I have to say I've never got to grips with a laryngoscope in a rabbit[/quote]

Me neither - though I've not tried Paul Flecknell's blade. I do it blind, listening.

[quote user="Martin Atkinson"]Presumably you use the endoscope just to depress the tongue and light up the way Marie?[/quote]

Thread the tube over the rigid endoscope e.g. http://www.youtube.com/watch?v=NBWdeY8JkSc

Re: V-gel rabbits

Martin Atkinson — Fri, 22 Nov 2013 17:13:16 GMT

[quote user="Marie Kubiak"]I have to admit I place most rabbit ET tubes with a rigid endoscope (makes it massively easier [/quote] Groovejet might think I'm clever but I have to say I've never got to grips with a laryngoscope in a rabbit. Presumably you use the endoscope just to depress the tongue and light up the way Marie?

[quote user="Marie Kubiak"]I like the security of having a tube in and knowing it's not going to move. [/quote]+1

[quote user="Marie Kubiak"]I've seen three rabbits die elsewhere when foreign material was pushed into the trachea on blind intubation [/quote] Eek!! Fortunately its never happened to me - you've made me aware now so it will probably happen on the next one! Time to review that laryngoscope technique?

Re: V-gel rabbits

Marie Kubiak — Fri, 22 Nov 2013 17:02:21 GMT

Never felt the need to get it - I like the security of having a tube in and knowing it's not going to move. I have to admit I place most rabbit ET tubes with a rigid endoscope (makes it massively easier plus, more importantly, I know I'm not going to force any food or debris into the trachea as I can see exactly where I'm going). I've seen three rabbits die elsewhere when foreign material was pushed into the trachea on blind intubation and would have some concerns with the V-gel also trapping food material over the glottis but guess the risk would be less as it isn't actually entering the trachea and the mandatory capnography would give an early indication of obstruction.

Marie

Re: V-gel rabbits

Rob Loxley — Fri, 22 Nov 2013 16:55:43 GMT

[quote user="GrooveJet"]

Does anyone know how much they actually cost to buy?

[/quote]

Millpledge are now the UK distributor and are selling them individually without any of the faff that you had to go through originally

Re: V-gel rabbits

Miriam Lodewyks — Fri, 22 Nov 2013 16:23:14 GMT

Does anyone know how much they actually cost to buy?

Re: V-gel rabbits

Martin Atkinson — Fri, 22 Nov 2013 16:01:32 GMT

[quote user="David Mills"]There was a thread on here ages ago saying they can be sterilised (on advice from the manufacturer) at least 40-50 times. Worth every penny I'd say.[/quote] Having started reading this thread I decided to look at the V-gel video. I have to say that some of my preconceptions have been shed and I am considering them. Plus it did say on there that they can be autoclaved up to 38 times and there is a recording system on the pack. I don't think they will replace ET tubes for cats because of the risk of vomiting but considering how many rabbits we anaesthetise I wouldn't be throwing them away that often.

Re: V-gel rabbits

Thomas Johnson — Fri, 22 Nov 2013 15:59:03 GMT

[quote user="Martin Atkinson"]

I looked at the V-gel tubes and while they seem like a good idea, as they are disposable they seem like a very expensive solution to a problem that doesn't exist.

[/quote]

They can be autoclaved 40 times, each time you do you punch through one of the 40 small holes in its storage tray so you can keep track. And reading between the lines when the rep came to see us, it's your choice whether you autoclave them between every use, you don't with ET tubes...

Re: V-gel rabbits

David Mills — Fri, 22 Nov 2013 14:34:17 GMT

[quote user="Martin Atkinson"] as they are disposable they seem like a very expensive solution[/quote]

They may be disposable but the don't need disposing of - unless you dispose of all your (human) ET tubes that say 'one use'/'disposable' on them??

There was a thread on here ages ago saying they can be sterilised (on advice from the manufacturer) at least 40-50 times. Worth every penny I'd say.

