Small Animal Emergency

1
Small Animal Emergency Critical Care Medicine

• Maureen McMichael, DVM
• Diplomate ACVECC
• Texas AM University

2
Emergency Critical Care

• Proposal - Independent SAECC Service - 2002
• Three phases
• Physical space/curriculum/consulting
• Emergency receiving service
• Critical Care service

3
Phase IPhysical 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

4
Phase IIEmergency 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

5
Phase IIEmergency Receiving Service

• Benefits
• Students ER rotation, rounds, sleep
• Interns Residents
• Clinical Services IM, surgery, onco
• Local Veterinarians
• Local Clients
• Hospital Income

6
Phase IIICritical 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

7
Phase IIICritical Care Service

• Benefits
• Students CC rotation, rounds
• Interns Residents
• Clinical Services relieve caseload
• Local Veterinarians case continuity

8
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)

9
Where Are We Now?

• Physical Space
• ICU protocols, POC testing, etc.
• Curriculum
• Emergency Receiving Service
• Critical Care Service

10
Phase IPhysical Space
New ICU
Old ICU
11
New ICU 3,000 sq ft
12
Phase IPhysical Space

• Equipment
• Ventilator
• Monitoring equipment
• Pyxis
• Protocols
• For technicians, for interns

13
Phase IPhysical Space

• CPCR protocols
• Constant rate infusions analgesia

14
Phase IPhysical Space

• ICU treatment sheets prompts for students
• Emergency drug dosages every animal

15
Phase IPhysical Space

• Point of care testing
• Rapid results 1 minute, 14 tests
• Blood gas teaching, patient care

16
Phase ICurriculum

• 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

17
Phase IIEmergency Receiving Service

• mid-October 2004
• No marketing outside local BVVMA
• Case load up significantly
• ER income up significantly

18
ER Cases and Fee Revenue
19
Phase IIEmergency Receiving Service

• Marketing Potential
• ER Magnets
• RDVM phone
• Advertising/PR
• ECC RDVM conference
• Ross students

20
Where Are We?

• Phase I Completed
• Phase II Very successful growth potential
• Phase III If ER continues to grow - need a CC
  service
• Resources??????

21
Resources Needed
22
(No Transcript)
23
(No Transcript)