Optimizing Anesthetic Outcomes with VETgirl Anesthesia Resource Bundle

September 2025
In this VETgirl online veterinary continuing education blog, Amanda M. Shelby, RVT, VTS (Anesthesia & Analgesia) walks us through how to use this valuable VETgirl Anesthesia Resource Bundle: the Anesthesia Checklist, Anesthetic SOAP Worksheet, and the Anesthetic Monitoring Chart. Download and start using them today to reduce errors, improve patient outcomes and team communication, all while elevating your confidence performing anesthesia!

By Amanda M. Shelby, RVT, VTS (Anesthesia & Analgesia), Senior CE Specialist, VETgirl

Anesthesia is a process, one with risks that can often be mitigated or at least minimized when best practices are used (i.e., checklists, performing thorough pre-anesthetic assessments, utilizing planning worksheets, and appropriately documented anesthetic medical records). While designing these is no easy task, at VETgirl, we strive to provide resources that elevate the level of care to pets, upholding established best practice standards while maintaining flexibility in function for the wide range of veterinary practices, and professionals we serve. This VETgirl Anesthesia Resource Bundle sets the course for minimizing human error in the peri-anesthetic period while maximizing patient outcome through a systematic approach to every sedation or anesthetic procedure.

Reducing Peri-Anesthetic Errors with the Anesthesia Checklist

Utilizing perioperative checklists has shown a significant reduction in morbidity and mortality in human and veterinary medicine.^(1-3)Use of checklists in the veterinary space has reduced medical-related errors (e.g. performing surgery on the wrong limb, administration [or lack of administration] of the wrong drug, dose or route of administration), reduced equipment malfunction or failures, incidence of anesthetic-related complications while improving communication among the veterinary care team, improving the timely administration of intraoperative antibiotics, and decreasing unexpected return to the OR.^{(2, 3)}Most preventable anesthetic incidents are the result of human error, which can be largely eliminated with the implementation of a checklist!^{(2, 4)}

Let’s walk through some of the important points of the checklist page:

Pre-Procedural, Anesthetic and Monitoring Equipment Checklist sections are to be performed before any medications are administered in-hospital to the patient. These sections focus on ensuring the correct procedure will be performed on the correct patient. It ensures appropriate informed consents and deposits are collected. It ensures the pet has been fasted according to the veterinarian’s specifications and any pre-hospital or current medications have been administered as prescribed before sedation or anesthesia.

Curious what the most recent recommendations for pre-anesthetic fasting and medication withholding are? Check out AAHA’s current pre-anesthetic fasting guidelines HERE and take a look at page 4 for the chronic medications to withhold the day of anesthesia HERE.⁽⁵⁾

Finally, it ensures all required equipment is available, in working order, and ready for use before the patient is sedated or anesthetized. The patient recovery area should also be prepared prior to patient induction. This minimizes the anesthetist abandoning that patient’s side during anesthesia. The remaining Post-Procedural Checklist items are completed during the period the patient is returning to normalcy under the supervision of the recovering team member.

Enhancing the Anesthetic Experience Using the Anesthetic Worksheet

Implementation of medical quality standards improves patient outcomes.⁽⁶⁾ The VETgirl Anesthetic Worksheet is designed to assist the veterinary care team in systematically considering each individualized patient from presentation throughout the anesthetic period. The design is intended to be comprehensive and adaptable to a variety of veterinary practices. Completion of the worksheet will enhance communication between the veterinarian and anesthetist regarding establishment of a balanced anesthetic plan with appropriate multimodal analgesia, reviewing patient comorbidities, and for the potential of intraprocedural complications with tailored therapy responses.

While not technically part of the medical record, like our VETgirl Anesthetic Monitoring Chart, this worksheet allows the whole anesthetic event to be systematically approached, the patient to be individualized, and documents the veterinary care team’s efforts in reducing morbidity and mortality through organized preparation and planning.

Let’s walk through the Anesthetic Worksheet together!

Organized in the familiar SOAP (signalment, objective, assessment, and planning) format, the form allows the veterinary care team to identify patient specifics. The signalment and Objective sections collect the minimum relevant patient information for anesthetic case management. Due to space limitations of the entry fields, end-users commonly elect to only list abnormal blood work and examination findings. Variables that are deemed priority (heart rate [HR], respiratory rate [RR], temperature, fear, anxiety and stress [FAS]/temperament, pain score, blood pressure [BP], PCV, TP) provide unique fields for completion. Within the Assessment section, fields are provided to note current medications, identified co-morbidities as they relate to impacting the peri-anesthetic period, and anticipated complications or concerns. Based on this information, the American Society of Anesthesiologists (ASA) physical status classification can be assigned.

