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This proposal outlines a three-phase plan for improving small animal emergency and critical care services, including physical space expansion, curriculum enhancement, and consulting services. The plan details the need for new ICU facilities, emergency case receiving services, and critical care resources. It also discusses the benefits for students, interns, residents, clinical services, local veterinarians, clients, and hospital income. The resources required for successful implementation include faculty, residents, interns, equipment, protocols, and continued rotation options.
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Small Animal Emergency & Critical Care Medicine Maureen McMichael, DVM Diplomate ACVECC Texas A&M University
Emergency & Critical Care • Proposal - Independent SAECC Service - 2002 • Three phases • Physical space/curriculum/consulting • Emergency receiving service • Critical Care service
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
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
Phase IIEmergency Receiving Service • Benefits • Students – ER rotation, rounds, sleep • Interns & Residents • Clinical Services – IM, surgery, onco • Local Veterinarians • Local Clients • Hospital Income
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
Phase IIICritical Care Service • Benefits • Students – CC rotation, rounds • Interns & Residents • Clinical Services – relieve caseload • Local Veterinarians – case continuity
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)
Where Are We Now? • Physical Space • ICU protocols, POC testing, etc. • Curriculum • Emergency Receiving Service • Critical Care Service
Phase IPhysical Space New ICU Old ICU
Phase IPhysical Space • Equipment • Ventilator • Monitoring equipment • Pyxis • Protocols • For technicians, for interns
Phase IPhysical Space • CPCR protocols • Constant rate infusions – analgesia
Phase IPhysical Space • ICU treatment sheets – prompts for students • Emergency drug dosages – every animal
Phase IPhysical Space • Point of care testing • Rapid results – 1 minute, 14 tests • Blood gas – teaching, patient care
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
Phase IIEmergency Receiving Service • mid-October 2004 • No marketing outside local BVVMA • Case load up significantly • ER income up significantly
Phase IIEmergency Receiving Service • Marketing Potential • ER Magnets • RDVM phone • Advertising/PR • ECC RDVM conference • Ross students
Where Are We? • Phase I – Completed • Phase II – Very successful – growth potential • Phase III – If ER continues to grow - need a CC service • Resources??????
