Emergency 1 Flashcards
Fielding Telephone Calls
- Difficult to offer accurate advice without examining the patient
- Ideally, animal should be presented to a veterinary hospital for assessment
- Never make a medical diagnosis or rule out an emergency over the telephone
Limit advice to concrete steps that client can take to address immediate problems prior to transporting the animal to a veterinary hospital, for example
- Apply a padded bandage to an open wound
- Give Karo syrup orally to an animal who is hypoglycemic
- Give hydrogen peroxide orally to animal that just ingested a toxic substance
Often, callers are seeking medical advice about whether an animal is in need of immediate medical attention
o OK to discuss animal’s condition over the phone and provide general advice based on owner-relayed information (i.e. animal does/does not appear to need immediate medical attention)
o It’s always best to err on the side of caution and recommend that the animal be examined if there’s any doubt about its condition
Interacting with clients at veterinary hospital
o Greet client and assess patient upon arrival to veterinary hospital
o Introduce yourself and explain your role in the care for their pet
o Express concern/empathy about their animal’s condition (verbally/nonverbally)
o When collecting medical histories try to ask open-ended questions and practice reflective listening
Triage
o The word triage means “to sort”
o Purpose is to determine the priority with which patients need to be treated
o Use of a standard triage form in the assessment of a patient is recommended
Upon arrival of the patient at the clinic the technician (assistant) must:
o Obtain patient history from owner
o Perform an initial assessment by observing patient
o Perform physical examination and obtain vital signs
Nonurgent
patient can wait, patient history and physical exam findings presented to veterinarian, thorough exam and diagnostics are recommended
Urgent
patient taken to exam room for physical examination, treatment consent form and CPR directive signed by owner, thorough exam by veterinarian and discussion of treatment plan with owner
Emergent
immediate medical stabilization is necessary, treatment consent acquired from owner, CPR directive signed by owner, initial stabilization begins while medical history is collected
Life threatening
immediate medical stabilization is necessary, treatment consent acquired from owner, CPR directive signed by owner, initial stabilization begins while medical history is collected
Hospitalization of the ECC patient
o Animals may be deemed to require immediate stabilization/hospitalization after initial assessment by a technician
o A hospitalization decision may not be made until after the animal is thoroughly examined by the emergency veterinarian
o Owners of hospitalized patients or outpatients requiring diagnostic tests or treatments must complete/authorize a series of forms giving permission for medical treatment:
o Treatment consent form
o Estimate of charges
Medical record will be created upon admittance, record will include:
o Client contact information
o Signed copy of estimate, treatment consent form, and CPR treatment directive
o Treatment sheets
Treatment sheets
A treatment order form may be completed by the veterinarian indicating the initial diagnostic and treatment procedures to be performed
A monitoring/treatment flow sheet will also be created and attached to the patient’s cage for quick reference
Monitoring the ECC patient
• Periodic hands-on physical assessment is necessary for every patient
• Objective and subjective parameters should be assessed
o Objective– MM color, CRT, HR, RR, temperature
o Subjective– Attitude, character of respiration, heart and lung sounds, pulse intensity, comfort level
• Mechanical equipment-based monitoring can provide additional, continuous information to better monitor the patient
Mechanical monitoring equipment includes:
o Electrocardiogram (ECG) monitor
o Pulse Oximeter
o Blood Pressure Monitor
o End-Tidal Carbon Dioxide Monitor
Electrocardiogram (ECG) monitor
cardiac arrhythmias may result from primary cardiac disease, trauma, shock, systemic inflammatory response syndrome
Pulse Oximeter
Measure of the percentage of hemoglobin saturated with oxygen
Can be used to diagnose hypoxemia in patients with respiratory problems
Blood Pressure Monitor
Blood pressure indicates tissue perfusion and is a good indicator of overall cardiovascular function
Abnormal BP may be seen in shock, heart disease, chronic renal failure
End-Tidal Carbon Dioxide Monitor
Measurement concentration of carbon dioxide in a single exhaled breath (capnography)
Used for monitoring ventilation in animals under anesthesia or on a ventilator, or those undergoing cardiopulmonary cerebral resuscitation
Common diagnostic tests performed on the ECC patient
Common diagnostic test performed on the ECC patient
- Hematocrit (PCV) and Total Plasma Protein
- Blood Chemistry/Electrolyte Panels
- Complete Blood Count
- Urine Volume and Urine Specific Gravity Measurement
- Blood Gas Analysis
- Lactate Concentration
- Coagulation Tests
Hematocrit (PCV) and Total Plasma Protein
o Quick, simple, inexpensive tests that help diagnose dehydration, anemia
Blood Chemistry/Electrolyte Panels
o Provide vital information to guide immediate therapy
o Blood chemistry/electrolyte panel abnormalities often observed in animals experiencing vomiting/diarrhea, diabetes mellitus, urinary tract disease, eclampsia
Complete Blood Count
o Complete blood counts help identify and manage animals with anemia, thrombocytopenia, infectious or inflammatory conditions
Urine Volume and Urine Specific Gravity
o Provide information about renal perfusion/function
o Used to assess hydration status during fluid administration
o Fluid volumes in the body, or those coming out of the body, can be estimated using a weight scale:
1 ml of fluid = 1 g of weight
1 L of fluid = 1 kg of weight
