Small Animal Emergency VMED 5463

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Moris Sutton
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1 179 Small Animal Emergency VMED 5463 Course Coordinator: Dr. Kirk Ryan ( Orientation: When to show up: 1. For Orientation: All emergency students should attend an orientation meeting the first Monday of the block (or ½ block ) at 4 pm in Room 1700 (aka. Dermatology rounds room ) by the student computer bank. 2. For all remaining shifts: You should report to the small animal ICU unless you have been instructed to meet in another hospital area for rounds. 3. A shift schedule will be provided via near the time of orientation. Emergency students will be assigned to shifts that correspond to the following: Week day Evenings (5pm 1 am) Week day Overnight (midnight 8 am) Days (8am 4pm) Evenings (4pm midnight) Overnight (midnight 9am) What to wear/bring: 1. This block involves both patient care and interactions with clients. Therefore, practical and professional attire is required. Scrubs are fine. Make sure you have a clean lab coat and name tag. 2. Additional Equipment: Stethoscope Thermometer Bandage Scissors Pen light Watch Reflex Hammer Pen Note pad / notebook This rotation will consist primarily of emergency medicine shifts in which you will admit and treat emergency cases presented to the small animal emergency service with the help of an Emergency Clinician.

Dermatology rounds room ) by the student computer bank. 2.

2 180 Overall Course Objectives: 1. Give students hands-on experience in primary care emergency medicine. 2. Teach the application of basic triage and advanced critical care. 3. Be able to perform or discuss performing clinical proficiency skills listed at the end of this orientation document. Transferring Cases: Case transfer of hospitalized animals is important to ensure continuity of care. At the end of your shift, you will transfer care of your cases to a regular clinical service (primarily CAM or CAS) student or an overnight ICU nurse. Emergency Shift Weekday Evenings Weekday Overnight Days Evenings Overnight Person Receiving Transfer (1) Overnight Emergency student (2) Overnight ICU nurse Transfer to regular daytime service (1) CAM/CAS student coming on the next shift (2) If no regular student is to follow, then cases are transferred to the regular service student who is on with you during your shift. (1) Overnight Emergency student (2) CAM/CAS student coming on next shift (3) Overnight ICU nurse (1) CAM/CAS student coming on the next shift (2) If no regular student is to follow, then cases are transferred to the regular service student who is on with you during your shift. NOTE: Case transfer protocol is subject to change. Questions or clarification should be directed to the clinician responsible for the case. You will confer with that clinician each morning until the case is transferred. You must be sure to get all appropriate information on the cases being transferred to you.

Transferring Cases: Case transfer of hospitalized animals is important to ensure continuity of care.

3 181 Paperwork: At orientation, you will be shown how to make a new chart when there is no receptionist. If you have questions or forget this procedure, the emergency clinician can help with this process. Since you will be transferring all cases at the end of your shifts, you will be responsible for writing SOAPs and ICU orders and TRANSFER FORMS for all emergency service patients. Transfer forms must be filled out and posted on the transfer board for any patients that stay in the hospital and are transferred to a specialty service. For all cases admitted by the Emergency Service, there is a FAX Update form that must be filled out and placed in the FAX box at the reception desk to be sent to the RDVM. Rounds: Students who are on evening shifts will have rounds with a house officer or faculty clinician two to four times per block before the start of their shift. These rounds will cover emergency-related topics as well as case discussions, and will start at 4:30 pm. A rounds schedule will be provided at orientation. Rounds will be held in room 1700 ( dermatology rounds room next to the computer tables) except for Imaging rounds, which will be held in the Radiology conference room. Client Communication: The long distance phone code to use for this rotation will be given to you at orientation. All clients with emergency patients in the hospital should receive a phone update between 7:30 and 9 am every day. If there is an overnight emergency student, they are responsible for this communication; otherwise the emergency clinician will communicate with the client. Other client communication should be done as needed; please make sure to document your communication in the medical record. Student Safety: The emergency clinical rotation requires students to be present at unusual hours. The SVM officer is available to assist you with safety concerns (examples include disorderly clients, suspicious persons, etc). Students on the overnight shift are encouraged to park in a safe and well-lit location close to the building. Helpful Resources: ASPCA Animal Poison Control Center: Website has monographs on poisons encountered by emergency vets: Pet Poison HelpLine: Website:

Since you will be transferring all cases at the end of your shifts, you will be responsible for writing SOAPs and ICU orders and TRANSFER FORMS for all emergency service patients.

