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How do you fare on monitoring critical patients? Test yourself!
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Principal Nurse Manager
51 Hale Road
Farnham, Surrey GU9 9RB
Kath started her veterinary nursing career in a busy first opinion practice, qualifying in January 2000. After qualification she spent time in first opinion and out of hours emergency care before taking a position as a night nurse in a referral practice. Kath enjoyed referral "hands on" patient care but her passion was for emergency and critical care. In June 2004 she moved to take a position as Senior Veterinary Nurse in the Vets Now Clinic in Farnham. She has lectured at regional and national meetings to a variety of nurses at all levels of their education.
Kath strives to offer the best emergency nursing care that can be provided and in November 2009 passed the American Veterinary Emergency and Critical Care Technician examination after two years of extra study. Kath feels that all nursing care is important but for her, none more so than nursing of the intensive and critical care patient where nurses can really make a difference with knowledge and training
She is also a phlebotomist for Pet Blood Bank UK and involved in various charity work. She is part owner of Triple H Training for Veterinary Nurses which is a webinar-based platform for accessible CPD for Veterinary Nurses. She also sits on the clinical board as an advisor for Vets-Now.
Questions to ask should include the following:
- A contact telephone number and the client’s name in case the phone gets cut off
- The pet’s name, age, breed and other pertinent details
- A brief overview of what the client perceives to be the problem and how the patient is behaving at that time, focusing on the 3 major body systems (cardiovascular, respiratory, central nervous system)
- Does the client have transport?
- Estimated time of arrival
In many cases, the first point of contact for an emergency patient is the client calling the practice and speaking to either a receptionist or veterinary nurse. Appropriate telephone triage is a skill that is relevant to every member of the practice team.
It is therefore sensible to have a checklist of questions for clients when they contact the clinic. This ensures gathering all relevant information to prepare for the clients arrival (e.g. oxygen for a dyspnoeic patient), allows effective prioritisation and ensures the veterinary team is aware that an emergency is on its way.
Volume 26(4), Winter 2016
Nursing the critical care patient – part 2: monitoring
by Katherine Howie
“Patients don’t get better when they eat – they get better because they eat”
Louise O. Dwyer
Monitoring urine output in emergency patients is an excellent indicator of the patient’s perfusion status. Ideally, fluid balance is monitored in all patients. This can be achieved by catheterisation (males and females!) and attaching to a closed system or by free catch or weighing of bedding and litter trays.
Nutritional support is often an after-thought but should be considered early in the treatment of emergency patients. Naso-gastric and naso-oesophageal tubes can be easily placed in conscious patients and provide an immediate means of nutritional support.
How do you fare on monitoring critical patients?
to test yourself!
Once the emergency patient has been stabilised and any hypovolaemia, hypoxia or perfusion deficits have been reversed, on-going monitoring and treatment are required. For example, trauma patients will need stabilising of the hypovolaemia, improvement of their clinical status and monitoring of perfusion parameters before investigating and stabilising secondary issues such as wound management, fracture management, bladder management and nutritional support.
Excellent nursing care and management alongside well-developed nursing plans to ensure continuity of care will improve patient outcomes and shorten hospitalisation periods.