A properly trained team is a great tool when it comes to an organized and consistent approach to critically ill patients. The shorter the response time, respecting the platinum minute, the greater the number of patients recovered during treatment; it is imperative that alertness is maintained to prevent delay in immediate resuscitation.
Emergency clinics and hospitals must have a work standard in which the division of tasks, preparation of materials and staff readiness are timed so that everything happens in the most efficient and quick way.
It is extremely important to emphasize that any veterinary establishment that may receive a patient as an emergency should be minimally prepared for the stabilization and initial approach, so that there is the possibility of removal to a referral center, quickly and efficiently.
Service area
We must maintain a dedicated area for emergency care, regardless of the hospital’s structure or volume of care. It must be remembered that most trauma cases involve a clinical and surgical approach. A good service area has to support both types of approach, concentrating efforts on rapid airway maintenance, positive ventilation, oxygen therapy, vascular access, fluid therapy, bleeding control, monitoring and thoracic and abdominal surgery service.
We must maintain a dedicated area for emergency care, regardless of the hospital’s structure or volume of care. It must be remembered that most trauma cases involve a clinical and surgical approach. A good service area has to support both types of approach, concentrating efforts on rapid airway maintenance, positive ventilation, oxygen therapy, vascular access, fluid therapy, bleeding control, monitoring and thoracic and abdominal surgery service.
All equipment must be available and ready to use. Attention to small details (such as leaving a fluid therapy kit ready for use, already cut adhesive strips, catheters by hand, endotracheal tube [cuf ] balloon tested and with syringes already attached) is imperative when the objective is to gain time and respect the platinum minute.
The emergency area must be open, clean, well communicated with the imaging and surgery sector, easily accessible and equipped with the necessary means to perform the first approach to critically ill patients.
We must be aware of the mandatory minimum conditions such as:
• Light spot
• Suction system
• Cabinet, table, cart or shelves where drugs and emergency supplies will be accommodated
• Heating system (infrared light, mattress, dryer etc.)
• Oxygen source and ventilatory support
• Lactimeter
• Vascular Doppler and periphery thermometer
• Monitoring service, which must include:
Oximetry, cardioscopy, capnography Defibrillator.
In the intensive care unit (ICU) the same requirements must be met, as emergencies can also occur in this environment. But in addition to what is suggested, an ICU should have a support sector for material sterilization, greater hospital infection control and specific laboratory and systems support (eg, hemodialysis, nutritional support, rehabilitation, hyperbaric medicine and specialized surgery).
References:
Adams, Cindy Lou, Suzanne M. Kurtz, Warwick Bayly, Christoph Mülling, and Anthony Suchman. Skills for communicating in veterinary medicine. Oxford: Otmoor Publishing, 2017.
Dunlop, Robert H., and D. I. Williams. Veterinary medicine: an illustrated history. Mosby-Year Book, Inc., 1996.
Schwabe, Calvin W. “Veterinary medicine and human health.” Veterinary medicine and human health. (1964).
Udall, Denney Hammond. “The practice of veterinary medicine.” The practice of veterinary medicine. (1954).
