Legs under or legs over ??

RE: Legs under or legs over ??

molladog — Mon, 06 Feb 2017 15:36:19 GMT

Always legs under.

Has anyone else been tickled by this thread .... leg over anyone !

RE: Legs under or legs over ??

WelshyNurse — Mon, 06 Feb 2017 15:27:55 GMT

Over 10 years in practice, legs always under

RE: Legs under or legs over ??

Vicky Ford-Fennah — Mon, 06 Feb 2017 12:21:04 GMT

Hi Ellie,

Patients should be turned legs under, especially deep chested breeds to reduce the risk of inducing torsion (saying that I don't think there are actually been any studies looking into it!). More important than this though is that patients recumbent in one lateral should not be moved too quickly into the other lateral - pause in sternal for a couple of breaths and then complete the move. This will reduce the respirator/cardiovascular effect e.g. VQ mismatch. This is of extra importance if there is or any suspicion of pathology in the chest.

The other key thing to remember is that it is vitally important that the ET tube is not twisted in the airway and obviously this is a risk when turning a patient. Personally I either disconnect my patient completely from the breathing system (occluding the breathing system to prevent environmental contamination) or continually hold the tube and muzzled with one hand and support the breathing system with the other, disconnecting/ loosening if any twisting starts to occur whilst the patient is turned.

Best wishes

Vicky

RE: Legs under or legs over ??

Kirsty RVN — Sun, 05 Feb 2017 10:50:44 GMT

It's definitely always legs under. I have been in practice 16 years. Started my training 6 years ago and qualified two years and during my degree placements and went to a few I was always taught legs under. I locum now and again been to a few places and is still always been legs under

RE: Legs under or legs over ??

PJ Zurawel — Sat, 04 Feb 2017 20:10:45 GMT

Where I did my training I was never taught any difference between over or under but where I work now we try to go legs under where possible to avoid twisting the gut

RE: Legs under or legs over ??

Courtney Scales — Sat, 04 Feb 2017 10:38:30 GMT

As well as all of the above - I turn legs under as it is more natural position for the ET tube.

RE: Legs under or legs over ??

Laura Parker — Fri, 03 Feb 2017 17:34:32 GMT

Hi Ellie,

You are quite right to say you should turn the patient via legs under for dentals. All patients should always be turned legs under regardless of procedure and breed. Of course aspiration is very dangerous but I would hope that you always have a secure airway (e.t. tube cuff inflated and has been checked for leaks by 'sighing' the patient. The main risk is regurgitation of stomach contents whether this is food or stomach acid. This can cause a lot of damage to the oesophagus if not noticed and dealt with immediately. It can even lead to an oesophageal stricture.

So continue doing legs under at all times and ensure the safety of your patients.

Laura Parker RVN MBVNA

Member of the Association of Veterinary Anaesthetists

RE: Legs under or legs over ??

Yvette Boffey — Fri, 03 Feb 2017 17:14:16 GMT

I've been working in practice for nearly 14 years and I have always done legs under never over.

RE: Legs under or legs over ??

melanie lavender — Fri, 03 Feb 2017 15:24:05 GMT

I have been nursing since 2000.

I have always been taught legs over and have done this up until i changed practices in 2015 where they have a policy of legs under.

I have never had or known of a problem with doing it leg over and if so would carry on doing it.

As they say... Better the Devil you know!...

RE: Legs under or legs over ??

bumble bee — Fri, 03 Feb 2017 11:20:15 GMT

We go legs under. Agree for dentals but also deep chested dogs to avoid GDV. Dont have evidence to support this but it just seems logical.