Interview with a Specialist Veterinary Technician Emergency Nurse
About Amy Readthorn RVN, DipCVN, AVN, BSC (Hons CVN), VNECC
Amy has been veterinary nursing for 15 years, which has included work at the PDSA, multi discipline referral practice and volunteering overseas on various rabies projects. For the last 7 years she has been senior ECC nurse at a busy, A&E hospital.
What are the most common emergencies you see in practice?
- Gastroenteritis
- Blocked cat
- Chocolate ingestion
- Dyspnoeic patient
- Collapsed patient
When taking emergency calls what are the main concerns that would require an appointment?
- Breathing problems
- Blood loss
- Pain
- Cognitive changes
- Collapsed
It is important to ask plenty of questions on emergency calls to get a full history and idea of what may have led to the call. Toxicities, trauma, urinary issues all will need a further history to establish what may be the cause as owners may not realise which information is important. For example many owners are not aware of what is toxic to their pet.
We are also able to reassure owners with how to monitor at home, if we don’t feel immediate attendance to the hospital is required.
Can you please talk us through your triage process?
Triage prioritises the severity of cases. For example, animals arriving bright, alert and responsive compared to collapsed animals which may need immediate stabilisation. Initial triage for most patients would be TPR, circulation and pain assessment. Getting a full history from owners at this point is important to highlight any immediate concerns.
How does this differ for a more severe emergency, such as a collapsed dog?
Some patients may require immediate stabalisation. This would include O2 therapy, I/V placement and taking baseline bloods. Lactate, glucose and PVC would be beneficial at this stage to inform the vet immediately to aid their diagnosis and treatment plan. Get other diagnostic equipment ready for use such as ultrasound, fluids and taking blood tubes for further tests.
What monitoring procedures should be considered for an unstable patient once admitted?
- Multi parameter
- Lactate
- Glucose
- Blood pressure
- TPR
- Fluid rates/boluses dependant on results
- MM CRT
- Pain score
- Hydration status
- Mentation
Constant supervision will be needed initially with recorded assessment dependent on patients responses. It is important to make the vet aware of any changes or lack of. The aim is to stabilise the patient so lack of this or deterioration will need changes to the treatment plan and possibly further diagnostics/intervention by vet.
What tips would you give for managing emergency situations?
Obtain a good history and consent to initial emergency treatment, in severe cases, if possible have a colleague do this while you assess patient.- Stay calm
- If breathing issues, O2 before anything
- Assess pain
- Get IV access
- Alert a vet
