As a pet owner you are likely to someday face the decision to euthanize your pet and as a veterinarian or veterinary technician you are the one to perform this euthanasia. The reason for euthanasia may be depending on the animal, for instance illness, age and behavioral problems or depending on the needs of the owner or the society, so called convenience euthanasia. Many different euthanasia methods can be used when putting an animal to sleep. The method preferred in animal hospitals is pharmacological euthanasia either by inhalation of anesthetics or by injection of a euthanasia agent. If the pet owner wishes to be present during the procedure it is important to prepare him for what will happen. Many animals are sedated before the euthanasia in order to reduce anxiety and to ensure a softer transition between life and death. The euthanasia agent can then be administrated for instance intravenously or intraperitonealy.

Intensivvårdsmiljön innebär att patienter är i en utsatt situation där integritet och avskildhet kan bli åsidosatt. Därtill behandlas de med potenta sederande och analgetiska läkemedel som i sin tur ger ogynnsamma effekter. Det är därför av vikt att sträva efter att så låga doser som möjligt administreras. Syftet med studien var att undersöka om det fanns någon skillnad i förbrukning av analgetiska och sedativa läkemedel mellan patienter som vårdats på en specialdesignad intensivvårdssal och patienter som vårdats på en ordinär intensivvårdssal på ett medelstort sjukhus i Västsverige. I studien ingick 149 patienter som vårdadats på en specialdesignad intensivvårdssal eller en ordinär intensivvårdssal.

Among researchers it has been established since decades that humans and animals have an internal biological clock that controls certain physiological mechanisms. One example regarding humans is the impairment of lung function during the night, causing the phenomenon ?nocturnal asthma? among asthmatics. Only a few studies concerning respiratory circadian rhythm in horses have been done previously and they showed a daily variation in horses with a chronic or an acute respiratory disease. The technique used in those studies was the conventional technique, which is invasive and less sensitive than the technique used in this study.

Cycling is one of the most sustainable transport modes available and it is widely promoted inmany urban areas. The health benefits from cycling has shown to be substantial, includingdecreased risks of diseases related to overweight and enhancing brain capacity. However, inurban areas cyclists can temporaly be exposed to high levels of air pollution, resulting inhealth risks as opposed to health benefits.The objective of this thesis is to develop a rasterbased test model in GIS that estimates theinhaled dose of air pollution for cyclists based on relative particle concentration in differenttransportation micro-environments. The method used is a least-cost path approach,calculating three different routes; shortest, fastest and least dose for four different trips withinSödermalm, Stockholm.The results show that the inhaled particle dose can be greatly reduced, 39% - 58% for three ofthe routes, by choosing the least dose route. One of the most interesting findings is thesubstantial increase of dose when high levels of particles are combined with uphill cycling.The conclusion for the thesis is that a raster-GIS model can be very useful for estimating doseof different air pollution particles and chemicals along cycling routes.

Rabbits carry a high risk of anesthesia related death. This study was part of a project to develop a form of total intravenous anesthesia (TIVA) with minimal effects on cardiac, respiratory and metabolic parameters. In the study, TIVA with sufentanil and midazolam (group TIVA, n=9) was compared with inhalation anesthesia with sevoflurane (group SEVO, n=9) in female rabbits undergoing surgery (ovariehysterectomi). All rabbits were pre-medicated with medetomidin and carprofen before anesthesia induction. Anesthesia was induced with TIVA (2.3 ?g/ ml sufentanil, 0.45 mg/ ml midazolam) at a rate of 4 ml/ kg/ h and the mean induction dose was 0.4 ?g/ kg of sufentanil and 0.1mg/ kg of midazolam.