Re: V-gel rabbits

Gillian Mostyn — Fri, 22 Nov 2013 10:23:49 GMT

[quote user="Martin Atkinson"] I would only give up after half a dozen failed attempts.[/quote]

I thought that

[quote user="Martin Atkinson"]they seem like a very expensive solution to a problem that doesn't exist. I have no problems inserting and maintaining and virtually zero complications [/quote]

eh?

Re: V-gel rabbits

Martin Atkinson — Fri, 22 Nov 2013 09:55:22 GMT

[quote user="CatherineThomas"]I've never seen it done in dorsal before. I have them in sternal and get the nurse to hold the head up vertically.[/quote]Sorry it must be my age - I mean't ventral i.e. sternal recumbancy - I'm not that clever! But I barely lift the head, the technique is to keep it horizontal and grovel on the floor so your ear is level with rabbit's head at the edge of the table. I pass a 2.5 or 3mm uncuffed tube over the tongue until I hear breathing sounds. Sometimes the tube goes into the trachea first time, if there is a gag reflex I squirt some lidocaine down the tube, withdraw, meanwhile place on Iso with mask if necessary, repeat procedure after about 30 seconds and 9 times out of 10 the tube goes in with no problem even in 1kg bunnies, 100% in bigger than 2 kg, I would only give up after half a dozen failed attempts.

Re: V-gel rabbits

CatherineThomas — Fri, 22 Nov 2013 07:16:09 GMT

[quote user="Martin Atkinson"]

[quote user="GrooveJet"]Well gosh Martin, aren't you a clever boy [/quote]Well this is an established fact I'm surprised you have taken so long to realise.

My technique for tubing rabbits is the listening through the tube one with the rabbit in dorsal recumbancy and my ear at bunny level. Works (nearly) every time, not so clever, just practice.

[/quote]

I've never seen it done in dorsal before. I have them in sternal and get the nurse to hold the head up vertically.

I bought a camera tripod with bendy legs for about £5 and we just use a bit of tape to tape the tubing to the top of it.

Re: V-gel rabbits

Martin Atkinson — Thu, 21 Nov 2013 18:28:20 GMT

[quote user="GrooveJet"]Well gosh Martin, aren't you a clever boy [/quote]Well this is an established fact I'm surprised you have taken so long to realise.

My technique for tubing rabbits is the listening through the tube one with the rabbit in dorsal recumbancy and my ear at bunny level. Works (nearly) every time, not so clever, just practice.

Re: V-gel rabbits

Miriam Lodewyks — Thu, 21 Nov 2013 17:15:59 GMT

Well gosh Martin, aren't you a clever boy

I've been trying to intubate rabbits for years, and still find it very frustrating at times, no matter how large the bunny is. I know some of my esteemed colleagues are very good at it, I've tried all sorts and just find it hard. Sadly the v-gels are prohibitively expensive, so haven't tried one yet, but it sure seems a lot easier than intubation to me...

Re: V-gel rabbits

Martin Atkinson — Thu, 21 Nov 2013 11:09:28 GMT

I looked at the V-gel tubes and while they seem like a good idea, as they are disposable they seem like a very expensive solution to a problem that doesn't exist. I have no problems inserting and maintaining and virtually zero complications (one in 38 years and that was a trainee nurse 20 years ago who repeatedly turned over a cat without disconnecting the adaptor) using Magill tubes or similar in anything that is tubeable down to 1 kg rabbits.

Re: V-gel rabbits

Thomas Johnson — Thu, 21 Nov 2013 09:04:51 GMT

[quote user="Chris Barker"]

Loving using the V gel in rabbits but does anyone use the D grip tube holder and if so how do you find it ?

[/quote]

We have the D grip and find it very useful, we also use it for cats anaesthetised in dorsal recumbancy (with V gels and ET tubes).

Re: V-gel rabbits

Mark Rowland — Thu, 21 Nov 2013 00:36:06 GMT

The v gels are great My nurses made a cardboard cutout of the holder that works a treat. What was the cost of that? Oh yes I remember, ZERO