Large Animal Emergency and Critical Care service

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Large Animal Emergency and Critical Care service
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LA ECC- History

• In 2002, a plan was developed by the equine
  sections to establish an independent service
  dedicated to Equine Emergency and Critical Care
• Faculty dedicated to ECC- interest and expertise
• Alleviate schedule disruption
• Improve student teaching
• Improve student schedule
• Decrease faculty after hours time commitment

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LA ECC- History

• Goal
• 3 faculty positions
• 1 Medicine
• 2 Surgery
• 3 lecturer position
• 1 medicine
• 2 surgery
• To allow full 24/7 coverage by senior faculty
  dedicated to ECC

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LA ECC- Current status

• 3 faculty positions
• Residents/interns from other services(3 for each
  after hour shift)

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LA ECC- Dedicated technician
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The faculty and staff of the college are
committed to exceptional teaching, research and
patient care
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LA ECC- Clinical Service
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Caseload-Types of cases

• 725 cases- 10.5 months

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Caseload- Surgical

• 181/725

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Caseload- Management
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LA ECC- Importance of satellite services
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ICU Service

• -Open ICU technicians offer ICU services to
  users
• -Under ICU technician supervisor Mr Vidal
  Villareal (V)
• -Overseen by ICU committee

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ICU facility
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LA ECC- Teaching
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LA ECC- Teaching

• Separate student rotation instituted for the
  class of 2003
• Within each rotation 2 groups
• Day students
• Night students
• Overlap at 400pm for rounds

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LA ECC -Teaching

• Curriculum
• Participate in core curriculum teaching
• Currently offer elective classes
• Neonatalogy
• Colic team
• Goal core course to integrate lectures related
  to ECC, both LA and SA

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LA ECC- Teaching

• Interns and residents
• Residents ACVIM, ACVS

Dr Meghan Gilhooly
Dr Catherine Mohr
Dr Berkeley Chesen ACVS
Dr Jason Mez ACVS
Dr Amy Plummer ACVS
Dr Jared Janke ACVIM
Dr Leslie Easterwood ACVIM
Dr Tracy Norman ACVIM
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LA ECC-Research

• Through Link GI group Drs Cohen and Roussel
• 1 Cohen ND, Lester GD, Sanchez LC, Merritt AM,
  Roussel AJ Jr. Evaluation of risk factors
  associated with development of postoperative
  ileus in horses. J Am Vet Med Assoc. 2004 Oct
  1225(7)1070-8.
• 2 Roussel AJ Jr, Cohen ND, Hooper RN, Rakestraw
  PC. Risk factors associated with development of
  postoperative ileus in horses. J Am Vet Med
  Assoc. 2001 Jul 1219(1)72-8. Erratum in J Am
  Vet Med Assoc 2001 Sep 15219(6)800.

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LA ECC- Research

• Clinical research
• Comparison of different analyzers for lactate
  measurement in normal horses (Marsh)
• Retrospective evaluation of cecal impactions in
  horses (Plummer, Rakestraw, Hardy)

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LA ECC-Research

• Collaborative studies
• Intraoperative lidocaine (Dr Chris Sanchez)
• Risk factors for duodenitis-proximal jejunitis
  (Dr Noah Cohen)

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LA ECC -Research

• Inter-department collaboration
• Mechanisms of edema resolution implications for
  treatment of cardiovascular disease. Glen Laine,
  Principal Investigator. Program of Excellence in
  Life Sciences, Texas AM University (Hardy)

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LA ECC- Organizations and College

• Veterinary Emergency and Critical Care Society
  (VECCS)
• American College of Veterinary Emergency and
  Critical Care
• Academy of Veterinary Emergency and Critical Care
  technicians
• Student chapter of VECCS

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American College of Veterinary Emergency and
Critical Care-ACVECC

• Recognized by the AVMA in 1989
• Currently 136 Diplomates
• New college for equine diplomates (1999)
• Currently only 14 equine Diplomates
• Increase training/expertise in ECC
• Participation in the college training and
  examination

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LA ECC- Future direction

• Continue to strive to improve teaching
• ACVECC residency training
• Continue to strive to improve service to clients
  and veterinarians
• Continue research efforts

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LA ECC- Importance to the community

• After hours emergencies less desirable for
  practitioners
• After hours expertise remains critical
• Close monitoring and intensive care may be
  difficult to achieve
• ECC may serve as primary, secondary or even
  tertiary referral center

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Outreach-Disaster preparedness
Technical Large Animal Emergency Rescue Drs.
Tomas Rebecca Gimenez
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THANK YOU!