Small Animal Emergency & Critical Care Medicine

1. Small Animal Emergency & Critical Care Medicine Maureen McMichael, DVM Diplomate ACVECC Texas A&M University

2. Emergency & Critical Care • Proposal - Independent SAECC Service - 2002 • Three phases • Physical space/curriculum/consulting • Emergency receiving service • Critical Care service

3. 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

4. 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

5. Phase IIEmergency Receiving Service • Benefits • Students – ER rotation, rounds, sleep • Interns & Residents • Clinical Services – IM, surgery, onco • Local Veterinarians • Local Clients • Hospital Income

6. 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

7. Phase IIICritical Care Service • Benefits • Students – CC rotation, rounds • Interns & Residents • Clinical Services – relieve caseload • Local Veterinarians – case continuity

8. 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)

9. Where Are We Now? • Physical Space • ICU protocols, POC testing, etc. • Curriculum • Emergency Receiving Service • Critical Care Service

10. Phase IPhysical Space New ICU Old ICU

11. New ICU – 3,000 sq ft

12. Phase IPhysical Space • Equipment • Ventilator • Monitoring equipment • Pyxis • Protocols • For technicians, for interns

13. Phase IPhysical Space • CPCR protocols • Constant rate infusions – analgesia

14. Phase IPhysical Space • ICU treatment sheets – prompts for students • Emergency drug dosages – every animal

15. Phase IPhysical Space • Point of care testing • Rapid results – 1 minute, 14 tests • Blood gas – teaching, patient care

16. 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

17. Phase IIEmergency Receiving Service • mid-October 2004 • No marketing outside local BVVMA • Case load up significantly • ER income up significantly

18. ER Cases and Fee Revenue

19. Phase IIEmergency Receiving Service • Marketing Potential • ER Magnets • RDVM phone • Advertising/PR • ECC RDVM conference • Ross students

20. Where Are We? • Phase I – Completed • Phase II – Very successful – growth potential • Phase III – If ER continues to grow - need a CC service • Resources??????

21. Resources Needed