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Small Animal Emergency & Critical Care Medicine
Maureen McMichael, DVM Diplomate ACVECC Texas A&M University
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Emergency & Critical Care
Proposal - Independent SAECC Service Three phases Physical space/curriculum/consulting Emergency receiving service Critical Care service
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Phase I Physical Space Design and build new 3,000 sq ft ICU
Old ICU too small Need for ICU protocols Need for critical care monitoring Need for POC testing Need for ECC in curriculum
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Phase II Emergency Receiving Service
Receive all incoming emergency cases Transfer all stable cases to appropriate service the following weekday ECC student rotation with didactic rounds ECC student manual
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Phase II Emergency Receiving Service
Benefits Students – ER rotation, rounds, sleep Interns & Residents Clinical Services – IM, surgery, onco Local Veterinarians Local Clients Hospital Income
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Phase III Critical Care Service
Separate CC service that takes trauma, toxins and all critical case transfers Separate student rotation Residents and interns – experience with complex critical cases
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Phase III Critical Care Service
Benefits Students – CC rotation, rounds Interns & Residents Clinical Services – relieve caseload Local Veterinarians – case continuity
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Resources Needed Full Plan – implement in stages
4-5 ECC faculty (2-3 ER, 2-3 CC) 3 ECC residents 1 dedicated ECC intern Continued rotation – house officers 6 Students (3 day and 3 night)
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Where Are We Now? Physical Space ICU protocols, POC testing, etc.
Curriculum Emergency Receiving Service Critical Care Service
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Phase I Physical Space New ICU Old ICU
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New ICU – 3,000 sq ft
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Phase I Physical Space Equipment Protocols
Ventilator Monitoring equipment Pyxis Protocols For technicians, for interns
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Phase I Physical Space CPCR protocols
Constant rate infusions – analgesia
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Phase I Physical Space ICU treatment sheets – prompts for students
Emergency drug dosages – every animal
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Phase I Physical Space Point of care testing
Rapid results – 1 minute, 14 tests Blood gas – teaching, patient care
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Phase I Curriculum First year CPCR, Respiratory physiology laboratories 2nd year – CPCR lecture, labs 3rd year – Clinical Skills lab 3rd year – 5 didactic ECC lectures 4th year – ER rotation ER student rotation manual
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Phase II Emergency Receiving Service
mid-October 2004 No marketing outside local BVVMA Case load up significantly ER income up significantly
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ER Cases and Fee Revenue
Year Oct Nov Dec Jan ER caseload 2003 164 204 107 2004 212 275 344 232 Change +48 +111 +140 +125 ER Fee 12,283 12,277 15,269 7,250 15,912 20,662 25,834 17,217 +3,629 +8,385 +10,565 +9,967
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Phase II Emergency Receiving Service
Marketing Potential ER Magnets RDVM phone Advertising/PR ECC RDVM conference Ross students
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Where Are We? Phase I – Completed
Phase II – Very successful – growth potential Phase III – If ER continues to grow - need a CC service Resources??????
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Resources Needed Davis ER MSU Tufts ER cases/yr 1500 4000 9000
ECC faculty 3 6 ECC residents 4 1/3 9 ECC interns - 2 5 ECC DVMs
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TAMU ER 3600 1 Davis ER MSU ER Tufts ER cases/yr 1500 4000 9000
ECC faculty 3 6/7 1 ECC residents 4 1/3 9 ECC interns - 2 5 ECC DVMs
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