The emergency patient…

Arriving to Vets Now with a quick tour of the practice and introduction to the team I changed and it was time to see my first consult with head vet Rebecca. It was not the bleeding dying dog or cat that I expected but a rabbit with early gastrointestinal stasis that had stopped eating – giving medication against pain and to encourage gut movement we hope that we had caught it early and that the rabbit would be fine.

One of the attractions of emergency and critical care is that you never really know what is going to come through the door. Most patients will go through telephone triage so we may get a little notice to prepare if necessary; however there is always the chance that someone will run a dying pet straight in. If you have time to telephone (or can get someone else to telephone) before you come then it is better because it allows preparation of anything necessary before you arrive. This can be even more important if there are already critical patients as it may be necessary to triage the least critical to a secondary area so we have a table to work on or a connector for oxygen.

The uncertainty of what is next is also one of the challenges of  emergency medicine; you need to be very confident in your ability to deal with whatever comes in. And you have to be able to cope well under pressure  – especially when multiple emergency patients arrive at the same time.

Whilst able to send some patients home, there were unfortunately a few where euthanasia was the best option – either because they were not treatable or because they lacked any quality of life. I’ve written an entire post on euthanasia that will follow in the next couple of days.

The day quickly became one of maggots with what felt like an endless supply of the wriggly white flesh eaters being found on a cat, pigeon and a rabbit. It is amazing how quickly with the summer heat that flies will take advantage of any moist fur to lay their eggs. The eggs tend to hatch rather quickly so within 24 hours there can be a serious problem if not treated so these were emergencies. Fortunately shaving half the cat managed to remove all the maggots and only the top layer of skin was damaged, however the pigeon and rabbit had much more extensive wounds and had to be euthanised on welfare grounds.

For my first day however it was a rather relaxed introduction to emergency practice – I had time to learn how things worked – and to pick the brains of the vets and vet nurses I was working with to get a better understanding of how it worked with Vets Now. It also gave me some time to practice some of the clinical skills such as manual PCV (blood cell counts) that I’d not done for several years.

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