1. EMERGENCY MEDICINE
and Critical Care

2. Common Emergencies and “Emergencies”
DKA
Drugs/Alcohol
HBC
Heat Stroke
Seizure
Dyspnea
Vestibular Dz
Trauma/Fracture
Vax Rxn
Torn Nail
Snake/Insect Bite
Fight Wounds
Urinary Obstruction

3. Phone Triage Understand your clinic’s policies get name and number
questions - determine need and get client on the road as quickly as possible - situation, breathing, mentation, visible wounds, seizing/duration, exposure
recommend wound care/induce vomiting PRN
EVERY CLIENT deserves your full attention - they don’t know what we know

4. In-House Triage Organization - assignments, drills, communication
alert DVM, give O privacy, separate pt and O
someone speak with O, determine likelihood of treatment, get permission for pain meds and CPCR quickly
muzzle pt PRN, get a wt, TPR, catheter, blood samples
2 minute exam

5. 2 Minute Exam
Respiratory
Cardiac
Neurologic
Palpate Abdomen

6. Brief Respiratory Exam
evaluate respirate rate, effort, and pattern
when in doubt, supplement O2 until an SPO2 is measured MM
Auscultation

7. Cardiovascular
mentation
heart rate/rhythm
pulse
CRT
MM (again)

8. Neurologic TBI, shock, and cardiac disease
normal, dull, obtunded, stupor, comatose
O history very important
pupils
gait
proprioception
visible head wounds

9. Abdomen
pain
posture
tympany

10. Immeidate Treatments Pain Meds Fluids Emergency Meds Oxygen
Immediate Wound Care

11. Initial Diagnostics TPR PCV/TP +/-GLU Blood Pressure Pulse Oximetry
ECG
Sonography

12. Update Owner Secondary Exam
recheck head/eyes/mentation
clip/clean wounds
additional medications
modify fluid therapy
additional diagnostics

13. Treatment Area Crash box and anything else needed within the same area
If meds cannot be kept in crash box, EVERYONE knows where they are kept
clean, well stocked, monitor exp. dates. learn this on DAY 1
if client calls ahead many things can be ready before hand

14. CPCR CardioPulmonary/Cerebrovascular Resuscitation
start immediately. no questions, no hesitation
CAB’s
make everyone in practice aware of risks

15. if no cardiac arrest, no compressions, watch very closely
3 minute intervals, pause to reassess and switch team members
do not stop chest compressions between intervals if not necessary
compressions/min
interposed abdominal compressions?

16. Airway ET tube tracheostomy Mask/RRC at least
suction ready, tilt pt PRN
8-12 resps/min
accupuncture

17. meds mostly IV IT at double dose (NAVEL)
IC as last resort, will cause damage
designated notetaker through whole process

18. O must be given realistic expectations
essentially doing this until the O can permit euthanasia
surgical complications are far more likely to be reversed, outside failures are very serious
Is this fair?