C10000150 / invoice 10000

Reason: Cut / SkinAppointment Notes: Paws App Details:Booking Type: Consultation (1-2 ailments)Booking Vet: - Any -Booking Notes: cut skinHistory:Presented to AREC overnight for laceration on L cheek. O tried to cut matted fur and cut the skin.BAR, EDDU normal, no VCDSFasted overnight Medications: Given antibiotics at AREC last nightExamine:Wound: 3cm laceration with a skin flap, healthy vital skinChest NAD MM pink & moist, abdo palp NAD, normothermic, PLNs WNLAssessment:Fit for sedationTreatment:Sedation: 0.35ml dom 0.35ml torbDepth: goodWound flushed with saline. Lidocaine 1.5mls instilled around wound. Wound surface debrided with scalpel blade.Subcutaneous layer closed using 2-0 PDS. Skin closed using 2-0 nylon - 2x cruciates, 1x simple interrupted.Post op meds:Atipam 0.35 mls IMNaloxone 2ml IV given to better observe if sedation was due to torb or due to lignocaine, see below:** Nurse mistakenly flushed the sedation through w 1-1.5ml of lignocaine drawn up for local. Bradycardia observed in sedation, 40bpm, likely attributeable to medetomidine, recovered well and uneventfully after atipam and naloxone given. Incident explained to O, unlikely to see any adverse effects as dose is within safe range (1.5ml = 30mg, pt is 35kg, this is under 1mg/kg which is routinely given as a loading dose for analgesia CRIs) Plan:Routine dischargeStitches out in 2 weeksTake home meds: meloxicam 2.3mls PO SID x 3 days; finish amoxyclav course per AREC    Vital Signs