The aim: was to describe and compare a group of experts and critical care nurses' agreement in detecting delirium in intubated, ventilator treated patients with sedation / analgesia, before and after an in house training intervention with the instrument Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).Method: A quasi-experimental study, one group pretest - posttest design. A convenience sample of 17 critical care nurses in a general intensive care unit included. To detect delirium the instrument CAM-ICU was used, 21 paired tests before and 22 after an educational intervention.Main Results: The results showed that after an in house training intervention sensitivity and kappa coefficient improved of the characteristic 1 "acute onset and fluctuating course," an improvement that was significant. In other features, and overall values were signs of numerical improvement and deterioration in sensitivity, specificity and kappa coefficient but no significant change.Conclusion: Implementing a new instrument for detecting delirium in clinical practice requires education and follow-up. A small sample of critical care nurses with varying ability to use the new instrument and the fact that patients' status may change rapidly making it difficult to draw any conclusions from this study.

Background: Examinations with the intent to assess neurological functions and level of conciousness are common in neurocritical care, but the effect on the patient is not entirely researched.Aim: The purpose of this study was to describe the patient?s situation at the neurological wake-up test concerning the environment, nursing interventions and the possibility given the patient to become awake, and if these conditions affect the outcome of the wake-up test.Methods: A quantitative observational study took place at a neurocritical care unit, where 20 patients were observed from interruption of sedation to the neurological assessment, which was performed by a neurosurgeon or a specialized critical care registered nurse. Nursing interventions, environmental factors and physiological parameters were documented.Result: Twelve intervention varieties to control patients? physiological parameters were used. CPP > 80 mmHg was found in 90 % of observations.

Både över- och undersedering kan öka riskerna för både morbiditet och mortalitet. Genom att ge rätt sederingsnivå till patienterna kan intensivvårdssjuksköterskor medverka till ett snabbare tillfrisknande och mindre vårdrelaterade komplikationer. Sedering är en viktig del i vården av respiratorpatienter och kräver stor kunskap hos intensivvårdssjuksköterskor. Syftet med studien var att undersöka hur intensivvårdssjuksköterskor upplevde omvårdnaden kring lätt sederade intensivvårdspatienter under respiratorbehandling. Uppsatsen är en kvalitativ studie och datainsamling genomfördes med hjälp av intervjuer med sex intensivvårdssjuksköterskor på en intensivvårdsavdelning i Västra Sverige.

Inledning: Sömn är ett vanligt problem hos äldre patienter på sjukhus och äldreboenden.  Brist på sömn leder till ökad risk att drabbas av stroke och hjärt-kärlsjukdom samt att det ger en negativ påverkan på rehabilitering. Sömnläkemedel är idag den främsta behandlingen mot sömnproblem, vilka ger biverkningar som exempelvis sedation dagtid, yrsel, talsvårigheter och mardrömmar.   Syfte: Syftet med denna litteraturstudie var att sammanställa vetenskapliga artiklar om vilka icke-farmakologiska åtgärder mot sömnproblem som sjuksköterskan kan tillämpa i sin profession för att främja sömnen hos äldre patienter. Metod: En litteraturstudie där originalartiklar söktes i databaserna PubMed, Medline och Cinahl varav 16 originalartiklar granskades och sammanställdes. Resultat: Resultatet i denna litteraturstudie visar att det finns icke-farmakologiska åtgärder för att förbättra sömnen. Dessa är akupunktur, nya rutiner samt kognitiv beteendeterapi. Förbättringarna som kan ses efter utförda icke-farmakologiska åtgärder är bland annat kortare insomningstid, ökad sömnduration, färre uppvaknanden och bättre sömn. Patienterna beskriver en förbättrad upplevelse av den egna sömnen efter tillämpning av dessa åtgärder. Slutsats: Resultatet i denna litteraturstudie visar att det finns olika beprövade icke-farmakologiska åtgärder vilka har en positiv effekt på sömnen.

Bakrund: Fast track-kirurgi är ett alltmer vanligt förekommande arbetssätt inom hjärtkirurgi. Tidigare studier har påvisat att en tidig extubation har medfört en vinst i patientens rehabili-teringsprocess samt bidragit till kortare vårdtider och sänkta sjukvårdskostnader. Syfte: Syftet med studien är att kartlägga och redovisa graden av smärta och konfusion efter extubation hos patienter som genomgått hjärtkirurgi. Metod: Material inhämtades genom en fortlöpande journalgranskning. Pilotstudien granskade patientjournaler samt övervakningsjournaler i realtid.