4 182 Emergency Phone Calls: DO: The answering service will page you to return all afterhours calls. Call the answering service to retrieve a list of callers and phone numbers. Log all phone calls in the call log note book. At the end of your shift, place all log sheets in the file folder for Dr. Ryan located outside Clinical Pathology (where lab results usually go). DON T: Do not return calls from referring veterinarians. Instead, pass these calls to the ER doctor. Do not give patient updates on cases other than your own. For all other cases, the student on the case must be called to return client phone calls for updates. If unable to reach student on the case, then contact the clinician on the case for instructions. You may call owners and let them know you are contacting the student, and give only generic info. Specific medical advice should not be given over the phone (including OTC medications). Proper medical advice requires an exam. All owner concerns should be taken seriously. If you have a question regarding an owner call, please consult the on-duty emergency clinician. Grading Criteria: Students will be assessed by house officers, ICU technicians and faculty in the following areas: 1. Knowledge base & knowledge application 5. Time Management 2. Patient care 6. Teamwork 3. Technical skills 7. Record Keeping 4. Communication skills 8. Professionalism / attitude If this is your first small animal rotation ever: Don t panic! You ve been studying to think like a veterinarian for a long time, and there are lots of folks here to help you do just that. Hospital Closure Emergency Receiving If the Veterinary Teaching Hospital and Clinic cancels normal receiving due to weather related or other condition and where larger than normal small animal emergency case load will be anticipated, students will be at risk to help with receiving and managing these emergency cases.

DON T: Do not return calls from referring veterinarians. Instead, pass these calls to the ER doctor. Do not give patient updates on cases other than your own.

5 183 SMALL ANIMAL EMERGENCY COURSE CLINICAL PROFICIENCY SKILLS LIST: 1. Comprehensive Patient Diagnosis 1.1. Obtain and record history 1.2. Perform physical exam 2. Comprehensive Treatment Planning 3. Anesthesia and Pain Management 3.1. Assess and treat pain 4. Basic Surgery Skills 4.1. Assess and treat wounds 5. Basic Medicine Skills 5.1. Perform and interpret physical exam 5.2. Perform physical restraint for technical procedures 5.3. Calculate and administer intravenous fluid therapy (type/rate/volume) Perform and assess results of serial laboratory data (CBC, Chem, UA) 5.5. Calculate drug therapy 5.6. Write a prescription 5.7. Perform intravenous catheterization 5.8. Collect venous blood samples 6. Emergency and Intensive Case Management 6.1. Use the principals of triage to identify priority patients from the number of small animal emergency cases presenting to the VTHC Use the principals of triage to identify priority problems in a patient with clinical problems affecting multiple body systems Devise an emergency diagnostic plan 6.4. Devise an emergency treatment plan 6.5. Perform cardiopulmonary resuscitation 6.6. Perform and assess vital signs (Temperature, pulse rate, respiratory rate) 6.7. Perform and assess results of Quick Assessment Tests (PCV/TP/BG/lactate) 6.8. Perform and assess ECG 6.9. Perform and assess results of indirect blood pressure Perform thoracocentesis Perform abdominocentesis Perform and interpret central venous pressure 7. Health Promotion 8. Client Communication and Ethical Conduct 8.1. Maintain a medical record 8.2. Perform client communication (pre-admission inquiry, clinical discussions, case updates) 9. Appreciation for Role of Research in Clinical Medicine

Perform physical restraint for technical procedures 5.3. Calculate and administer intravenous fluid therapy (type/rate/volume). 5.4.

Welcome! Your interest in the veterinary technology program at ACC is greatly appreciated. As a new degree option, there are and will be

Welcome! Your interest in the veterinary technology program at ACC is greatly appreciated. As a new degree option, there are and will be opportunities to help shape, develop, and become part of the growth