The Plan section allows the veterinary care team to outline desired peri-anesthetic monitoring and equipment to be used. Also included are calculation worksheets for developing the anesthetic and analgesic plan, including inclusion of local blocks, constant rate infusions, and emergency/reversal drugs. This section also has a dedicated recovery planning area to emphasize that the anesthetic process continues past the point of extubation. Systematic completion of this worksheet enhances case management collaboration and communication of the whole veterinary care team involved in the patient’s procedure.

Meeting Medical Charting Needs with the Anesthetic Monitoring Chart

The VETgirl Anesthetic Monitoring Chart is designed as a graphical anesthetic recording document. It serves as the legal record documenting the anesthetic procedure, patient vital parameters, and medications or actions performed during the procedure. Additionally, the document provides cross-reference documentation of drug administration, especially helpful for controlled drugs. However, this document does not replace the need for maintaining controlled drug logs per federal and state laws. It begins with priority patient and client information, veterinary care team members identification (e.g., veterinarian, veterinary technician), and procedural information. A dedicated pre-anesthetic examination field encourages the anesthetist to complete a TPR and pain score assessment before administration of medications. Dedicated premedication and induction fields encourage good medical record-keeping practices, which include identification of the drug name (not only the trade name), dose, volume, and route of administration delivered. The graphical section provides an opportunity to write unique time entries with the bold vertical lines designed to denote 15-minute time intervals and each lighter vertical line representing five-minute intervals. The vitals outlined mirror efforts to meet the current minimal recommendations from The American College of Veterinary Anesthesia and Analgesic Small Animal Anesthes ia and Sedation Monitoring Guidelines 2025.⁽⁸⁾ A vital sign symbol key is offered at the bottom of the page with the ability for the end-user to write in additional symbols for less routinely monitored vitals.

Space is always a limiting factor in balancing thorough recording keeping on the anesthetic record. To account for these limitations, we provided a generous field called perianesthetic notes/events where the anesthetist is encouraged to chronologically write intraoperative observations and drug administrations. For example, when a heat source is started, the anesthetist could write: “1. Heat source started.” A #1 could then be placed at the corresponding time on the graphical charting area, or a time stamp could be recorded next to the perianesthetic notes/events. Check out our completed example below. The importance is to document every action and observation accurately and concisely on the anesthetic record.

Clinical example of the Anesthetic Monitoring Chart

Utilizing the VETgirl Anesthetic Bundle can help improve team communication and reduce medical-related errors while fulfilling the legal record-keeping needs during an anesthetic procedure. As with any process, team buy-in enhances implementation. We hope you find the resources adaptable to your practice’s needs and helpful in elevating team communication and patient care during the peri-anesthetic process!

Abbreviations:
ASA American Society of Anesthesiologists
BP blood pressure
E emergency
FAS fear, anxiety and stress
GDV gastric dilation volvulus
HR heart rate
OHE ovariohysterectomy
PCV packed cell volume
RR respiratory rate
SOAP subjective, objective, assessment, plan
TP total protein

References:

Fudickar A, Hörle K, Wiltfang J, et al. The effect of the WHO Surgical Safety Checklist on complication rate and communication. Deutsches Ärzteblatt International. 2012;109(42):695.
Love L, Graham L, Love K. The Use of a Checklist Reduces Errors in Equipment Set-up by Veterinary Student Anesthetists. VAA. 2025.
Thieman Mankin KM, Jeffery ND, Kerwin SC. The impact of a surgical checklist on surgical outcomes in an academic institution. Vet Surg. 2021;50(4):848-57.
Cooper JB, Newbower RS, Long CD, et al. Preventable anesthesia mishaps: a study of human factors. BMJ Quality & Safety. 2002;11(3):277-82.
Grubb T, Sager J, Gaynor JS, et al. 2020 AAHA anesthesia and monitoring guidelines for dogs and cats. JAAHA. 2020;56(2):59-82.
Morrison JA, Spofford N, Yang M, et al. Development and implementation of veterinary anesthesia medical quality standards for primary care. VAA. 2022;49(3):233-42.

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Optimizing Anesthetic Outcomes with VETgirl Anesthesia Resource Bundle