HUR UPPLEVER ASTMA PATIENTER SITT VARDAGSLIV? EN LITTERATURSTUDIE SAKHI FAZILA Sakhi, F. Hur upplever astmapatienter sitt vardagsliv? En litteraturstudie. Examensarbete i omvårdnad 15 högskolepoäng.

The intention of this study is to investigate possible excitation on dogs due to buprenorphine treatment. The reason for it to be about buprenorphine and not any other opioid is due to its relevance being one of the most popular opioids in animal care, as well as the authors own experience with what seems to be buprenorphine induced excitation in her own dog. The study consists of a literature review and an internet based survey containing thirty questions sent out to twelve animal clinics and animal hospitals. Significant agitative effects on behavior has been found in studies on horses, sheep, goats, rats and mice, but no one shows the effects of buprenorphine on dogs. The literature on opiod effects on dog behavior seems sparse.

The aim: was to describe and compare a group of experts and critical care nurses' agreement in detecting delirium in intubated, ventilator treated patients with sedation / analgesia, before and after an in house training intervention with the instrument Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).Method: A quasi-experimental study, one group pretest - posttest design. A convenience sample of 17 critical care nurses in a general intensive care unit included. To detect delirium the instrument CAM-ICU was used, 21 paired tests before and 22 after an educational intervention.Main Results: The results showed that after an in house training intervention sensitivity and kappa coefficient improved of the characteristic 1 "acute onset and fluctuating course," an improvement that was significant. In other features, and overall values were signs of numerical improvement and deterioration in sensitivity, specificity and kappa coefficient but no significant change.Conclusion: Implementing a new instrument for detecting delirium in clinical practice requires education and follow-up. A small sample of critical care nurses with varying ability to use the new instrument and the fact that patients' status may change rapidly making it difficult to draw any conclusions from this study.

Bakgrund: När patienter med lungcancer befinner sig i den sena fasen med palliativ vård i livets slutskede är det inte ovanligt att de på grund av outhärdlig smärta och/eller ångest och oro har ett behov av att få sedering som behandlingsform. Det kan dock finnas en risk att patienterna inte alltid får tillräcklig lindring i samband med detta lidande. För att lindra lidandet hos dessa patienter är det viktigt att sjuksköterskan är väl förtrogen med denna behandlingsform. Därtill krävs en uppmärksamhet gällande patientens behov av behandlingsformen.Syfte: Syftet var att beskriva sjuksköterskors upplevelser kring sedering som behandlingsform vid vård i livets slutskede hos patienter med lungcancer.Metod: Studien utgick från en hermeneutisk vetenskapsteoretisk grund och utgjordes av åtta intervjuer. Analysen genomfördes med hjälp av en kvalitativ manifest och latent innehållsanalys.Resultat: Temat "Att få känna tillit och stöd i situationen" baseras på följande kategorier: lidandets betydelse, jobbiga situationers betydelse, arbetsklimatets betydelse, vårdplaneringens betydelse och den upplevda erfarenhetens betydelse.Slutsats: Det måste finnas ett kollegialt stöd och möjlighet till reflektionsstunder för att sjuksköterskor ska orka arbeta med palliativ sedering för patienter med lungcancer i livets slutskede.

The purpose of this literature study was to describe techniques for monitoring general anesthesia and standing chemical restraint in the horse. A number of various techniques and devices related to e.g. blood pressure measurement, blood gas analysis and pulse oximetry are defined, and finally their clinical relevance and reliability are discussed. The equine patient is generally far more exposed to anesthesia-related risks than other smaller species. Complications such as hypotension and hypercapnia are commonly seen during general anesthesia. Thus, close monitoring is essentially performed by the veterinary nurse, whom is responsible for monitoring the anesthetized patient.