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Introduction: Use of mechanical ventilation during general anesthesia is a necessary practice in the anesthetization of small cetaceans as spontaneous ventilation fails to provide adequate gas exchange. Currently available methods of ventilation do not account for the intermittent breathing strategy of representative species within this infraorder of fully aquatic mammals and may have a significant effect on cardiac and respiratory physiology. Methods: To understand the impact of mechanical ventilation on cardiopulmonary function in one small species of cetacean, the bottlenose dolphin (Tursiops truncatus), we compared controlled mechanical ventilation (CMV) to a novel ventilation method known as apneustic anesthesia ventilation (AAV). AAV simulates the normal inspiratory breath-hold pattern of dolphins. Ten anesthetic procedures (dental procedure, n = 9; bronchoscopy, n = 2) were performed on nine dolphins (age range: 10-42 years; mean = 32 years; median = 37 years; female = 3, 40%; male = 6, 60%). In a cross-over study design, dolphins were instrumented and randomly assigned to AAV or CMV as the initial mode of ventilation, then switched to the alternate mode. Baseline cardiopulmonary data were collected and again after 30 min on each mode of ventilation. Cardiac index, stroke volume index, systemic vascular resistance, alveolar dead space, alveolar-arterial oxygen tension gradient, arterial oxygen content, oxygen delivery index, and dynamic respiratory system compliance index were calculated at each of the four time points. Results: During AAV, dolphins had higher arterial oxygen tension, higher mean airway pressure, reduced alveolar dead space ventilation and lower alveolararterial oxygen difference. Cardiovascular performance was not statistically different between the two modes. Discussion: Our study suggests AAV, which more closely resembles the conscious intermittent respiratory pattern phenotype of dolphins, improves ventilation and pulmonary function in the anesthetized dolphin. Future studies should evaluate the cardiopulmonary effects of neutral buoyancy and cardiopulmonary sparing drug protocols to reduce the need for hemodynamic support of current protocols. [ABSTRACT FROM AUTHOR]

The relative effectiveness of live tissue (LT)- and inanimate simulation (SIM)-based training of combat medics is the subject of intense debate. A structured interview was utilized to determine the training modality preferences and the perceived value of LT- and SIM-based combat casualty care training of 25 senior special operations medics. Participant demographics and training experience, Likert scale-based assessment of training modality value, selection of preferred training modality for 11 combat casualty care procedures, and 12 open-ended questions probing opinions of the limitations and benefits of LT- and SIM-based training were collected from this convenience sample. All participants indicated significant combat medic experience and training. Of the 11 procedures questioned, LT was identified as superior for seven with mixed responses for the remaining four. LT was consistently identified as an essential training modality with tactile sensation and the physiologic responses of animal models to injury and therapy as primary benefits. Across procedures, 100% of participants felt that LT should be used in combat casualty care training and 96% felt that SIM should also be utilized. Repeatability and accuracy of size/weight were identified as key benefits of SIM training. Respondents reported that capability, self-confidence, success, and resilience of the combat medic all benefitted from LT training. The overriding theme was the general superiority of LT with recognition of the unique and complementary benefits of SIM. [ABSTRACT FROM AUTHOR]

The article presents a study on the diagnosis and treatment of retained fetal skeleton in a rescued manatee in Florida. The study presented a female manatee which was observed with a fetal bone from the vulva. It states that the manatee was diagnosed with uterine retention of a fetal skeleton using ultrasound and hysteroscopy. It adds that episiotomy was conducted to the uterus for the removal of the skeleton. It notes that the retention of a dead fetus is life-threatening to manatees, in which retained tissues must be removed.

Objective– To compare the placement feasibility and amount of bone trauma induced by 3 intraosseous (IO) access techniques in cats: an automatic impact penetration device (A), an automatic rotary insertion device (B), and a manual IO needle (C). Design– Prospective ex vivo study. Setting– University. Animals– Eighteen adult mixed breed feline cadavers. Interventions– Cadavers provided 72 total IO insertion locations divided equally between the right and left humerus and tibia. The 3 IO techniques were randomly allocated to these locations. Time to successful insertion, ease of insertion, and success rate were recorded. Each insertion site was analyzed for the number of bone fragments and defect diameter by computed tomography. Measurements and Main Results– Device B had lower time of insertion ( P=0.01) compared with devices A and C. Device B had better ease of insertion scores ( P<0.01) compared with devices A and C. No differences were detected between insertion sites (tibia versus humerus). No differences in the number of bone fragments, defect diameter, or success rate were detected among devices ( P=0.06, 0.31, and 0.14, respectively). Conclusions– All 3 IO access methods evaluated yield acceptable results. Device B is significantly faster and easier to place in cat cadavers when compared with other methods. [ABSTRACT FROM AUTHOR]